… 82. (1) Persons who are found to be insane shall not be detained in prisons and arrangements shall be made to remove them to mental institutions as soon as possible. (2) Prisoners who suffer from other mental diseases or abnormalities shall be observed and treated in specialized institutions under medical management. (3) During their stay in a prison, such prisoners shall be placed under the special supervision of a medical officer. (4) The medical or psychiatric service of the penal institutions shall provide for the psychiatric treatment of all other prisoners who are in need of such treatment. 83. It is desirable that steps should be taken, by arrangement with the appropriate agencies, to ensure if necessary the continuation of psychiatric treatment after release and the provision of social-psychiatric after-care. IMPLICATIONS In many prison systems a significant proportion of prisoners suffer from some form of mental illness. Prisoners who are insane should not be in prison. The prison authorities should make every effort to have them transferred to a psychiatric hospital. While they remain in prison they will require special care. There should be a close relationship between the prison medical officer and health-care specialists in the community so that use can be made of community expertise. It is particularly important in the case of prisoners who are receiving psychiatric treatment that arrangements should be made for their continuing care after they are released. PRACTICAL RECOMMENDATIONS ■ Some prisoners may need specialist health care which is not available in the prison. In such cases the prisoners should be transferred to outside specialist care. If it is not possible to transfer such prisoners to outside facilities, they must be transferred to a prison with equivalent specialist facilities. ■ Prison is not the right place for people who are mentally ill. Their care should be the concern of medical management. Keeping mentally ill people in prison makes prison life more difficult for everyone in the institution: staff and other prisoners, as well as the prisoner who is mentally ill. ■ Screening and monitoring the mental health of prisoners helps to identify those who should not be in prison. It is important to distinguish between prisoners who intentionally disrupt the order of the prison and prisoners who are mentally disordered and whose behaviour is disruptive. Sometimes prisoners whose views do not fit with those of the establishment are treated as disruptive or mentally disordered. It is important that diagnosis of mental health should be based on medical criteria only. 70