■ The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment has recommended that "a doctor qualified in psychiatry should be attached to the health-care service of each prison, and some of the nurses employed there should have had training in this field. The provision of medical and nursing staff, as well as the layout of prisons, should be such as to enable regular pharmacological, psychotherapeutic and occupational therapy programmes to be carried out." ■ Special provision may have to be made for prisoners who are drug-dependent and are in the process of withdrawal. TOPICS FOR DISCUSSION Prisons often have to deal with individuals for whom the community has run out of alternatives. A significant proportion of those who are in prison are petty offenders. They present a problem for the law-abiding members of the community but are not major criminals. Many of them suffer from some form of mental disorder. Sometimes this is a result of drug or alcohol abuse. How can prison staff be helped to cope with such people? There is often a great deal of ignorance and uncertainty about how HIV/AIDS is transmitted and the extent to which its presence constitutes a danger to staff and other prisoners. What considerations should apply to prisoners with HIV/AIDS? To what extent do they need to be treated differently from other prisoners? CASE STUDIES 1. A prisoner has been diagnosed by the psychiatrist as mentally disordered and in need of hospital care. The local health authorities agree but say that a bed cannot be found for the prisoner for some time. How should he be treated while he is awaiting transfer to the psychiatric hospital? 2. Your prison receives its first prisoner who is known to be HIV-positive. Prison staff do not know how to manage this prisoner. They are afraid that they may contract the illness through contact with her. They are afraid that this may affect their families. Other prisoners make it clear that they will not allow this prisoner to come into contact with any of them. You are the senior medical person. You know how this prisoner should be treated. How do you go about convincing staff and prisoners that this new person poses no threat to their health if they behave appropriately? 71