CAT/C/48/3 for the need to improve cooperation and coordination with United Nations security officers, to encourage restraint on the part of Subcommittee members and an increased awareness of the need for a location- and culture-specific approach to dress codes. 47. Similarly, taking into account the requirement to develop specialized standards for health care in places of detention, the Subcommittee decided that a working group on medical issues should be convened, initially comprising Subcommittee members with medical backgrounds and subsequently expanding to include members with other professional backgrounds. The Subcommittee also decided to task the Working Group with organizing a discussion within the Plenary on issues concerning visits to persons with mental health illnesses and disabilities during the course of 2012. C. Issues arising from visits 48. During the year in review the Subcommittee has identified a number of issues in the course of its visits which it wishes to highlight, and upon which it is reflecting. To assist in these reflections the Subcommittee has produced a number of papers which are summarized below and which may be accessed in full through the web link provided. The Subcommittee welcomes input from those who might be able it assist it in its process of ongoing reflection on these subjects. 49. Recognizing that Subcommittee visits have tended to focus on traditional places of detention, with the expansion of the Subcommittee and subsequent range of expertise that is currently available within it, the Subcommittee has made an effort to increase its activities in relation to non-traditional places of detention during 2011, including immigration facilities and medical rehabilitation centres. In line with its mandate, the Subcommittee is hoping to continue this trend in 2012. 50. The enlargement of the Subcommittee, resulting in larger delegations during visits, meant that there were numerous logistical difficulties in planning and conducting visits. There was also concern that the delegations did not spend an adequate amount of time in some facilities, and while the Subcommittee will formulate ways through which the matter can be addressed, it should be appreciated that there are constraints (e.g. in relation to the use of interpreters and transportation) that require consideration, which makes it extremely difficult to balance out the issues. Nevertheless, larger delegations meant that the teams could split up and cover more places of detention than was possible in the past. 1. Mental health and detention 51. People with mental health problems and intellectual disabilities in many countries are at the lowest level of the social hierarchy. Discrimination, prejudice, deprivation of fundamental human rights and violation of their dignity are widespread. The United Nations Convention on the Rights of Persons with Disabilities, adopted in 2006, represents a paradigm shift in attitudes to persons with disabilities, who are no longer regarded as objects of pity requiring treatment, protection and charity, but as deserving of the full range of human rights on an equal basis with others. Monitoring mental health institutions will be a growing focus of the Subcommittee’s activities in the future. 52. For this purpose, the Subcommittee has developed guidelines with a list of key issues to be explored, such as patients’ living conditions, general health care for mental patients, the spectrum of psychiatric treatment, means of restraint for agitated and/or violent patients, legal and ethical safeguards in the context of involuntary placement, record keeping, medical confidentiality and informed consent, availability of qualified staff such as psychiatrists, psychiatric nurses and occupational therapists, training possibilities for staff, participation of patients in research, and sterilization and abortion without consent. 13