2. SAFETY, SECURITY AND DIGNITY FOR ALL 2.4. PRISONERS WITH DISABILITIES 88 The Mandela Rules have been updated to reflect the situation and needs of prisoners with disabilities and to ensure that they have full and effective access to prison life on an equal basis, and are treated in accordance with their health needs.142 RELEVANT RULES: PRISONERS WITH DISABILITIES Rule 5(2): Prison administrations shall make all staying in prison would mean an exacerbation of reasonable accommodation and adjustments to ensure that prisoners with physical, mental or other disabilities have full and effective access to prison life on an equitable basis. Rule 39(3): Before imposing disciplinary sanctions, 2 prison administrations shall consider whether and how a prisoner’s mental illness or developmental disability may have contributed to his or her conduct and the commission of the offence or act underlying the disciplinary charge. Prison administrations shall not sanction any conduct of a prisoner that is considered to be the direct result of his or her mental illness or intellectual disability. 70 Rule 109: 1. Persons who are found to be not criminally their condition, shall not be detained in prisons, and arrangements shall be made to transfer them to mental health facilities as soon as possible. 2. If necessary, other prisoners with mental disabilities and/or health conditions can be observed and treated in specialized facilities under the supervision of qualified health-care professionals. 3. The health-care service shall provide for the psychiatric treatment of all other prisoners who are in need of such treatment. Rule 110: It is desirable that steps should be taken, by arrangement with the appropriate agencies, to ensure if necessary the continuation of psychiatric treatment after release and the provision of social-psychiatric aftercare. responsible, or who are later diagnosed with severe mental disabilities and/or health conditions, for whom 142 WHY IS IT IMPORTANT? 89 Prisoners with various types of disabilities will have specific disability related needs that prisons might not be adequately equipped to accommodate, including, for instance, the need for wheelchairs, canes and orthotics, sign language interpreters and information in formats that are accessible to persons who are blind or who suffer from visual impairments. 90 Prisons are also often unable to fulfil the general accessibility requirements for persons with various types of disabilities. Similarly, prisons and prison staff are not usually equipped to recognize and deal with prisoners who have mental health conditions. The ageing prison population in many countries suggests that the number of persons with disabilities in prison will rise and their needs will increasingly have to be considered. 91 The UNODC Handbook on Prisoners with Special Needs contains detailed guidance on how to manage prisoners with disabilities, pointing out, that “[t]he difficulties persons with disabilities face in society are magnified in prisons, given the nature of the closed and restricted environment and violence resulting from overcrowding, lack of proper prisoner differentiation and supervision, among others. Prison overcrowding accelerates the disabling process, with the neglect, psychological stress and lack of adequate medical care, characteristic of overcrowded prison. (…) Thus imprisonment represents a disproportionately harsh punishment for offenders with disabilities, often worsening their situation and placing a significant burden on the prison system’s resources.”143 142. The Mandela Rules, op. cit., note 1: the first sentence of Rule 109 deals with the criminal liability of those with mental disabilities and/or health conditions and therefore goes beyond the remit of prison authorities. Decisions to imprison persons with mental disabilities and/or health conditions are the responsibility of judicial officials. 143. Handbook on Prisoners with Special Needs, UNODC, op. cit., note 87, p. 43. Guidance document on the Nelson Mandela Rules