A/HRC/31/57/Add.4 133. The number of professional staff serving the medical needs of inmates is in general severely inadequate, as are the medical supplies and surrounding facilities. 134. In one prison, he found patients lying on the floor, cared for only by other sick inmates whose physical situation was only slightly better. 135. The health situations of inmates must be subject to regular evaluation by impartial experts without delay; in situations in which an inmate has a chronic or terminal disease or condition, he or she should have the possibility to have his or her regimen changed to a more appropriate one, e.g. home detention or hospital detention. 136. The Special Rapporteur received numerous and worrying reports of sedatives being used excessively with the purpose of “keeping the adolescents calm” and confirmed, in one place visited, that most children were receiving sedatives by prescription. 137. The inclusion of inmates in the general public health system is insufficient; there is a need to respond to the particular needs of inmates that stem from overcrowded detention conditions, and to prevent and treat prevalent diseases. 138. The Special Rapporteur welcomes an envisaged R$50 million investment in 2015 in the national policy on health care for people deprived of their liberty, as established by an ordinance of the ministries of justice and health on 2 January 2014. One strategic objective of this investment is to “contribute to the control and/or reduction of the most frequent complaints that affect the prison population”. He understands that 24 states are already taking part in the implementation of the policy. 139. Noting that many mentally ill people are not treated, but merely incarcerated, the Special Rapporteur visited a public psychiatric hospital which had a specific area for inmates who had been sent on a judicial order. He learned that some of those inmates had no medical justification for being there, but were being held as a “courtesy”, since conditions were often better, and overcrowding less pronounced, than in ordinary detention facilities. 140. Law No. 11.343 is aimed at directing drug users to medical attention and treatment provided by so-called “therapeutic communities”, private institutions partially financed by the State under the Ministry of Justice. Mental health patients are also detained in therapeutic communities. The Special Rapporteur received worrying reports of frequent torture and ill-treatment, as well as poor conditions. He wishes to stress the Government’s responsibility for protecting the physical and psychological integrity of people in these facilities, regardless of the facility’s affiliation, or absence thereof, with the State. This includes enforcement of oversight mechanisms. V. Conclusions and recommendations A. Conclusions 141. With regard to legislation, safeguards, prevention and institutional reform, Brazil has made significant progress on paper; however, implementation is lagging far behind. 142. Torture and ill-treatment in the course of interrogation are frequent occurrences. Killings by police and by prison staff continue and are not isolated incidents. They most notably affect persons belonging to racial, sexual, gender and other minority groups. 20