Prisoner with Special needs

All prisoners have a right to health, equivalent to that in the general community, as part of their basic
human rights. This right should guide all jurisdictions in determining the amount and quality of health
care provided in prisons. Prisoners with special needs have a right to access general and specialist health
care services, which take account of special health care needs, corresponding to the individual prisoners’
health assessment and background.

Prisoners with mental health care needs comprise a particularly vulnerable group in prisons and have a
complex set of needs relating to the protection of their human rights, including provision of appropriate
mental health care.

INTERNATIONAL STANDARD

The principle of non-discrimination enshrined in the United Nations Standard Minimum Rules should be
understood to cover prisoners with disabilities. More specifically the principles contained in the United
Nations Convention on the Rights of Persons with Disabilities adopted on 13 December 2006, apply to all
persons with disabilities, including those facing criminal prosecution, detainees and prisoners.

General obligations:

States Parties undertake to ensure and promote the full realization of all human rights and fundamental
freedoms for all persons with disabilities without discrimination of any kind on the basis of disability.

To adopt all appropriate legislative, administrative and other measures for the implementation of the
rights recognized in the present Convention;

To take all appropriate measures, including legislation, to modify or abolish existing laws, regulations,
customs and practices that constitute discrimination against persons with disabilities;

Responding to the needs of offenders with mental health care needs

Mental health care services:

To ensure that the health services provided to prisoners is of an equivalent level to those in

the community.

 To ensure that preventing mental health conditions from arising and early intervention

comprise essential components of mental health provision.

To ensure that every prisoner undergoes a health assessment on entry to prison. The screening should
include assessment to determine mental disabilities, risk of self-harm and suicide

and be undertaken by qualified mental health professionals.

 To include screening for the presence of possible co-morbid substance disorders in all mental
health assessments.

 To ensure that prisoners have easy access to mental health care services, without any

discrimination on the basis of mental disability or other status.

 To provide prisoners with full information about treatment options and involve them to the

maximum possible extent in decision-making regarding their own treatment programme, if

necessary with the application of supported decision-making procedures, and receive free

and informed consent for treatment.

 To ensure that any treatment without free and informed consent is subject to stringent

safeguards and is controlled by legislation, in line with Convention on the Rights of Persons

with Disabilities.

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory
impairments which in interaction with various barriers may hinder their full and effective participation in
society on an equal basis with others.

SPECIAL NEEDS AND CHALLENGES

The special needs of prisoners with disabilities naturally depend on the nature of their disability, though
there are some key concerns that are common to all.

INTERNATIONAL STANDARDS

United Nations Convention on the Rights of Persons with Disabilities

General obligations:

1. States Parties undertake to ensure and promote the full realization of all human rights and
fundamental freedoms for all persons with disabilities without discrimination of any kind on the basis of
disability. To this end, States Parties undertake:

(a) To adopt all appropriate legislative, administrative and other measures for the implementation of the
rights recognized in the present Convention

(b) To take all appropriate measures, including legislation, to modify or abolish existing laws, regulations,
customs and practices that constitute discrimination against persons with disabilities

Responding to the needs of offenders with mental health care needs

Health care:

To ensure that prisoners with disabilities are not discriminated against in their access to health care. This
includes the obligation to provide suitable assistance to prisoners who have problems with
communication, due to their disability.
To provide the same level of specialist health care for disabilities, available in the community.

3.Etnic and racial minorities and indigenous people

A minority group is a sociological group that does not constitute a politically dominant plurality of the
total population of a given society. A sociological minority is not necessarily a numerical minority it may
include any group that is disadvantaged with respect to a dominant group in terms of social status,
education, employment, wealth and political power. A Minority groups generally differ from the
majority due to their ethnicity, race and descent, among others, which is reflected in different ethnic,
religious and cultural practices and languages.

Special needs and challenges

Ethnic and racial minorities and indigenous peoples comprise a vulnerable group in the criminal justice
system and have special needs based on culture, traditions, religion, language and ethnicity, which
prison systems often fail to address. Some of the needs are common to all. Others vary depending on
the culture and background of the prisoner.

