The Bangkok Rules 27 Rule 6 (2) The assessment should take into account the mental health history of the prisoner, drug and/or alcohol addiction and prior self-harm and suicide attempts, in determining risks. In a number of countries research indicates that women have much higher levels of mental health-care needs than men on entry to prison, are more likely to be addicted to drugs and have higher rates of self-harm attempts. In at least one country, research indicates higher levels of suicide among women prisoners in comparison to men. Research in some countries indicates that prisoners who commit suicide suffered from some form of mental disability or substance dependence (or both) on entry to prison. Studies of prisoner suicides have also indicated that long-term sentences, single-cell use, mental disabilities, substance abuse and a history of suicidal tendencies are associated with an increased suicide risk.40 Research has also identified a higher prevalence of self-harm history among prisoners who commit suicide, compared to the general population, as well as higher levels of suicide “ideation” among self-harmers in prison.41 Thus, prisoners who harm themselves may be considered at higher risk of attempting suicide than others. Rule 6 (3) It is important that the reproductive health history of women is recorded in their medical files to assist with determining any future treatment. Current reproductive health complications should receive the appropriate medical responses without delay. For example, women who have recently undergone abortions, experienced miscarriages or complications during delivery may need urgent medical attention. Those who have recently given birth require post-natal care and, often, counselling related to this circumstance. Rule 6 (4) Research in a number of countries has found that a large proportion of women entering prison have a drug dependency. Drug offences are one of the most common category of crimes committed by women and drugs are often key to women’s offending behaviour.42 Some research also indicates that women prisoners are more likely to be addicted to harder drugs than male prisoners.43 It is therefore important to diagnose any treatment needs for drug dependency on entry to prison, in order to provide the requisite healthcare services, as early as possible during detention and imprisonment, taking into account that drug dependency is a recognised underlying factor that can lead to conflict with the law and therefore to re-offending following release, if left untreated. ___________ Matsching T., Frühwald S and Frottier P., Suicide behind bars, an international review, Klinische Abteilung für Sozialpsychiatrie und Evaluationsforschung, Universitätsklinik für Psychiatrie, AKH Wien, Österreich. Psychiatr Prax. 2006 Jan;33 (1):6-13. 41 McArthur, M., Camilleri, P. and Webb, H., Strategies for Managing Suicide and Self-harm in Prisons, Australian Institute of Criminology, 1999, p. 1. 42 For example, it is estimated that at least 75% of women arriving in prison in England and Wales have some sort of drug-related problem at the time of arrest and another estimation states that 75% of women entering European prisons are problematic drug and alcohol users (see WHO/Europe, Health in Prisons, A WHO guide to the essentials in prison health (2007) and Women in Prison, A Review of the Conditions in Member States of the Council of Europe, Quaker Council for European Affairs, p. 12, citing “Health Care Needs of Women in Prison”: The Gap Between Policy and Implementation”, MacDonald M. presentation at “What Works with Women Offenders”, June 2005). 43 A Review of the Conditions in Member States of the Council of Europe, Quaker Council for European Affairs, p. 12. 40