CAT/OP/GBR/ROSP/1 2. Mental health in prisons 72. The Subcommittee notes with concern the high rates of chronic and acute mental disorders in detention, in particular within the prison population. The Subcommittee is concerned at the high prevalence of self-harm and self-inflicted deaths in prisons, including among juvenile offenders.42 73. The Subcommittee is concerned that prisons and police stations are being used as a “safe environment” for preventing self-harm or harm to others, while awaiting placement in a specialized psychiatric facility. The Subcommittee received ample information from civil society, the national human rights institution and the national preventive mechanism, indicating that prison personnel were not adequately trained to deal with prisoners with mental health problems and psychosocial disabilities. Delays in transfers of persons, including young offenders, from prisons to psychiatric hospitals were noted to sometimes last for several months. Such delays were caused by difficulties in retrieving data for the proper disposition and management of mentally ill detainees or by the lack of psychiatric beds, and they exacerbated mental health problems and increased the risk of ill-treatment. 74. Furthermore, the Subcommittee is alarmed at the placement of some prisoners with acute mental health conditions in segregation units. The Subcommittee is concerned that some persons, as a result of the mental health conditions they suffer, may present violent behaviour and that the response of staff in these cases is largely punitive. The Subcommittee interviewed several persons in segregation units in Her Majesty’s Prisons in Risley and Manchester and concludes that the current capacity of the system to properly address the mental health of persons in detention does not match the actual needs. It is of note that the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment found in 2016 that the use of segregation for inmates at serious risk of attempting self-harm or suicide was unsuitable and unacceptable.43 75. The Subcommittee recommends that the State party develop a comprehensive national policy and strategy to ensure appropriate access to health-care and mental health-care services across the criminal justice system, with particular attention to juvenile offenders. It also recommends that the State party immediately transfer persons with acute mental health problems, especially children with acute mental health problems, to an appropriate psychiatric facility, and abstain from using police cells and prisons as a “safe environment”. In this connection, high priority should be given to increasing the number of beds in psychiatric hospitals. 76. The Subcommittee echoes the recommendation of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment that prisoners with severe mental health conditions should not be placed in segregation units as an alternative to normal accommodation. Instead, such prisoners should be treated in a closed hospital environment, suitably equipped and with sufficient qualified staff to provide them with the necessary assistance.44 77. The Subcommittee also recommends that all prison staff be trained to recognize the possible symptoms of mental health problems and apply prompt and appropriate referral procedures to medical personnel. IV. Situation of persons deprived of their liberty 78. The Subcommittee wishes to record that it did not come across any cases of torture in the places of detention visited. 42 43 44 14 Prison Reform Trust, Prison: The Facts – Bromley Briefings Summer 2019 (2019). “Report to the Government of the United Kingdom on the visit to the United Kingdom carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 30 March to 12 April 2016”. Ibid., paras. 66 and 68.