-16 of Fundamental and Human Rights, that explores how to apply systemic approach in the work of National Preventive Mechanisms to enhance their impact. Introduction to the Handbook: Monitoring Prison Violence There is no EU-wide study on prison violence, hence, it is difficult to assess the overall situation concerning this issue in the EU area. However, various sources unambiguously point to a conspicuous and steady increase in violent incidents in prisons across the European Union.10 Violence in prison may not only amount to a serious violation of human rights, including torture and ill-treatment, but is often a symptom of much broader and systemic problems in penal institutions. In the majority of cases, the occurrence of violence can in fact be linked to other causes, such as deplorable living conditions, understaffing and lengthy lockup times in cells as well as the cultural norms and attitudes of persons working and living in prison. All such factors are of extreme importance, yet many States and prison administrations limit themselves to treating only the symptoms and not the causes of this complex problem, thereby failing to provide a long-term solution to the problem. But in order to understand prison violence and to effectively prevent it, one must look beyond the direct causes of each incident, and take a holistic approach that also considers underlying factors that enable violence, such as structural, situational and cultural issues. NPMs can have an important role in this regard. In practice, however, monitoring a complex phenomenon like violence, identifying its forms and 10. But see Jens Modvig ‘Violence, sexual abuse and torture in prisons’ in WHO/Europe, ‘Prison and Health: World Health organization Regional Office for Europe’ (2014) 19ff <https://apps.who.int/iris/ bitstream/handle/10665/128603/Prisons%20and%20Health.pdf?sequence=1&isAllowed=y>; Dignity, ‘Monitoring Health in Places of Detention: An Overview for Health Professionals’ (Dignity 2020) 236 [hereinafter: Dignity 2020]; Eurostat Statistics Explained, ‘Prison Statistics: Overcrowding and Empty Cells’ (July 2020) <https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Prison_ statistics#Overcrowding_and_empty_cells>; European Committee for the Prevention of Torture (CPT), ‘27th General Report of the CPT’ Activities, 1 January – 31 December 2017’ (2018) CPT/Inf(2018)4, 16ff; European Union Agency for Fundamental Rights (FRA), Criminal Detention Conditions in the European Union: Rules and Reality (Publications Office of the European Union 2019) 43; CPT, ‘28th General Report of the CPT’s Activities, 1 January - 31 December 2018’ (2019) CPT/Inf(2019)9, 18 ff; CPT, ‘29th General Report of the CPT’s Activities, 1 January-31 December 2019’ (2020) CPT/Inf(2020)17, 22ff.