the medical staff.134 Due to the deficiencies in the outpatient medical records, it is difficult to objectively assess how the inmate's health status has changed over the years. In addition, in the report "Impact of Detention Conditions on Prisoners' Health", the Public Defender focuses on the introduction of an electronic information system for medical staff and the entire penitentiary system, which will eliminate problems with medical documentation and enables collection, timely exchange and accessibility of reliable information for medical examination, treatment and further analysis. It should be noted that inpatient and outpatient medical facilities in the civil sector are required to provide health information of all identified patients to the Electronic Health Records (EHR) system.135 As patients in outpatient facilities receive outpatient medical care, it is important that their health information be entered into an electronic health record (EHR) system, which will help systematize this information. Managing mental health problems remains a significant challenge for the penitentiary health care system. In order for a patient to receive adequate psychiatric care it is important to refer him in a timely manner to a psychiatrist. Mental health screening is carried out during initial placement in facilities N2 and N8 with the screening tool that was integrated in the medical card. Mental health screening is no longer conducted in other institutions because this part of the medical card has already been completed. Onetime filling of the above-mentioned questionnaire is not enough. Deprivation of liberty for a person is in itself a massive psychotrauma that may contribute to the detection or decompensation of mental health problems. Early diagnosis and preventive approach, which is relevant in disease management and prevention, are of particular importance in the mental health care of prisoners in the penitentiary system. The burden of mental and behavioral disorders is much heavier in penitentiaries and the number of such patients far exceeds the number of patients in the civil sector.136 During the stay in the penitentiary facility, the prisoner is referred to a psychiatrist by a family doctor, a doctor on duty and in rare cases by a psychologist. Family doctors do not have the tools to objectively assess the mental health status of prisoners. The 2019 report of the National Preventive Mechanism emphasizes the importance of introducing an instrument for family doctors to objectively assess the mental health status of prisoners.137 For example, there are changes in the blood test of one of the patients, expressed leukocytopenia (decrease in the number of leukocytes), thrombocytopenia (lack of platelets), anemia (decrease in hemoglobin in the erythrocytes and the number of erythrocytes in the blood). Despite these data, no consultation with a therapist or infectious disease specialist was performed. Also, one of the patients underwent a blood test for markers of transmittable diseases during the placement in the establishment, which revealed the presence of markers of syphilis and viral hepatitis C. The increase of the "AST" rate is noteworthy. After a consultation with a venereologist, an unspecified atrial fibrillation was diagnosed and bicillinotherapy was prescribed. Hepatitis C was not consulted and no treatment was prescribed. 135 Order of the Minister of Internally Displaced Persons from the Occupied Territories, Labor, Health and Social Affairs of Georgia of January 3, 2019 "On Determining the Functioning and Procedure of the Electronic Health Record System (EHR)". 136 Study on persons with mental health issues in penitentiary institutions, Torrey EF, Kennard AD, Eslinger D, Lamb R, Pavle J. More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States Treatment Advocacy Center. 2010. Available at: https://bit.ly/3j9pKrM [last visited: 02.02.2021]. 137 National Preventive Mechanism 2019 Annual Report, p. 75, see the link: <https://bit.ly/3bzHWJz > [last visited: 14.01.2021]. 134 54