By visiting the Clinic for neurology and psychiatry for children and youth, the representatives of the Protector of Citizens from the Department of the National Preventive Mechanism and the Sector for the rights of the child, gender equality and the rights of persons with disabilities, marked the International Human Rights Day, wishing to highlight the importance of child and adolescent psychiatry and the problems that children and young people with neurological, intellectual and mental disabilities, as well as their parents, face in increasing numbers and at a younger age than before.

The Clinic is the largest institution for pediatric and adolescent neurology and psychiatry in the Balkans and is unique in its application of the concept of neuropsychiatry in the country, and at the same time, it is also a center for rare neurological diseases, the teaching base of the departments of neurology and psychiatry of the Faculty of Medicine of the University of Belgrade, as well as the headquarters of the Association for child and adolescent psychiatry and allied professions of Serbia. This institution is unique in its ability to fully diagnose comorbidity i.e. the associated symptoms in the field of neurological and psychiatric disorders, primarily pervasive developmental disorders, which are characteristic of childhood and adolescence.

The management of the Clinic informed the representatives of the Protector of Citizens about the history of the Clinic, the organization of work and the importance of this institution in the health care system. It was emphasized that the Clinic is available to patients 24 hours every day of the year, that classes are organized for school children, and that patients from certain countries in the region are also treated at the Clinic. The representatives of the Protector of Citizens visited the Clinic's premises and accommodation facilities for children and their companions during treatment at the institution. During the visit, employees told the NPM team that there was a need to increase the capacity, i.e. the number of beds for psychiatric patients, as there are currently only ten of them. They also pointed out the need to open a day hospital for psychiatric patients within this institution, in which parental education would also take place.

Expert in the field of protection of the rights of children and youth with intellectual and mental disabilities, Melanie Reeves from the USA, is on a visit to Serbia for several days, at the invitation of the MDRI-S association.

On this occasion, representatives of the National Preventive Mechanism hosted her today at the institution of the Protector of Citizens, where she held a seminar for employees dealing with the rights of children and persons with disabilities and the NPM representatives, as well as representatives of the competent ministry, on the topic “Children and adults with disabilities have the right to live in the community”. At the end of the lecture, Melanie Reeves also spoke with the Protector of Citizens, Zoran Pasalic, about her findings during visits to state institutions and social welfare homes where children and young people are housed.

The representatives of the NPM, together with the expert, Ms. Reeves, visited the Stationary of the Center for Protection of Infants, Children and Youth in Zvecanska Street on Tuesday, which is the center's largest and most famous organizational unit. The director of the institution, Ivan Milacic, informed the guest about the institution's capacities, the methods of work and the role in the prevention of placement of children in institutions, which the center implements through numerous programs for supporting the biological family.

It was pointed out to the expert, Ms. Reeves, that Serbia is one of the countries with the least number of children in institutions in Europe, that children in Serbia stay for a relatively short time in institutions (from 5 to 7 years), and that there have been some positive results in the field of deinstitutionalization, since today there are only 675 children in institutions and about 5000 in foster families, while some 20 years ago this number was equal.
It was also pointed out that services for the support to biological and foster families are not sufficiently developed for children with disabilities and that foster parents are not sufficiently trained to take care of their needs, which is evidenced by the fact that in the past years there has been on average only one child with disabilities placed in foster families. Children with disabilities, especially those who have significant health problems in addition to intellectual disabilities, are most often not accommodated in small communities of the home type, since there are no material and staffing conditions for this.

The Protector of Citizens pays particular attention to the protection of rights of persons with intellectual and mental disabilities, a vulnerable and highly stigmatized and marginalized social group. The process of deinstitutionalization is still in its infancy, and placement in institutions remains the dominant form of protection for people with mental disorders, said Zoran Pasalic, the Protector of Citizens, on the occasion of International Mental Health Day. Therefore, it is necessary to adopt a strategy for the inclusion of people with mental disabilities in the community, and to develop life support services and networks of services for the protection of mental health in the local community.