INTERNATIONAL STANDARDS

International Covenant on Civil and Political Rights: In those States in which ethnic, religious or linguistic
minorities exist, persons belonging to such minorities shall not be denied the right, in community with
other members of their group, to enjoy their own culture, to profess and practice their own religion, or
to use their own language.

1. States Parties condemn racial discrimination and undertake to pursue by all appropriate means and
without delay a policy of eliminating racial discrimination in all its forms and promoting understanding
among all races, and, to this end:

(c) Each State Party shall take effective measures to review governmental, national and local policies,
and to amend, rescind or nullify any laws and regulations which have the effect of creating or
perpetuating racial discrimination wherever it exists;

(d) Each State Party shall prohibit and bring to an end, by all appropriate means, including legislation as
required by circumstances, racial discrimination by any persons, group or organization.

Responding to the needs of offenders with mental health care needs

Health care:

To provide equal access to health care for minority and indigenous prisoners, taking into account, their
particularly high risk status with regard to certain health conditions, such as drug and alcohol
dependency.

To ensure that the health care offered in prison takes account of the cultural background of prisoners.

4.Foreing national prisons

Special needs and challenges

There are three main categories of foreign prisoners. The first category is made up of those who have
travelled from one country to another with the specific aim of committing an offence, such as drug
smuggling or trafficking in human beings. The second category comprises long-term residents in a
country, who may even have been born there, but who have not been granted citizenship for various
reasons. The third category is made up of those who are staying legally in the country of residence for a
short period (e.g. as migrant workers) who commit an offence.

INTERNATIONAL STANDARDS

United Nations Standard Minimum Rules for the Treatment of Prisoners Discipline and punishment
Where necessary and practicable the prisoner shall be allowed to make his defense through an
interpreter.

Religion:

41. (1) If the institution contains a sufficient number of prisoners of the same religion, a qualified
representative of that religion shall be appointed or approved. If the number of prisoners justifies it and
conditions permit, the arrangement should be on a full-time basis.

(2) A qualified representative appointed or approved under paragraph (1) shall be allowed to hold
regular services and to pay pastoral visits in private to prisoners of his religion at proper times.

(3) Access to a qualified representative of any religion shall not be refused to any prisoner. On the other
hand, if any prisoner should object to a visit of any religious representative, his attitude shall be fully
respected.

42. So far as practicable, every prisoner shall be allowed to satisfy the needs of his religious life by
attending the services provided in the institution and having in his possession the books of religious
observance and instruction of his denomination.

Contact with the outside world

38. (1) Prisoners who are foreign nationals shall be allowed reasonable facilities to communicate with
the diplomatic and consular representatives of the State to which they belong.

(2) Prisoners who are nationals of States without diplomatic or consular representation in the

country and refugees or stateless persons shall be allowed similar facilities to communicate with the
diplomatic representative of the State which takes charge of their interests or any national or
international authority whose task it is to protect such persons.
Responding to the needs of offenders with mental health care needs

Linguistic needs:

To ensure that prison rules and regulations are available in written form in a number of

languages corresponding to the nationalities most commonly represented in prisons and to provide
foreign national prisoners with a copy on admission.

To make available additional copies in the library.

To explain them carefully to each prisoner in a language he or she understands, immediately after
admission to prison and subsequently, as necessary.

To ensure that prison libraries hold an adequate number of books, periodicals and newspapers in a
variety of foreign languages.

To facilitate communication between prisoners of the same nationality, taking into account

security considerations and the wishes of the prisoners themselves.

To provide the opportunity for foreign prisoners to learn the language spoken in the country of
imprisonment.

To ensure that interpreting is available during legal counselling, health care provision, disciplinary
hearings and complaints procedures.

To allow prisoners to use their own language during prison visits and communications by letter and
telephone.

Sexual orientation is understood to refer to each person’s capacity for profound emotional, affection
and sexual attraction to, and intimate and sexual relations with, individuals of a different gender or the
same gender or more than one gender.

Gender identity is understood to refer to each person’s deeply felt internal and individual experience of
gender, which may or may not correspond with the sex assigned at birth, including the personal sense of
the body (which may involve, if freely chosen, modification of bodily appearance or function by medical,
surgical or other means) and other expressions of gender, including dress, speech and mannerisms.

