visited were inadequate, with a considerable number of prisoners spending up to 22 hours per day locked up in their cells. The situation was particularly bleak for juveniles placed on "separation" lists, who could spend up to 23.5 hours a day locked up alone in their cells, for extensive periods – even, occasionally, up to 80 days. The report recommends that juveniles should not be segregated in such conditions, even for the purposes of good order, and instead be placed in small staff-intensive units. In response the United Kingdom authorities state that their strategy to tackle prison overcrowding is based on a combination of early intervention upstream and on reducing reoffending after release for those who are sentenced to immediate custody. As regards the particular situation of juvenile offenders, they outline the rules and measures in place to prevent a situation akin to solitary confinement. 65. As regards the psychiatric institutions visited, the CPT’s report recognises the clear dedication of mental health professionals. However, it recommends some serious reflection and change, for example as regards strengthening the safeguards surrounding consent to treatment, the application of specific treatment measures and the use of means of restraint, as well as making appropriate arrangements for transfers to more secure hospitals. In the high secure hospitals, the CPT’s report is very critical of the way long-term seclusion is applied and expresses misgivings over the use of force deployed to control patients and it calls for a review of the nighttime confinement policy. As regards current procedures on the use of restraints, the United Kingdom authorities mention in their response an action plan on reducing their use, as well as a new training module for all in-patient staff, developed after a review of the de-escalation training. On the issue of strengthening safeguards for persons placed in involuntary psychiatric care, the response states that the Government has commissioned an independent review of the Mental Health Act and associated practice. 66. The CPT’s report also points to the need for greater efforts to recruit and retain registered mental health nurses, whose numbers have decreased significantly while the numbers of detained patients have risen. In their response, the United Kingdom authorities provide details of the reforms under way, including plans to create 21,000 new mental health care posts by 2021. 67. The response also provides information on the action taken by the United Kingdom authorities to address the CPT’s recommendations concerning the treatment of persons detained by the police and the situation in immigration centres. The CPT held high-level talks in April 2017 with senior ministers and officials in particular to discuss the ongoing prison reform and issues surrounding involuntary psychiatric care (see paragraph 19 above). Report published in April 2017 (CPT/Inf(2017)9), response published in January 2018 (CPT/Inf(2018)1) Publication highlights ► Page 23