4 9. Using pretrial detention other than as an exception of last resort further exacerbates other existing problems in the region, such as high rates of prison overcrowding. This, in turn, triggers a situation in which the fundamental rights of inmates, such as the right to humane treatment, are violated. In the vast majority of the countries in the region, persons held on pretrial detention are exposed to the same conditions as convicts, and sometimes to an even worse treatment. Persons in pretrial detention are usually subjected to immense personal stress as a result of lost income and forced separation from their families and communities. In addition, they suffer the psychological and emotional impact that being deprived of liberty without having been convicted causes, and, in general, are exposed to a climate of violence, corruption, and the unsanitary and inhume conditions prevailing in the vast majority of prisons in the 11 region. Even suicide rates in prison are higher among pretrial detainees . All these reasons highlight the gravity of this measure and the need for its application to come 12 with extreme precautions to respect judicial guarantees. 10. The Commission has observed as well that the use of pretrial detention has a disproportionate effect on persons who belong to economically vulnerable groups. These people usually face obstacles in accessing other precautionary measures, such as bail, and cannot afford a private attorney, which means they have no choice other than a public defender, with its concomitant limitations. 11. Furthermore, because of the costs involved, holding a large number of persons awaiting trial in custody does not constitute good practice from the prison management standpoint. The non-exceptional use of this measure also means that the generally scarce resources of the prison system will fall far short of meeting the needs of the growing prison population. 12. Additionally, holding a person in pretrial detention for a prolonged period can result in a situation in which judges are much more inclined to convict in order to uphold, to a certain extent, their earlier decision to detain the accused over the 13 course of the trial. In this sense, an eventual acquittal could be equivalent to an admission that an innocent person was incarcerated for an extended period of time. Considering all this, the protracted detention of an individual without him or her being brought to trial constitutes, to a certain extent, a presumption of guilt. 11 WHO, Department of Mental Health and Substance Abuse, Preventing Suicide in Jails and Prisons, 2007, pp. 3 – 5, available at: http://www.who.int/mental_health/prevention/suicide/resource_jails_prisons.pdf. 12 With regard to the negative effects of pretrial detention, see in general: Open Society/Justice Initiative, The Socioeconomic Impact of Pretrial Detention, 2011; Open Society/Justice Initiative, Pretrial Detention and Torture: Why Pretrial Detainees face the Greater Risk, 2011; Open Society/Justice Initiative, Pretrial Detention and Health: Unintended Consequences, Deadly Results, 2011. 13 See also UN, Working Group on Arbitrary Detentions, Annual Report submitted to the Human Rights Council, A/HRC/4/40, published on January 9, 2007, para. 68; and UN, Special Rapporteur on Torture and other cruel, inhuman or degrading treatment or punishment, Interim Report, A/64/215, published on August 3, 2009, para. 42.