The full-time position of a psychiatrist could be found only in Establishment No. 8, while other facilities have visiting specialists. Both prisoners and medical staff refer to the workload of psychiatrists and note that they often have to wait to consult a psychiatrist.171 Psychiatric care in the facilities is limited to a one-time or a repeated consultation of the psychiatrist and treatment with drugs, which does not comply with the principles of modern biopsychosocial approach or evidence-based health care. Psychiatric cases are not subject to multidisciplinary assessment or management in the facilities. It is important that a psychologist and a social worker be involved in the processes of psychiatric assessment and management, and that communication between a psychiatrist and the institution's social service be increased. It is also important that the basics of psychiatric care be detailed at the normative level, like the suicide prevention programme, by indicating the functions and responsibilities of each member of the multidisciplinary team. The Special Preventive Group believes that certain services being introduced in the community could be made available in the penitentiary facilities as well, through inter-agency coordination.172 It should be welcomed that three mobile groups staffed with civil sector specialists173 in accordance with the civic model have started functioning in Establishment No. 8 from November 2019. In order to ensure that prisoners with mental health problems have access to appropriate psycho-social rehabilitation programmes, it is advisable to attract service providers and encourage civic intervention, in addition to mobilizing the necessary staff. Management of critical cases The penitentiary staff, including medical staff, do not have skills necessary for the management of psychiatric critical cases or verbal methods of de-escalation. In case of emergency in Establishments Nos. 14 and 15, the patient is placed in a solitary confinement cell, under video surveillance, and then is transferred to the psychiatric unit of Establishment No. 18 as an urgent case.174 As for Establishments 171 In Establishment No. 2, the psychiatrist provides consultations three times a week; an average of 12 prisoners are consulted per visit. Establishment No. 3 is visited by the psychiatrist once a week; an average of 5 prisoners are consulted during one visit. Establishment No 14 is also visited by the psychiatrist once a week; an average of 11 prisoners are consulted. In Establishment No. 8, the psychiatrist consults about 7-8 prisoners a day. The psychiatrist’s workload is especially heavy in Establishment No. 15, where the psychiatrist consults about 35-40 convicts during one visit, which in turn affects the quality of consultations. 172 Report on the Impact of Conditions of Detention on Prisoners' Health, p. 81. 173 According to the civil sector model, mobile groups are staffed by a psychiatrist, psychologist and a nurse. 174 It was found out during the visit that one of the convicts in Establishment No. 14 was diagnosed with an unclear psychiatric disorder and due to the aggravation of his mental health condition, he was placed in a solitary confinement cell before being transferred to Establishment No. 18, where the doctor on duty injected him with Tisercin in combination with Magnesia twice, causing a drop in his blood pressure, after which, it became neccessary to inject the patient with another medication to increase his blood pressure. It should also be noted that the convict's condition started to complicate on July 7, 2019 and he was seen by a psychiatrist on July 10. 62