which were recorded by the doctor. Subsequent interviews undertaken with prisoners by the Department have confirmed these claims. As a result of this incident, the Minister of Justice of the Republika Srpska discharged the prison director and reinstated the previous director in this position. Most interviewees, including those beaten up, agreed that the situation significantly improved with the change of prison directors, particularly in relation to security and the general treatment of prisoners. Initially, the disciplinary proceedings against prison guards did not produce any significant results. Nonetheless, according to the prison director, ultimately some measures were imposed against certain staff; the exact sanctions, however, were not possible to ascertain. Further, interviewed prisoners were not aware of any measures taken against guards. In such cases of violence, it was also credibly asserted that prison guards remained with the prisoners during the doctor’s examination of their wounds and injuries, thereby possibly discouraging prisoners from notifying the respective physician of physical mistreatment. This course of action, which not only prevents access to adequate health care but also violates the right to a prisoner’s confidentiality, was justified by prison authorities as a means of protecting physicians from dangerous prisoners.27 The Banja Luka Prison Director noted that this practice had been abandoned since then. While this is one example that occurred outside of the Mission’s research process, it was mentioned during interviews, and it represents a significant incident both in terms of the treatment experienced, as well as the ensuring follow up from the Republika Srpska Ministry of Justice. 1.4 Victims of psychological or mental abuse 1.4.1. International Standards The UN Human Rights Committee recognizes that an act of torture or cruel, inhuman, or degrading treatment does not always cause physical suffering but can instead be the cause of mental suffering.28 The Council of Europe stipulates that psychiatric treatment or issues of mental health arising in prison requires adequate treatment by properly trained staff and suitable facilities. 29 Similarly, the European Court of Human Rights also held that a failure to 27 A prisoner’s right to confidentiality is breached when there is the presence of a guard as found in the European Prison Rules, Rule 42.3: “When examining a prisoner the medical practitioner or a qualified nurse reporting to such a medical practitioner shall pay particular attention to: a. observing the normal rules of medical confidentiality..” Rule 43.1: “The medical practitioner shall have the care of the physical and mental health of the prisoners and shall see, under the conditions and with a frequency consistent with health care standards in the community, all sick prisoners, all who report illness or injury and any prisoner to whom attention is specially directed.” Also see CoE Recommendation No. R (98) 7, Article 13: “Medical confidentiality should be guaranteed and respected with the same rigour as in the population as a whole.” 28 Human Rights Committee, General Comment 20, Article 7 (Forty-fourth session, 1992), Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, U.N. Doc. HRI/GEN/1/Rev.1 at 30 (1994). Para. 5. “The prohibition in Article 7 relates not only to acts that cause physical pain but also to acts that cause mental suffering to the victim. In the Committee's view, moreover, the prohibition must extend to corporal punishment, including excessive chastisement ordered as punishment for a crime or as an educative or disciplinary measure.” 29 Council of Europe Committee of Ministers Recommendation No. R (98) 7 of the Committee of Ministers to Member States Concerning the Ethical and Organizational Aspects of Health Care in Prison, para. 55 provides that: “Prisoners suffering from serious mental disturbance should be kept and cared for in a hospital facility which is adequately equipped and possesses appropriately trained staff.” The European Prison Rules also 9