1. MEDICS CATALONIA PROJECT
First Part: Summary about the project

2. Levels of Psychiatric attention in Catalan prisons
(The 3 levels share computerized clinical history. It is shared among the 80% of our Public Health System since 2015)
Small Prisons
Consultant
Psychiatrist
Large Prisons
Psychiatric
Nursing
Departments
In the big complex
of Brians 1
Penitentiary
Hospital
First
Second
Third

3. Psychiatric visits and self-harms Period from 1st January 2013 to 30th April 2014
Population
Psichyatrics visits
Self-harms
Attempted suicide
Suicide
Number
Ratio %
Youth Prison
787
126
0,16 33
4,19 1
0,13
Br1 Female
508
2506
4,93 54
10,63 26
5,12
0,20
Br1 Men
2669
3728
1,40 66
2,47 23
0,86
0,04

11. NURSING STAFF Acute pain Abuse of drugs Lack of impulse control
A better assessm of indiv. needs
Improve
self-
management
Profess. training courses
Psycotherap. treatment
Pharmaco-logical treatment
Help family

12. MEDICS CATALONIA PROJECT
Second Part: According to our staff

13. (1) In order to identify psychopathological disorders and possible sources of help, our staff believes the following:
1st. PROTOCOL information + a link or contact with a professional expert in psychopathology
2nd. TRAINING courses (according to directors, treatment area + health staff, the lack of trained staff in health is the most negative factor that affects their intervention)
3rd. PSYCOTHERAPEUTIC TREATMENT (individual or group psychological treatment)

14. (2) In order to identify psychopathological disorders and possible sources of help, our staff believes the following:
4th. To increase outdoor activities + family visits
5th. To prompt the inmates in joining in self-help groups + to start therapeutic activities
6th. To give more support to the inmates students who attend classes and who require it

15. MEDICS CATALONIA PROJECT
Third part: Conclusions and Proposals

16. CONCLUSIONS (1) In general, for all the penitentiary staff:
To increase the motivation, activating incentive policies (only 13% of Catalan correctional officers answered the questionnaires)
PROFESSIONAL TRAINING for all groups, supplemented by on line curses and material (this means a low cost activity for the Administration)
To work on a MULTIDISCIPLINARY TEAM BASES AMONG PROFESSIONALS (First of all, it’s necessary to show the groups how to gain coordination. Once they have learnt some coordination techniques, the training courses can be given)
Teachers should be able to identify what are the personal problems which influence the inmates

17. CONCLUSIONS (2) For Inmates with psychopathological problems:
To carry out personal programmes in order to treat each patient, so:
«a Taylor made programme for each inmate with a mental disorder is needed and a personal social rehab programme is required»
(medication, psychological study -structural analysis of social behaviour and social interactions-, activities, therapeutic outings...)

18. PROPOSALS (1)
In psychiatric/psychopathological issues:
The computerized medical report should be shared by all the medical staff and other professionals (clinical psychologist, educators, social workers)
To develop the idea of personal treatment plans
To set up psychiatric multidisciplinary teams
To create inside and outside the prison system a psychiatric coordination policy

19. PROPOSALS (2)
In order to improve the care of inmates with mental disorders
To start an outpatients program outside the prison system in the facilities provided by the community, in low and medium security units under specialized supervision (ex. security measures with low or moderate risk of recidivism).
To set up, in those units and also for serious cases, a specialized team made up by a forensic doctor, a specialist in legal medicine and a psychiatrist.
To establish a network of psychiatric outpatient’s services outside prison.
To empower the psychiatrists and criminal justice technicians, so they can propose the judges the most suitable centre in which the patient should be assigned

20. FINAL CONSIDERATION Do all offenders with psychopathological disorders have to be in prison?
It will obviously depend on:
1. What kind of offense they have committed
2. What sort of mental disorder they are suffering from
So, it’s essential a good diagnosis, an appropriate treatment and a correct follow up, both inside and outside the prison (Judges have to be assured that offenders will be supervised and that there will be no security reasons which advice that the offender has to remain in prison)

21. According to the recommendation R(2006)2 of the Committee of European Ministers
12.1 says: «People who suffer from mental illness which mental health condition is incompatible with detention in prison should be arrested in an establishment designed for this purpose».
12.2 says: «If these people are in jail, their situation and their needs should be governed by special rules»
42.3 says: «Agreements with the community services are necessary in order to continue the cares, if after the release, the person consents»

22. THANKS FOR YOUR ATTENTION !!