PRACTICAL RECOMMENDATIONS ■ The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment has recommended that every newly arrived prisoner should be properly interviewed and physically examined by a medical doctor as soon as possible after his admission. Save in exceptional circumstances, that interview/ examination should be carried out on the day of admission, especially insofar as remand establishments are concerned. Such medical screening on admission could also be performed by a fully qualified nurse reporting to a doctor. ■ Prison staff should be able to respond to the results of the medical screening by identifying prisoners' problems, both physical and mental, and dealing with them in a confidential manner. ■ Medical staff should separate those prisoners with severe problems and plan a programme of treatment for them. ■ If there is a high number of daily admissions to a prison it may be more practical for prisoners to be seen at the point of admission by a qualified nurse, who will refer urgent cases to the medical officer for immediate attention. The medical officer can then see all the other persons within 24 hours of admission. ■ The prison authorities are responsible for making special arrangements to deal with prisoners who are found to be suffering from contagious or infectious diseases. ■ Effective screening should include assessment of the risk of suicide or self-harm. All staff should be sensitive to such risk at the point of admission and at other times during imprisonment. Prisoners thought to be at risk may be referred to a counsellor, placed in a cell with another carefully selected prisoner or observed by staff at frequent intervals for their protection. TOPICS FOR DISCUSSION The point of first admission to custody is likely to be a stressful time for prisoners. The medical staff in the reception area of the prison can play an important role in re-assuring prisoners that they will be treated in a decent and humane manner and that they will not be abused. What techniques can they use when doing this? Health-care staff who work in the reception area of the prison may be the first to obtain information about a prisoner's state of health. If they suspect that a newly admitted prisoner may be mentally unstable, what should they say to the other staff who have to deal with the prisoner in the reception area? How should such a prisoner be treated? What should health-care staff do in similar circumstances if they realize that a prisoner has a transmissible disease? Discuss the role of the prison doctor in assessing whether prisoners are fit to undergo punishment. CASE STUDY A prisoner is admitted late one evening. He gives every appearance of being suicidal. The medical officer has gone home and cannot be contacted. Bearing in mind the international instruments, what action should staff take to ensure that the prisoner does not harm himself overnight? 64