Annual Report 2014 of the National Preventive Mechanism 239. The dosage and combinations of medication prescribed to patients should be adequate, since overmedication has various relevant adverse effects on the health and wellbeing of patients: risks arising from the cardiovascular side effects (high rates of metabolic syndrome, morbid obesity...), short-term neuro-motor problems (walking difficulties) and in the mean and long term (dyskinesia, trembling and others), an unkempt and chronic look having effects on the image and self-respect of the patient, and a feeling of clumsiness, slowness, which hinders rehabilitation programs. 240. Agreements should be reached with the autonomous community healthcare authorities for it to be possible to access from the penitentiary psychiatric hospitals and units the clinical information of the public health services, to have the medical records of the patients and avoid duplicating tests, among other advantages. 241. Courses for ongoing training of personnel should be given regularly, for example, on peaceful dispute resolution or handling of persons with mental diseases. 242. Currently, the transfer of patients from one centre to another may imply a route of several days through various penitentiary establishments, which is stressing for them, in a context in which the adequate, complete and timely taking of their customary medication cannot be ensured. Before the transfer, the medical practitioner should report whether, if the transfer is carried out in the normal manner in a regular transportation –of the specific conditions of which he should be aware: number of hours of each trip, nights spent at other establishments and total duration of the transportation-, this could have effects on the state and evolution of the patient, taking into account his pathology, his past and current statue, the risk of alterations in the taking of medication and other circumstances of interest, for such information to be used to evaluate more adequately whether it is advisable to carry out the transfer in a special direct manner, to safeguard the health of the patients. III.3.3 Centres for juvenile offenders 243. Measures of deprivation of liberty should be implemented at specific centres, close to the place of residence of the offending person, where therapeutic measures may be provided simultaneously such as ambulatory treatment to stop consuming toxic substances or psychological treatment of abnormalities or mental or perception disturbances, that cause a serious alteration of awareness of the situation in these minors. 244. It is considered essential for minors to be able to file complaints and requests in writing with the management of the centre, the court authorities, the Ombudsman’s Office or other similar institutions, using a printed form and in closed envelopes to 90

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