1989–2019

GLOBAL YEARS TRENDS 2019

SPECIAL FOCUS Pull-out section Healthcare in Global Prison Trends 2019 Penal Reform International The Thailand Institute of Justice (PRI) is an independent (TIJ) is a public organisation This document is co-published and non-governmental organisation established by the Government produced with financial assistance that develops and promotes of Thailand in 2011 and officially from the Thailand Institute of Justice fair, effective and proportionate recognised by the (TIJ). It is the fifth edition in Penal responses to Office on Drugs and as Reform International’s (PRI) Global problems worldwide. the latest member of the United Prison Trends series. Nations Crime Prevention and We promote alternatives to prison that This report was authored by Criminal Justice Programme support the rehabilitation of offenders, Vicki Prais and Frances Sheahan. Network Institutes in 2016. and promote the right of detainees The authors drew on information to fair and humane treatment. We One of the primary objectives of provided by contributors to PRI’s campaign for the prevention of torture the TIJ is to promote and support expert guest blog series available and the abolition of the death penalty, the implementation of the United at www.penalreform.org/blog and and we work to ensure just and Nations Rules for the Treatment of information kindly provided by appropriate responses to children and Women and Non-custodial partner organisations. The report women who come into contact with Measures for Women Offenders was edited by Martha Crowley. the law. (the Bangkok Rules). Its contents are the sole We currently have programmes in In addition, the TIJ strives to serve responsibility of PRI. the Middle East and North Africa, as a bridge that transports global This publication may be freely Central Asia, the South Caucasus and ideas to local practices with an reviewed, abstracted, reproduced Sub-Saharan Africa, and work with emphasis on fundamental issues and translated, in part or in partner organisations in other regions. including interconnections between whole, but not for sale or for use the rule of law and sustainable To receive our monthly e-newsletter, in conjunction with commercial development, human rights, peace please sign up at purposes. Any changes to the text and security. www.penalreform.org/keep-informed of this publication must be approved For more information, please visit by PRI. Due credit must be given to Penal Reform International www.tijthailand.org PRI, the TIJ and to this publication. Headquarters Enquiries should be addressed to 1 Ardleigh Road Thailand Institute of Justice [email protected] London N1 4HS GPF Building 15th–16th Floor Witthayu Road, Pathum Wan ISBN: 978-1-909521-64-3 Bangkok 10330 +44 (0) 207 923 0946 First published in May 2019. Thailand Email: [email protected] © Penal Reform International 2019 : @PenalReformInt +66 2118 9400 : @penalreforminternational Email: [email protected] Twitter: @TIJthailand www.penalreform.org Facebook: @tijthailand.org www.tijthailand.org

Acknowledgements Dr Catherine Appleton, University Aisha Osman, Penal Reform Sunita Stürup-Toft, of Nottingham International & WHO UK Collaborating Jean-Sébastien Blanc, Association Oscar Ouedraogo, Penal Reform Centre for Health in Prisons for the Prevention of Torture International Programme Dr Miranda Davies, Nuffield Trust Jaanki Patel, Penal Reform Dr Philippa Tomczak, University of Nottingham Dr Abigail Dymond, University International of Exeter Stephen Pitts, Independent Rozelien Van Erdeghem, Penal Reform International, University Dr Matti Tapani Joutsen, Thailand Consultant, community-based justice of Vienna Institute of Justice Dr Emma Plugge, WHO UK Professor Dirk van Zyl Smit, Dr Ian Marder, Maynooth University Collaborating Centre for Health in Prisons Programme, Public Health University of Nottingham and Chair Matthew Mcevoy, Omega Research England & Tropical , Nuffield of Penal Reform International Foundation Department of Medicine, University Marie Nougier, International Drug of Oxford Cover photo © Carlos Jasso for Reuters. Policy Consortium Yoga class inside a juvenile Prarthana Rao, Thailand Institute centre – part of a voluntary programme Cholpon Askerbekovna Omurkanova, of Justice that uses yoga to reduce stress, Chair of the Public Council Professor Mary Rogan, Trinity and amongst detainees in of the State Service of Execution College Dublin, the University juvenile centres in Mexico City. of under the Government of Dublin of the Kyrgyz Republic Graphic design by Alex Valy. Chiara Sangiorgio, Amnesty Printed on recycled paper, manufactured International using 100% post-consumer waste. CONTENTS

