ARCT has identified the following concerns through Monitoring Mental Health Institutions:the main challenges in the area of mental health and intellectual disabilities are: •Small number of community-based services especially in the regions. Majority of adults with mental health problems and intellectual disabilities are still isolated or placed in the institutions •There are no standards and effective mechanisms of certification of service providers and ensuring good quality of care •Health professionals still employ the medical model •poor quality of the medicines   •Not existing mechanism for coordination of different stakeholder’s at all levels (planning implementation and monitoring), no continuity of care   •Lack of political will, understanding and knowledge at the level of local authorities prevents coherent palnning of services at local level.  •Poor knowledge and skills of professionals working with people with mental health problems and intellectual disabilities.   •Poor case management system and insufficient multi and inter-disciplinary coordination in the mental health field   •Lack of funding sources  •Inclusive education does not meet the needs of children and young people with intellectual disabilities and behavioral problems  •Stigma and stereotypes significantly hamper social integration and employment of people with mental health problems and intellectual disabilities