inadequate locations with respect to the staff‟s ability to deliver good care and adequate infrastructure. None of the recommendations addressed to the EU member states in the European Commission‟s 2009 Report of the Ad Hoc Expert Group on the Transition from Institutional to Community-based Care62 were implemented. In May 2010, the Ministry of Labor and Social Policy developed a draft political document entitled Vision on the Deinstitutionalization of Senior Citizens with Mental Disorders, Mental Retardation and Dementia.63 This draft, which could be a step towards the implementation of some of the EC recommendations, was not adopted by the end of the year. It contains findings that once again confirm the poor conditions and the unclear future of people with mental problems accommodated in institutions. The draft recognizes that the existing social services system in Bulgaria is unable to meet the real needs of people with mental disabilities. It recognizes the need for “transforming the institutional model into stationary and mobile community-based services.” Despite this recognition and the declared intentions, the results are highly unsatisfactory. Data provided by the Agency for Social Assistance (ASA) show that as of December 31, 2010, there were 3,498 persons in institutions for people with mental disabilities. Of them, 1,169 were in homes for adults with psychiatric disorders (HAPD) and 2,329 in homes for adults with mental retardation (HAMR). The total number of the institutions remained unchanged: 15 institutions for adults with psychiatric disorders and 28 for adults with mental retardation.64 No institutions have been closed, nor has any institution been relocated to a community with better infrastructure. The obstacles to the deinstitutionalization process remained in 2010. There was no change with regard to the assessment of the needs of community-based social services. The draft vision on deinstitutionalization contains an estimate of the number of people who are likely to need social services due to a psychiatric disorder. According to the document, “persons suffering from a psychiatric disorder at some time in their life account for 25 percent of the world‟s population.” It also states that this number needs to be increased by 409, the number of people who had come of age by December 31, 2010, and who were located in specialized institutions for children with disabilities. This estimate, based on general information, is not statistically accurate. It does not result in conclusions on the number of services needed, their territorial distribution and type. The draft vision fails to consider the fact that the people who are currently in institutions are those who need support the most in order to have a life in the community again. There is no data on the number and the needs of people who are permanently living in psychiatric hospitals. The lack of information about their needs inevitably leads to supply deficit. Even the known, incomplete and sparse information makes it clear that the existing services are highly insufficient. This leads us to another obstacle that was not overcome in 2010: the lack of community-based services. ASA data show that since January 31, 2011, there were 18 protected homes for people with psychiatric disorders, with a total capacity of 183 people, as well as 63 protected homes with a total capacity of 533 people, five transition homes for people with mental retardation with a total capacity of 55 people, and two transition homes for people with psychiatric disorders with a total capacity of nine people.65 Again by ASA data, as of December 31, 2010, there were a total of 50 daycare centers for the social integration and rehabilitation of disabled persons; it is not clear how many of these admit people with mental disabilities.66 The draft vision on deinstitutionalization recognizes the lack of community-based social services as one of the main risks to the process. The uneven distribution of services by territory and type is another risk in this category that is recognized in the document. The lack of programs aimed at building or rebuilding skills was another barrier to deinstitutionalization, which remained unresolved in 2010. This deficiency is especially damaging to people in institutions due to their isolated lifestyle, the lack of access to information and the lack of meaningful activities. As a result they gradually develop the institutionalism syndrome, which in many cases is more damaging than the actual mental disorder. The depersonalization of people accommodated in institutions may be overcome simply by providing and guaranteeing personal possessions and guaranteeing
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