Annual Report 2012: Spain’s National Preventive Mechanism The medical or psychiatric criteria to justify the reasons for therapeutic custody are not clear The «Teresa de Calcuta» center is the only one in the Community of Madrid that has a therapeutic or mental health module At the «Zambrana» center lack of a clear distinction between the therapeutic custody unit and the others was noted 126 160. Two of the centers visited, namely «Teresa de Calcuta» and «Zambrana», have specific units for serving therapeutic custody measures. On the day of the inspection visits, «Teresa de Calcuta» had 24 juveniles in the therapeutic regime (19 for mental health and 5 for drug addictions) and «Zambrana» had 4 (2 for mental health and 2 for drug addictions). Although the «Las Palmeras» center does not have a therapeutic unit, an ad hoc treatment had been established for a female juvenile in therapeutic custody. According to the reports of the external experts, the files of minors in custody with therapeutic regimes at those centers did not clearly reflect the medical or psychiatric criteria to justify sending these adolescents to this type of unit, given that «therapeutic custody» is ordered in a judgment, with prior diagnosis and assessment of the juvenile by social services, but not by mental health professionals. In the opinion of the psychiatrists on the inspection teams, given that there was no prior medical or psychiatric diagno­ sis, it was not clear what condition was to be treated, and it seemed that the custody regime was applied to formally comply with the provisions of the court judgment. The «Teresa de Calcuta» center is the only center in the Community of Madrid that has a therapeutic or mental health module. Given that it only has 24 places, this means that less than 1% of juvenile court sentences in semi-open or closed custody include admissions to a therapeutic unit. The criteria that justify send­ ing an adolescent to this type of unit are not clear. In all the medical records consulted at the «Teresa de Calcuta» center, the external experts noted that they contained appropriate psychiatric diagnosis and considered that overall minors in custody are medicated little, especially in comparison with the treatments they had prior to entering the center. All of these points highlight a notable ther­ apeutic policy on the part of the professionals and the obvious fact that the insti­ tution itself serves to contain the minors, as it offers an environment in which higher dosages of medication are not necessary. In respect to psychiatric diagno­ ses, all of the medical records consulted contained appropriate diagnosis pre­ scriptions. At the «Zambrana» center lack of some differentiation of the therapeutic custody unit from the others was noted. The minors and professionals interviewed at the center did not have a clear idea of the differences involved in being assigned to the therapeutic unit, and did not see it as a unit having a specialized or therapeutic mental health program. In fact there are no differences between the intervention with a minor in therapeutic custody and the intervention with any other minor at the center in need of psychiatric attention. The professionals interviewed pointed out that due to the personalized attention provided, the therapeutic unit was for all minors who needed it. This was verified during the inspection visit, since of the total of 66 minors in custody, there were only 4 places in the thera­ peutic custody unit, and about 30 minors were being monitored and the psychia­ trist saw them as a minimum once a month. THE OMBUDSMAN OF SPAIN