3. INCIDENT PREVENTION AND RESPONSE 13 If alternative methods of control have been tried but failed, Penal Reform International (PRI) and the Association for the Prevention of Torture (APT) have suggested that “[f]abric leg restraints, appropriately tested and selected in line with human rights standards, could provide a more humane, yet effective, alternative to the use of ‘metal on skin’.”178 Any metal restraints in use should be double locking to reduce the risk of overtightening. Safeguards for the use of restraints Instruments of restraint should be used in a manner than minimises, where possible, the pain caused by their application, and they should be removed at the earliest possible opportunity. They should never be applied, or their application prolonged, as a form of punishment. 15 Once prisoners are placed in restraints no other means of force should be used against them unless they still pose an immediate and serious threat that cannot be contained by less extreme measures. 16 Prisoners held under any form of restraint should be kept under constant and adequate supervision, as recommended by the CPT.179 Such monitoring is important to prevent against strangulation or any other danger linked to use of the restraint. Particular care must be taken when using restraints on sick or injured prisoners, elderly prisoners and those with specific physical or mental health conditions and disabilities. 17 Restraints should not be used on prisoners during visits from family or friends, or during medical appointments, unless they are absolutely necessary to protect other person’s property, or to prevent escape. 18 Restraints should be removed before prisoners appear before a judicial or administrative authority to avoid humiliation and to reduce the risk that prisoners are assumed to be guilty or dangerous because they are wearing restraints. 19 The WHO has noted that actively suicidal prisoners may require protective clothing or restraints but notes that, in such cases, “clear policies and procedures must be in place if they are to be used. These must outline the situations in which restraints are appropriate and inappropriate, methods for ensuring that the least restrictive alternatives are used first, safety issues, time limits for use of restraints, the need for monitoring and supervision while in restraints, and access to mental health staff.”180 20 If the prison director is not available to authorize the use of restraints, then another senior staff member should be delegated the responsibility for authorizing such action. 3 14 Post-incident procedures 21 Any time a restraint is used the process must be properly supervised and recorded in the prisoner file management system, in accordance with Rule 8(c). The records should indicate, at minimum, the type of restraint used, why the restraint was used, for how long it was used, who applied it and who authorized its use. The records should also include details of any injuries sustained by the prisoner, details of when the restraint was no longer needed and any complaints that may have been raised by the prisoner concerning the use of the restraint (Rule 8(d)).181 22 In addition to recording the use of a restraint in individual files, prison administrations should also keep and analyse disaggregated statistics on their use. This can help prisons to safeguard against the discriminatory use of restraints and ensure that safeguards are properly managed. The collection and use of prison data is dealt with in more detail in Chapter 1 of this guidance document. 23 Every time a restraint is used there should also be a debriefing process. It is good practice to also include the experience of the prisoner in such processes. 178. Instruments of restraint: Addressing risk factors to prevent torture and ill‑treatment, PRI/APT, op. cit., note 164, p. 1. 179. 2nd General Report on the CPT’s activities, op. cit., note 79, para. 53. 180. Preventing Suicide in Jails and Prisons, World Health Organization/International Association for Suicide Prevention, 2007, p. 17 at apps.who.int/iris/handle/10665/43678. 181. See for example: Report to the Polish Government on the visit to Poland carried out by the European Committee for the Prevention of Torture, 2 June 2015, CPT/Inf(2014) 21, para. 104. Guidance document on the Nelson Mandela Rules 83