Contents

Foreword 2 Introduction 3 Key facts and figures 4

1. Crime and 7 Crime rates and the use of imprisonment 7 8 Closing space for civil society 10 11

2. Trends in the use of imprisonment 12 Pre-trial detention 12 Sentencing 13 Death penalty 15 Life imprisonment 16 Drugs and imprisonment 18

3. Prison populations 20 Women 20 Foreign national prisoners, minorities and Indigenous peoples 21 Children and young people 22 Elderly people 25 Lesbian, gay, bisexual, transgender and intersex people 26

4. Prison management 27 Security and violence 27 Prison staff 28 Contact with the outside world 31 Rehabilitation and reintegration 33 Fragile and conflict-affected states 34 Violent extremism in prison 35

5. Role and use of technologies 37

6. Alternatives to imprisonment 40

Key recommendations 42

Endnotes 44

CENTREFOLD

Special Focus 2019 (pull-out section) Healthcare in prisons

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 1 FOREWORD

Foreword

The daily life of a prison is a mirror The right to healthcare that is the spread of infectious diseases and reflection of society, as Nelson accessible, acceptable, high quality act as a catalyst for the destabilisation Mandela said in 1998: ‘The way and safe is an inalienable human right, of prisons. The UN Standard Minimum that a society treats its prisoners is and is the subject of this edition’s Rules for Non-custodial Measures one of the sharpest reflections of Special Focus. Article 12 of the (the Tokyo Rules) call on states to use its character.’ The 2019 edition of International Covenant on Economic, alternative measures to imprisonment Global Prison Trends, produced by Social and Cultural Rights and Rule 24 more widely, taking into account the Penal Reform International and the of the UN Standard Minimum Rules political, economic, social and cultural Thailand Institute of Justice, highlights for the Treatment of Prisoners (the conditions of each country, as well as the following issues within prisons Nelson Mandela Rules) oblige states the goals and objectives of its criminal systems: overcrowding; a lack of to provide prisoners with medical justice system. Alternative measures effective programmes for rehabilitation care in case of health problems, and enable offenders to avoid the negative and reintegration; an emphasis on to not discriminate against offenders consequences of imprisonment. In security above all; insufficient staff and because of their status as prisoners. many parts of the world, alternative low wages; the influence of criminal Each prison should make efforts to measures are still at a developmental subcultures; the vulnerable position of ensure that prisoners are treated by stage and greater collaboration and women, children, the elderly, prisoners qualified medical personnel and are cooperation is needed to ensure with disabilities and ethnic and racial provided with appropriate their effectiveness. minorities; insufficient or ineffective and healthcare services. Vulnerable application of alternative measures to categories of prisoners – such as imprisonment; and violent extremism women, children, the elderly and Cholpon Askerbekovna Omurkanova and radicalisation in prisons. people with disabilities – need Chair of the Public Council of the State additional guarantees of access to Within Global Prison Trends 2019, Service of Execution of Punishment under medical care. The aim of Goal 3 of the Government of the Kyrgyz Republic the chapter on prison management the Sustainable Development Goals deserves special attention. Prison – agreed by United Nations member management should be implemented states in 2015 – is to ‘ensure healthy by well-trained and professional staff, lives and promote well-being for all at and the human rights of prisoners all ages’ by 2030. Thus, by ensuring should be respected, including the appropriate prison health services and right to non-. There the well-being of those in custody, should be safe conditions for all prisons have an important role in members of the prison, opportunities promoting the health of some of the for constructive dialogue with society, most disadvantaged people in society transparency, and accountability. and in contributing to the achievement In many countries, work in prisons of Sustainable Development Goal 3. is menial and low-paid, and is not seen as an opportunity to gain skills In most countries, preference is still for future employment. In prison given to imprisonment, including for management, women are not afforded minor offences. The consequence of equal status and many prisons still this policy is the criminalisation of high cannot provide staff with decent and numbers of people, as well as prison acceptable working conditions. overcrowding – which can increase

