Annual Report 2014 of the National Preventive Mechanism 166. Clear instructions should be given on the cases and conditions in which mechanical restraints should be used, expressly excluding their use as punishment, which would be a form of torture and cruel, inhuman and degrading treatment, for them to be always respectful and in accordance with the human rights. 167. Immobilisation should only be applied exceptionally when no other less burdensome manner exists to achieve the sought purpose, and weighing up the need for application in each particular case. However, the application of this measure on a customary and routine basis, for example, after self-injuries of the inmates, as “negative reinforcement” to discourage certain actions is, in the opinion of this institution, inconsistent with the requirements of article 72 of the RP. 168. The application of isolation and mechanical restraint to inmates with serious mental disorders and even psychotic disorders should be prohibited, since in such cases it could be torture, given the high risk that the isolation may cause psychotic crises or decompensate previously existing disorders. 169. Immobilisations should be reduced to the minimum time necessary. Long periods of immobilisation are extremely rare in the healthcare context, since they imply serious health risks (ischemic injuries due to excessive compression of arms and legs, reduction and/or loss of conscience due to dehydration and/or low blood pressure, confusion syndromes and disorientation, risk of thrombosis...). Accordingly, mechanical restraints for long time periods should be exceptionally founded given their serious adverse effects on the rights of inmates, and should be reviewed by the management of each CP and by the relevant central services. 170. Clear rules should exist and specific training courses should be given to the public officers on the adequate method for mechanical restraints. 171. Immobilisation should be applied proportionately according to the specific situation of the inmate (with contention of one, three or five points), instead of always with the maximum possible restriction. 172. Persons who are immobilised should be accompanied at a first moment by a person who explains the reason for the measure and assumes a role of reducing tension and, in any case, they should be permanently supervised, to avoid potential complications that could occur while they are absolutely immobilised and incapacitated to react adequately to such eventual complications. It is also necessary to supplement such supervision with a video-surveillance system that permits the pictures and sound to be recorded for the duration of such a restrictive measure. The practice of the SGIP, at the CP of which the control must be carried out every hour, and cases have even been detected in which the supervision is carried out at longer intervals, and also –with few exceptions– are lacking video-surveillance in immobilisation cells, is a matter of concern. 72