CAT/C/RUS/CO/6 concerned at continuing reports of overcrowding in certain facilities and harsh material conditions, including inadequate access to food, water, heating, ventilation, sanitation, hygiene and medical care. The Committee is concerned at reports of the equally poor conditions of detention for children who were born in prisons and the lack of access to adequate medical care and educational programmes for those children and mothers. The Committee is concerned at the discrepancy between the high number of deaths and charges brought against prison staff concerning these deaths and the low number of sanctions actually imposed. Noting that the high mortality rate is due to a high incidence of transmissible diseases, including tuberculosis and HIV/AIDS, among prisoners and the lack of adequate medical care, the Committee is also concerned at reports of inadequate access to HIV testing and specialized treatment, such as highly active antiretroviral therapy. Furthermore, it is concerned at reports of the particularly unbearable conditions in which detainees are transported to a different place of detention, including cases where detainees were reportedly transported in single-person van compartments measuring 0.3 m² (arts. 11 and 16). 39. The State party should: (a) Bring the conditions of detention into line with international standards, including the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), by, inter alia, ensuring that detainees, in particular members of vulnerable groups such as children born in prisons, are provided with adequate material and hygienic conditions; adequate sewage systems and sanitary installations, including toilets and showers; heated cells; sufficient ventilation; an adequate quality and quantity of food, bedding, blankets and items for personal hygiene; health care; outdoor activities; and family visits; (b) Reinforce its efforts to reduce the number of deaths in custody, including cases of suicide. It should investigate all incidents of such deaths and ensure independent forensic examinations; provide autopsy reports to the family members of the deceased and, if requested, permit family members to commission private autopsies; and prosecute those responsible for violations of the Convention resulting in such deaths and, if they are convicted, punish them accordingly and provide redress to relatives of victims; (c) Combat the spread of infectious diseases and vigorously implement harm-reduction programmes in places of detention in order to reduce the number of deaths from tuberculosis and the incidence of HIV/AIDS, and provide specialized medical care to detainees suffering from those diseases. Involuntary placement in psychiatric institutions 40. The Committee is concerned at consistent reports that law enforcement uses involuntary placement in a psychiatric institution as a form of harassment and punishment of political opponents and activists, particularly those in Crimea, including the involuntary hospitalization in 2016 of Ilmi Umerov, the Mejlis Deputy Chair, and five Crimean Tatar men suspected of being terrorists. The Committee regrets that, in practice, courts reportedly do not always respect the law requiring patients’ presence at the proceeding considering their involuntary hospitalization; that patients held in psychoneurological hospitals are prohibited by staff from filing complaints or accessing legal counsel; and that no effective monitoring mechanism exists for the situations in psychiatric institutions (arts. 11 and 16). 41. The State party should: (a) Take measures to put an end to the practice of involuntary placement in a psychiatric institution, particularly in Crimea; (b) Ensure that all persons are guaranteed, in law and in practice, effective safeguards concerning their involuntary internment and psychiatric and medical treatment in psychiatric institutions; (c) Establish an effective independent monitoring mechanism to review the situations of psychiatric institutions and allow the public oversight commissions and non-governmental organizations to conduct monitoring visits to these institutions. 9