2 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 INTRODUCTION

Introduction

2019 marks the third year of children, women, older people, and The prison environment as a whole collaboration between Penal Reform lesbian, gay, bisexual, transgender and impacts the health of prisoners, and International and the Thailand Institute intersex prisoners. prison health is not limited to the of Justice to create Global Prison provision of healthcare. As in previous In this edition’s Special Focus, we Trends. The spirit of this partnership editions of Global Prison Trends, highlight the impact prison can have lies in the acknowledgement that we look at the causes of prison on the physical and mental health of lasting, effective change cannot be overcrowding – a factor that negatively prisoners. Goals 2, 3 and 6 of the achieved in isolation. In the past impacts the health of all prisoners Sustainable Development Goals on decade, while there have been – which include the unnecessary hunger, health, and water and sanitation numerous positive steps in criminal use of pre-trial detention, ineffective are all related to the basic needs of justice and – such as criminalisation of drug users, and prisoners – which are not met in many the adoption of the revised UN Nelson disproportionate increases in the length prison systems around the world. Mandela Rules and the UN Bangkok of sentences, including a massive We believe that the primary purposes Rules – there are also many challenges increase in life sentences since the of prison are rehabilitation and that still need to be overcome. Only beginning of the century. reintegration. Rehabilitation is, however, with this spirit of collaboration and only possible if prisons enable offenders Through Global Prison Trends 2019, multi-stakeholder engagement can we to rebuild their lives, by learning, we hope to show that society as a move towards a more humane criminal developing and preparing to positively whole is affected by the management justice system. The fifth edition of contribute to society. Prisoners often of criminal justice and prison systems. Global Prison Trends is our joint effort have higher prevalence of physical We aim to inform policymakers and civil to provide a platform to bring pressing and mental illnesses than the general society alike: turning our attention to issues related to crime prevention and population, but healthcare in prison building fair and effective criminal justice criminal justice to the foreground. is too often neglected across high, systems will help to strengthen respect This year, Penal Reform International medium and low-income countries. for human rights, which in turn will help is also proud to celebrate its 30th to solidify the rule of law and achieve As well as healthcare for prisoners, anniversary. As we reflect back on the the Sustainable Development Goals. ensuring that care is given to the health past 30 years, it is clear that there are of prison staff is also vital. Staff health certain groups of people in prison who has an impact on the attention given are especially vulnerable and whose Florian Irminger to the health of prisoners. Healthy Dr Kittipong Kittayarak needs must be addressed. Designed, prison staff are obviously better Executive Director Executive Director built and managed for men, our equipped to deal with the particularly Penal Reform Thailand Institute criminal justice systems continue to be stressful situations they encounter, such International of Justice mostly ill-equipped to respond to the as self-harm, violence against others in needs of specific populations, such as prisons and .

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 3 KEY FACTS AND FIGURES

More than

10million BUT Men, women and children are PRISON IN PRISON WORLDWIDE CRIME POPULATIONS rates are in DECLINE are INCREASING

Prisons are OVERCROWDED % In at least 30of detainees are AWAITING TRIAL, presumed innocent 121 • Worldwide, prisoners COUNTRIES disproportionately come from MARGINALISED and POOR backgrounds According to one UK study The number of of Around the world WOMEN 95% CHILDREN & become displaced from CHILDREN GIRLS the family home when a in prison MOTHER goes to prison are DETAINED or increased by 53% LIVE in prison between 2000 2017 WOMEN PRISONERS BUT are often harshly Causing them sentenced for long-term 1 MORALITY > Compromised PRISONS that cater PSYCHOLOGICAL cognitive for a predominantly male and PHYSICAL development prison population are 2 DRUG HARM > Post-traumatic ILL-EQUIPPED to OFFENSES stress address the needs of > Increased women prisoners suicide risk

A growing number of A high proportion of women prisoners: Lack of gender-specific CHILDREN are being detained 1 commit minor non-violent healthcare: • in the context of offences > Increased risk of ill-health COUNTER-TERRORISM • are driven to offend due operations 2 Inadequate or non-existent to poverty rehabilitation opportunities: • are victims of abuse > Reinforced discrimination • have mental health and/or > Higher risk of reoffending drug-related issues

4 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 KEY FACTS AND FIGURES

The number of PEOPLE in PRISON increased by

The use of the BUT this is linked to an 20% INCREASED USE in between DEATH 2002 2015 PENALTY LIFE is DECREASING SENTENCES

The number DRUG- of prisoners serving OVERCROWDING RELATED creates LIFE SENTENCES increased by convictions INSANITARY and VIOLENT FAIL TO REDUCE drug consumption or PRISON drug-related crimes, % but 84 INCREASE between prison CONDITIONS populations > HARMFUL to prisoners’ 2000 2018 physical and mental wellbeing > impede REHABILITATION

