the case, the reasons for resorting to the measure, the name of the doctor
who ordered or approved it, and an account of any injuries sustained by
patients or staf.
Reducing recourse to the use of restraint to a viable minimum requires a change
of culture in the unit. The role of management is crucial in this regard. Unless
the management encourages staf and ofers them alternatives, an established
practice of frequent recourse to means of restraint is likely to prevail.
Psychiatric care after discharge
For persons who had been undergoing psychiatric treatment, steps should
be taken to assure their continued care. Although no longer requiring place‑
ment in a psychiatric unit, a patient may nevertheless still need treatment
or may beneft from a protected environment.17 It is necessary to provide
for continuity of treatment when prisoners are transferred back to their
custodial setting.
2.5 Suicide prevention
Given the high incidence of mental disorders in prisons, the prison medi‑
cal services should be concerned about mental hygiene issues, including
prevention of the harmful psychological effects of certain aspects of
detention. It is well known that effective prevention can reduce the risk
of mental disorders.18
Organisational approach to suicide prevention
Suicide prevention requires intervention also from outside the health sector.19
In its 3rd General Report20 the CPT made several recommendations in this
respect. Prison management, including the head of the prison health service,
should ensure that there is an adequate awareness of suicide prevention
throughout the establishment and that appropriate procedures are in place.
17. CPT/Inf (98)12.
18. Prevention of mental disorders: efective interventions and policy options. A report of the World
Health Organization. Department of Mental Health and Substance Abuse in collaboration
with the Prevention Research Centre of the Universities of Nijmegen and Maastricht,
WHO (2004).
19. Public health action for the prevention of suicide, WHO (2012).
20. CPT/Inf (93)12.
Prison health care and medical ethics Page 38
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