CAT/OP/NZL/1 F. Mental health in places of detention 58. All police stations and corrections facilities visited by the Subcommittee had cells for persons with medical or acute mental health problems, or for persons who posed a risk to themselves or to others. The Subcommittee noted the high rates of often chronic and acute mental disorders within the prison population and observed that while all the facilities visited had medication readily available, detainees had to be referred to the district health boards for specialist mental health care. Moreover, the Subcommittee was concerned that there did not appear to be any national strategy on the provision of mental health care in places of detention. It was concerned that not all detainees received timely and adequate treatment and the provision and availability of health-care staff, health premises and equipment varied widely across the facilities visited. The Subcommittee heard claims that the police had difficulty in finding general practitioners willing to work at their stations and had problems of transportation for the external medical staff. It concluded that the current capacity of the system to address the mental health of persons in detention properly did not match the actual needs. 59. The Subcommittee recommends that a comprehensive national policy and strategy be developed to ensure appropriate access to health care and mental healthcare services across the criminal justice system. A significant increase in the provision of mental health-care services is required to cope with the high number of detainees with mental health problems. 60. The Subcommittee noted that, in general, risk and medical assessments were routinely conducted by officers on the basis of standard risk assessment forms, which were centralized in electronic records. Both police and corrections officers expressed concern that they lacked the competence to do so. Likewise, the Subcommittee was concerned that in matters regarding health, and mental health in particular, officers were required to make decisions for which they did not feel sufficiently qualified. 61. The Subcommittee recommends that the State party ensure that an accessible, adequate and efficient referral system be established and all officers provided with adequate training. The State party should also ensure that steps are taken to promote a better understanding of mental health issues and the need for protection by police and corrections personnel. New Zealand Police 62. The Subcommittee commends the practice of having mental health nurses in police stations and believes that this initiative has resulted in better monitoring and continuity of care for persons in police custody. The Subcommittee would like to see this practice applied nationally. 63. The Subcommittee recommends that to the extent possible, a full-time, on-site nurse be available to follow up and monitor the mental health status of persons in custody. Corrections facilities 64. The threshold for admitting detainees with mental health needs to a local hospital is extremely high, partly because of long waiting lists and delays in admissions for those outside the prison system. As a result, detainees who have made multiple suicide attempts and those with acute or chronic mental health conditions are not being transferred to appropriate psychiatric facilities and are being held in “at-risk units”, often for prolonged periods of time and in conditions akin to that of a disciplinary regime. The Subcommittee believes that the denial of qualified psychiatric assistance under such circumstances and in 13