said that in some cases the treatment of patients is inconsistent and intermittent.165 In some cases, the patient's condition is neglected by the medical staff or no examinations are provided in accordance with the patient's complaints.166 That’s why epicrises are necessary,167 so that to prevent that important information about the prisoner's health is left beyond the attention of medical staff. In addition, it is important to ensure the supply of medicines in the process of treatment, which was a significant problem in Establishment No. 8.168 Mental health care Adequate psychiatric care Managing mental health problems remains a significant challenge for the penitentiary health care system. Early detection and diagnosis are of particular importance for the management of mental health problems. It should be noted that mental health screening tools169 have been integrated in prisoners’ outpatient medical cards in Establishments Nos. 2 and 8 since the 4th quarter of 2018. This part of the medical card is already filled in when prisoners are placed in other penitentiary facilities, so their mental health is not re-assessed. In order to ensure that patients receive adequate psychiatric care, it is important to refer them to a specialist in a timely manner. During initial placement in Establishments Nos. 2 and 8, mental health screening is limited to filling in the above questionnaire just once, which is insufficient and fails to provide timely detection of mental health problems. During placement in the facility, prisoners are referred to a psychiatrist by a family doctor, doctor on duty, or, in rare cases, psychologist. Family doctors do not have necessary tools to objectively assess the mental health condition of prisoners. According to the reply received from the Special Penitentiary Service,170 the Medical Department is developing a mental health permanent screening document, which should be welcomed. 165 For example, pauses were observed in the document showing the times of providing the prescribed medicine to one of the patients suffering from arterial hypertension in Establishment No. 14. The same problem was observed in the treatment of one of the patients. 166 See the report on the visit paid to Establishments Nos. 2, 8, 14 and 15, p. 57; 167 Doctor’s report, comprehensive written explanations about the origin, development and course of the disease and the nature and results of the treatment. 168 During the visits, the acute problem of supply of medicines was revealed only in Establishment No. 8. No similar problem has been detected in other facilities. This problem was also indicated by medical staff and was proved by the documentation as well. See the report on the visit paid to Establishments Nos. 2, 8, 14 and 15; See the link: <http://www.ombudsman.ge/res/docs/2019121618092132463.pdf> [last accessed: 18.02.2020]. 169 The tool includes questions about psychiatric history, suicide, stress, addiction to psychoactive substances, traumatic experiences and the need for psychiatrist or other specialists’ consultations. 170 Reply No. 371652/01 of the Special Penitentiary Service of the Ministry of Justice of Georgia, December 13, 2019. 61