substance‑misuse diagnoses) has been found in 37% of sentenced male prisoners, 63% of men on remand, 57% of sentenced women and 76% of women on remand. Multiple diagnoses are common, especially among remand prisoners: approximately a quarter of men and a third of women on remand received two or more diagnoses.3 It is clear that the burden of serious, yet treatable mental disorders in prison is substantial. Given the limited resources of the prison system, it is doubtful whether all those in need receive the appropriate care as envisaged by the ECHR. 2.1 Mental health services in prisons The high incidence of mental disorders in a prison setting increases the responsibility of the prison health‑care system. To start with, there should be a doctor qualifed in psychiatry afliated to the health‑care service of each prison, and some of the nurses employed there should have training in this feld. The number of medical and nursing staf and the layout of prisons should be such as to enable regular pharmacological, psychotherapeutic and occupational therapy programmes to be carried out.4 Measures in relation to mental health disorders in a prison setting Not treating psychiatric illnesses in a prison setting may easily constitute inhuman and degrading treatment,5 so ad hoc measures are needed. Those responsible should consider the following measures for prisoners with psy‑ chiatric disorders: X motivating and training medical staf and psychologists working in prison to diagnose such cases and to participate actively in their management, X providing specialist care in prison for such cases by assigning a psychiatrist to arrange regular consultations, X ensuring the availability of adequate supplies of psychotropic drugs, X ensuring that, when necessary, longer‑term hospital care with an active psychosocial component is possible, 3. Gunn J., Maden A. and Swinton M: Mentally disordered prisoners. London: Home Ofce (1991); Maden A., Taylor C. J. A., Brooke D. et al: Mental disorder in remand prisoners. London: Home Ofce (1995). 4. Slawomir Musial v. Poland 28300/06, Aerts v. Belgium 25357/94. 5. CPT/Inf (2005)18; Slawomir Musial v. Poland 28300/06, Aerts v. Belgium 25357/94. Prison health care and medical ethics Page 30