contact between inmates and doctors without the involvement of non-medical staff; installation of a call button in the establishments and the obligation of medical staff to inspect the cells on a daily basis; providing at least one meal for medical staff at the facility; addition of dental nurses in the establishments; conducting professional trainings for the medical staff of the institutions; ensuring the appropriate frequency of specialists' visits to the N8 and N15 facilities so that the waiting time for patients does not exceed 2 weeks; correcting deficiencies in filling outpatient medical records; introduction of electronic information system in the penitentiary system; taking all measures so that the term of the regular outpatient referral does not exceed 1 month, the term of regular inpatient referral does not exceed 4 months and urgent referral does not exceed - 5 days. Unfortunately, none of the above recommendations have been implemented. In the reporting period, it was not possible to assess the implementation of the recommendation regarding the elimination of the deficiencies related to the supply of medicines in the N8 establishment by taking into account the analyzed data on the demand and consumption of medicines prescribed during the procurement period. The National Preventive Mechanism will pay particular attention to the implementation of this recommendation during subsequent monitoring visits. Against the background of the restrictions imposed in penitentiary establishments, the issue of mental health protection of prisoners became even more urgent. It is unfortunate that managing mental health problems remains a significant challenge for the penitentiary health care system. Significant recommendations issued by the Public Defender in this regard have not been implemented: the strategy of attracting providers of mental health services has not been implemented; there is no periodic mental health screening in penitentiary establishments. The number of psychiatrists has not been increased, therefore the number of patients admitted by a psychiatrist in one day exceeds 15; the proper frequency of visits to the psychiatrist is not provided in the facilities and the waiting time of the patient exceeds 2 weeks; the composition of the psychiatric multidisciplinary team, the functions of each team member and the procedure for organizing and provision of psychiatric care are not described at the statutory level; no crisis prevention and management guidelines have been developed. The medical staff of the facility was not trained in crisis prevention and management; the multidisciplinary team did not assess the needs of patients with mental health problems who did not require inpatient treatment. An individual needs-tailored bio-psycho-social assistance plan has not been developed; Clinical-laboratory dynamic assessment and control of the risk of developing agranulocytosis, metabolic processes and especially hyperglycemia is not provided for the management of side effects of drugs. During the reporting period, it was not possible to assess the implementation of the recommendation on whether despite the request of the Public Defender the Medical Service Quality Management Division of the General Inspectorate of the Special Penitentiary Service examined the practice of issuing psychotropic drugs and what measures were taken to prevent misuse of psychotropic drugs. The National Preventive Mechanism will pay particular attention to the implementation of this recommendation during subsequent monitoring visits. 31

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