Special needs and challenges

LGBT persons, when arrested for an alleged offence or when lodging a complaint of harassment by third
parties, may be subjected to further victimization by the police, including verbal, physical and sexual
assault and rape.

INTERNATIONAL STANDARD

STATES SHALL:
A. Ensure that placement in detention avoids further marginalising persons on the basis of sexual
orientation or gender identity or subjecting them to risk of violence, ill-treatment or physical, mental or
sexual abuse;

B. Provide adequate access to medical care and counselling appropriate to the needs of those in
custody, recognizing any particular needs of persons on the basis of their sexual orientation or gender
identity, including with regard to reproductive health, access to HIV/AIDS information and therapy and
access to hormonal or other therapy as well as to gender-reassignment treatments where desired;

C. Ensure, to the extent possible, that all prisoners participate in decisions regarding the place of
detention appropriate to their sexual orientation and gender identity;

D. Put protective measures in place for all prisoners vulnerable to violence or abuse on the basis of their
sexual orientation, gender identity or gender expression and ensure, so far as is reasonably practicable,
that such protective measures involve no greater restriction of their rights than is experienced by the
general prison population;

E. Ensure that conjugal visits, where permitted, are granted on an equal basis to all prisoners and
detainees, regardless of the gender of their partner;

F. Provide for the independent monitoring of detention facilities by the State as well as by
nongovernmental organizations including organizations working in the spheres of sexual orientation and
gender identity;

G. Undertake programmers of training and awareness-raising for prison personnel and all other officials
in the public and private sector who are engaged in detention facilities, regarding international human
rights standards and principles of equality and non-discrimination, including in relation to sexual
orientation and gender identity.

Responding to the needs of LGBT offenders

Health care

To ensure that LGBT prisoners undergo a full health screening on entry to prison as with all prisoners,
and that they receive medical care equivalent to that in the community and to that which other
prisoners receive.

To meet the special health care needs of LGBT prisoners, including treatment available in the
community for gender dysphoria, such as hormone therapy, as well as sex reassignment surgery, if
available in the community.

To provide programmers on HIV prevention and information booklets on transmission of HIV/AIDS and
means of protection to all prisoners, including LGBT prisoners.

6. OLDER PRISONERS

In demographic analysis, age 60 is typically taken as the dividing line between older and younger cohorts
of the population. On the other hand, many people, especially in the developed countries, think of 65 as
the cut-off point because it is at this age that many people become eligible for full pension and social
security benefits for older persons; but such a cut-off point does not apply everywhere else. Old age,
therefore, cannot be defined exactly because the concept does not have the same meaning in all
societies. Nor, with the steady expansion of life expectancy, does it correspond to a specific time span.

Special needs and challenges

Older persons are likely to need particular assistance in their access to legal counsel on arrest, in pre-
trial detention and prison, to assist them during the trial and any appeals process, as well as later on, to
help them gain early conditional or compassionate release. If they are an older offender at the time they
commit the offence, they may not have a family, or ties may have been disrupted, and they may
additionally have multiple needs, due to poor mental or physical health or disabilities.

INTERNATIONAL STANDARDS

Although no specific standards have been adopted in relating to the treatment of older prisoners, the
United Nations Principles for Older People, adopted in 1991, provide general principles which apply to
the rights and needs of all older people, covering the principles that should guide policies and
programmers developed for older prisoners.

Responding to the needs of older offenders

Health care:

To ensure that the medical, nutritional and psychological health care needs of older prisoners are met,
with the engagement of a multidisciplinary team of specialist staff.

To establish close cooperation with community health services to ensure that specialist care is provided
by outside medical services, as necessary, and that prisoners whose needs cannot be met in prison are
transferred to civilian hospitals.

To provide special programmers addressing mental disabilities, such as depression and fear of dying, as
well as individual counselling, as necessary.

Contact with the outside world.

To place older prisoners as close as possible to home in order to help them maintain contacts with
family members. In addition, where resources allow, to organize family visits for those who are too old
to travel.

To grant regular prison leave as an integral element of prison regime, enabling older prisoners to spend
time with their families and thereby to maintain contact and reduce the sense of isolation.

To encourage organizations of civil society which work with older persons to include prison visits and
projects in prisons within their programmers.