group. 2.6.2.3. Monitoring priority: psychiatric care of detained persons In the course of the commission’s activities with respect to police detention, it became clear from numerous observations that the psychiatric care provided to detained persons may be inadequate for various reasons. Therefore, even before the deployment of the working group on suicide prevention, the NPM established this topic as a monitoring priority for 2015. In this regard, the NPM addressed the following problems in particular. As already mentioned elsewhere, the NPM called for the term “fitness to undergo detention” to be defined in the Code of Conduct for Detention. In the opinion of the NPM, one must proceed with great sensitivity in assessing whether a person is unfit to undergo detention due to mental impairment. The Federal Ministry of the Interior stated that the assessment of the fitness to undergo detention is made by police physicians during the examination of the detainee and based on the overall clinical picture. If necessary, police physicians will obtain a psychiatric opinion regarding the existence and degree of seriousness of a mental illness, the treatment during detention and regular follow-up examinations. Fitness to undergo detention when there are mental problems The Federal Ministry of the Interior named two principal criteria for possible release from detention due to mental complaints, i.e. if the illness is expected to get worse and/or there is no ability to provide care. In this regard, one commission showed that most prisoners were found to be unfit to undergo detention based on somatic findings during a hunger strike. By contrast, almost no persons were declared to be unfit to undergo detention on mental grounds. In this regard, the commission criticised the fact that the documentation system in police detention centres does not enable a systematic review of findings that a person is unfit to undergo detention. The office of the medical superintendent in the Federal Ministry of the Interior argued that the unfitness of a person to undergo detention is often based on both somatic and mental grounds. Therefore, a strict separation of the grounds for unfitness to undergo detention in the documentation is not useful. As a result, the NPM was unable to draw any suitable conclusions from the findings that detainees were unfit to undergo detention, which it examined. In general, the NPM repeatedly criticised the quality of the medical documentation (comprehensibility, completeness, consistency) – including cases of mental problems. Medical documentation In the opinion of the NPM, if there are clear indications of the existence of mental impairment on the medical history sheet or the detention log, police physicians should quickly obtain the opinion of a medical expert. The Federal Ministry of the Interior emphasised that, if there are symptoms on the medical history sheet that indicate a psychiatric Deployment of psychiatrists 129

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