Minister of Corrections not to allow the placement of mentally ill prisoners in solitary confinement cells. Unfortunately, there were still incidents of placing mentally ill prisoners in solitary confinement in 2016.319 The Special Preventive Group inspected the documentation in establishment no. 3 and found out that during the first months of 2016, out of 51 instances of placement in de-escalation rooms, in 22 cases, disciplinary measures were imposed on the prisoners during their stay in the de-escalation rooms or within the interval of one day.320 Out of 22 instances, in 11 cases, prisoners had various mental disorders; among them, in one case, the prisoner had persistent delusional disorder (F22) and organic personality disorder (F07.0); in two cases, sleep disorders not due to a substance or known physiological condition (F51); and in seven cases, disorders of personality and impulse control (F60.3). Accordingly, the prisoners’ behaviour could have been caused by their mental health condition, which was later the basis for the disciplinary penalty imposed on them. The above-mentioned 11 prisoners placed in the de-escalation room have not been visited by a psychiatrist during their stay in the room. They received psychiatric consultation in some cases before their placement in a de-escalation room or within a few days after removal from these rooms. The environment and conditions in the de-escalation rooms are not safe321 and do not minimise the risk of self-harm.322 This is confirmed by the incidents of self-harm inflicted by the prisoners when they were placed in the de-escalation rooms. It is imperative to take all necessary measures for avoiding the future placement of prisoners suffering from mental health problems in de-escalation rooms and their provision with timely and adequate psychiatric help. Besides, it is particularly important to develop psychosocial rehabilitation services. 3.9.6. DEATHS AND SUICIDES In 2016, 17 prisoners died in the penitentiary establishments. Unfortunately, the number of deaths in the penitentiary system has increased.323 According to the Information received from the Medical Department of the Ministry of Corrections, the reasons for deaths were registered as follows: myocardial infarction, suicide, congestive heart failure, acute insufficient blood flow to the brain (brain ischemia), thromboembolism, oesophageal perforations due to foreign body, and septic shock. Similar to the previous years, the majority of prisoners died from congestive heart failure. It is imperative to pay attention to the screening and early diagnosis of cardiovascular and respiratory system in order to enable the provision of timely and adequate medical services in the future. 319 See in detail under the subchapter Regime, Disciplinary Responsibility and Incentives. 320 One day before placement into a de-escalation room and the next day after removal from the de-escalation room. 321 According to the information provided by the Ministry of Corrections, there is no cushioning material available in Georgia for lining the walls in de-escalation rooms 322 The floor and the walls in the de-escalation rooms are not cushioned. 323 In 2015, 12 prisoners died in the penitentiary system. NATIONAL PREVENTIVE MECHANISM (NPM), 2016 149