–5– 111. The CPT also wishes to stress that female juveniles should under no circumstances receive less care, protection, assistance and training than male juveniles, despite the fact that their numbers are much lower and that detention centres are nearly always designed for male inmates. If necessary, additional measures should be taken to ensure equal treatment. 112. In various establishments visited, the CPT observed the existence of a differentiated incentive-based regime in which progress is rewarded to juveniles who are co-operative and display good behaviour, while inmates who display negative behaviour are demoted and subjected to various restrictions. In the CPT’s view, a behavioural approach can be beneficial in encouraging juvenile inmates to abide by the norms of living within a group and pursue constructive paths of self-development. However, withdrawal of incentives due to non-compliance can quickly reach a level of deprivation which is incompatible with minimum requirements. In particular, steps should be taken to avoid the juveniles concerned being subjected to a regime which is akin to solitary confinement. In addition, there should be formal and transparent procedures in order to avoid “educational measures” becoming or being perceived as arbitrary. d. health care 113. When examining the issue of health-care services in prisons, the CPT has been guided in its work by a number of general criteria (access to a doctor; equivalence of care; patient’s consent and confidentiality; preventive health care; professional independence and professional competence). Moreover, in its 23rd General Report, the Committee set out in detail its standards regarding the role of prison health-care services in preventing ill-treatment (notably through the systematic recording of injuries and the provision of information to the relevant authorities). Naturally, all the aforementioned standards apply equally to detention centres for juveniles. 114. Having said that, the CPT always pays special attention to the specific medical needs of juveniles deprived of their liberty. It is particularly important that the health-care service offered to juveniles constitutes an integrated part of a multidisciplinary (medico-psycho-social) programme of care. This implies, inter alia, that upon admission all juveniles should benefit from a comprehensive individual medical, psychological and social needs assessment and that there is always close coordination between the work of an establishment’s health-care team (doctors, nurses, psychologists, etc.) and that of other professionals, including specialised educators, social workers and teachers, who have regular contact with inmates. The goal should be to ensure that the health care delivered to juvenile inmates forms part of a seamless web of support and therapy. 115. All juveniles should be properly interviewed and physically examined by a medical doctor, or a qualified nurse reporting to a doctor, as soon as possible after their admission to the detention centre; preferably, on the day of arrival. If properly performed, such medical screening on admission should enable the establishment’s health-care service to identify young persons with potential health problems (e.g. drug addiction, sexual abuse and suicidal tendencies). The identification of such problems at a sufficiently early stage will facilitate the taking of effective preventive action within the framework of the establishment’s medico-psycho-social programme of care. 116. It is also widely recognised that detained juveniles have a tendency to engage in risk-taking behaviour, especially with respect to drugs, alcohol and sexual practices, and that they are more likely to engage in self-harm. In consequence, in every detention centre for juveniles, there should be a comprehensive strategy for the management of substance abuse (including prevention and treatment) and the prevention of self-harm and suicide. The provision of health education about transmissible diseases is another important element of a preventive health-care programme. Juveniles with mental-health problems should be cared for by psychiatrists and psychologists specialising in the mental health of children and adolescents.