A fire at a mental health clinic in the Voronezh region, western Russia, has killed at least 21 people, the emergency ministry says.
Another two people are still reportedly missing after the blaze.
More than 20 people are being treated in hospital, and there are fears the death toll will rise further.
The building was completely destroyed by the fire that began late on December 12, reports say. The cause of the blaze is being investigated.
A number of fires at state institutions across Russia in recent years have resulted in heavy losses of life.
In September 2013, 37 people died in a fire that swept through a psychiatric hospital in the north-western Novgorod region.
Several months earlier, a blaze at another psychiatric hospital near Moscow killed 38 people.
In 2009, 23 people died at an old people’s home in the north-west Komi region, while in 2007, 63 were killed at a home in Krasnodar, southern Russia.
In 2006, a fire at a Moscow drug rehabilitation clinic killed 45 women.