In order to prevent any form of abuse, to improve conditions of stay in psychiatric institutions and to manage the treatment of persons with mental disabilities in accordance with the applicable regulations and standards, the Protector of Citizens, in performing the activities of the National Preventive Mechanism (NPM), visited all psychiatry departments at the (four) clinical centers (Kragujevac, Belgrade, Nis, Novi Sad) in 2019, as well as the Center for Mental Health in Nis. A study visit to the Department of Psychiatry of the General Hospital in Sabac was also carried out.

The Protector of Citizens points to the importance of respecting the rights of persons with mental disabilities, without prejudice, participation of patients in preparation of individual treatment plans and the informed consent to a medical measure, as well as to the freedom to make a decision regarding their own life and health, except when that directly threatens the lives and health of others.

The Protector of Citizens particularly emphasizes the need to establish appropriate health care institutions for developmental psychiatry (or developmental neurology and psychiatry), since the psychiatric care of children and minors/adolescents, in small spaces, as is the case in the inpatient pediatric wards of the Clinic for Psychiatry of the Clinical Center of Vojvodina and the Center for mental health in Nis, significantly complicates the work of employees and the adjustment of psychosocial activities to the needs and capabilities of each patient.

Lack of resources to improve the material conditions of patient accommodation and the development of psychosocial rehabilitation programs for all patients, as well as insufficient number of employees, of different profiles, are the main problems faced by employees in the institutions visited.

Serbia, as a member of the Council of Europe and as a state that has ratified Protocols 6 and 13 to the European Convention on Human Rights, which seek to abolish the death penalty, strongly opposes its existence. “Starting from the universal right to life and human dignity, which cannot be taken away from anyone, this type of punishment is absolutely unacceptable in a legal system of a country”, said the Protector of Citizens, Zoran Pasalic, on the occasion of October 10, the World and European Day against the Death Penalty.

The European Union is actively fighting for the abolition of the death penalty because it is an inhumane act that is not tolerated by the international law today. Today, death sentences are abolished in about 140 countries in the world, while about 50 countries still have them in their legal systems and in those countries up to several thousand people are executed every year. In developed countries, life sentence dominates as the most severe prescribed sentence, with or without possibility of parole.

The Protector of Citizens reminds that the death penalty in Serbia was abolished in 2002 and that it was last executed ten years before that. Despite this, the issue of the need to bring the death penalty back has occasionally been raised in public in Serbia in recent years, especially when monstrous crimes against children or multiple murders occur. “However, we must be aware that the Constitution of the Republic of Serbia itself says that human life is inviolable, so the Protector of Citizens remains determined in its position that the reintroduction of the death penalty should never be allowed”, Zoran Pasalic said.

Representatives of the NPM of the Republic of Serbia participated in the second meeting of the South-East Europe NPM Network, organized on the topic “Specific needs of minors in detention facilities” in Skopje.

The meeting emphasized that minors are a particularly vulnerable and sensitive category of citizens, and that juvenile detention is an inadequate measure and can be harmful in multiple ways, which is why it should be used as a measure of last resort, after all other options are exhausted.

In situations when juvenile detention must be applied, as emphasized at the meeting, the measure must be implemented together with fulfilling the necessary conditions – employees who work with minors must have specific knowledge of their needs and must develop a relationship of mutual trust in their work. Minors must also be allowed to attend school, as well as to access medical, social and psychological care and support. The environment in juvenile care facilities also needs to be tailored to their needs, while their rights must be presented to them in a language they understand and in an appropriate way, those are the conclusions of the Southeast-Europe NPM Network meeting.

The two-day meeting in Skopje was attended by NPM representatives from 13 countries – Albania, Austria, Bulgaria, Croatia, Greece, Hungary, Northern Macedonia, Montenegro, Romania, Slovenia, Serbia, Bosnia and Herzegovina and Kosovo*. In Skopje, it was also agreed that the Republic of Croatia chairs the Southeast-Europe NPM Network in 2020 as well.