In many countries SOLITARY PRISONERS are still CONFINEMENT PREVENTED is still WIDELY USED despite its severe STAFF detrimental effect SHORTAGES on mental health and budget cuts in many countries have led to an increase in

from having regular VIOLENCE TORTURE CONTACT in prison, where and degrading with the STAFF ARE AT RISK treatment of prisoners for their physical and OUTSIDE WORLD is mental wellbeing PREVALENT in many countries

Death in prisons: SUBSTANDARD prison conditions and • Female prison officers POOR TREATMENT of prisoners leads to serious SUICIDE are a minority and many is the single most face HARASSMENT common cause at work, both from HUMAN RIGHTS prisoners and other staff VIOLATIONS

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 5 CRIME AND IMPRISONMENT

Prison officer in prison corridor, Japan.

Worldwide, the common thread is that prisoners disproportionately come from poor and marginalised backgrounds

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PART ONE Crime and imprisonment

Crime rates and the use of imprisonment Despite the efforts made by the vulnerable.7 A report by the global Europe. Outside of Russia, Europe’s international community to harmonise initiative Know Violence in Childhood8 prison population has increased how crimes are categorised,1 it estimated that at least three out of by three per cent. The significant remains a challenge to accurately every four of the world’s 1.7 billion decrease in Russia’s prison population measure crimes rates across the children had experienced some form has led to the closing of 93 prisons world. This is not least because of of interpersonal violence, cruelty or in the last seven years.12 the fragmented and incomplete data abuse in their daily lives during 2015, The US still maintains its position available. However, there is evidence regardless of whether they lived in as the country with the world’s to suggest that there has been an rich countries or poor, in the global highest national rate of imprisonment overall decrease in the rate of crime North or the global South. Although (675 prisoners per 100,000 of the globally, although there are large violence against children is a universal national population), far ahead of the variations regionally and between phenomenon, regional differences do next countries on the list – El Salvador countries.2 There are two notable areas exist. For example, the highest rates (597 per 100,000) and Turkmenistan where the rates of offending have of physical and sexual violence against (552 per 100,000). Significant changes increased significantly: cybercrime children were found in Africa, the have taken place in individual countries and drug-related crimes.3 With Middle East and South Asia, while the since the 11th World Prison Population regard to the increase in cybercrime,4 highest homicide rates were in Latin List was produced in 2015. From one (unproven) hypothesis is that America and West and Central Africa. 2015 to 2018, there was a large ‘traditional’ crime has not necessarily The 12th edition of the World Prison increase in the rate of imprisonment in decreased but has migrated or Population List, produced by the Cambodia (a 68 per cent increase in ‘reinvented’ itself in the context Institute for Criminal Policy Research prisoners per 100,000 of the national of cyberspace.5 (ICPR) in 2018, estimates that there population), Nicaragua (61 per cent), The crime of intentional homicide were over 11 million people in prison (53 per cent) and the is regarded as one of the most globally in 2018, either in pre-trial (48 per cent). There have also been measurable and comparable indicators detention or after conviction and large decreases in the past three years for monitoring rates of violent deaths, .9 Around half of all prisoners in Mexico (23 per cent) and Romania and is often considered both a proxy are in just four countries – the US, (22 per cent). for violent crime as well as an indicator China, Russia and Brazil. There is no simple explanation for of levels of security within countries. There are very significant regional these widely varying rates in the While an overall decline in intentional differences in prison populations. use and over-use of imprisonment. homicide was observed from 2004 to Since 2000, the total prison population However, the ICPR finds that ‘the net 2015,6 there were significant regional in Oceania has increased by 86 per result of these divergent trends is a variations and high concentrations cent; in the Americas by 41 per world in which the rate of increase of intentional homicide in certain cent; in Asia by 38 per cent; and in in the known total prison population countries and within very specific Africa by 29 per cent. Particularly (3.7 per cent) continues to exceed urban areas. Latin America is the large increases have been recorded the increase in the general population region with the highest homicide rates in South America (175 per cent) and (3.0 per cent)’. in the world. However, this violence Southeast Asia (122 per cent).10 is concentrated in certain countries The size of the prison population In Europe, by contrast, the total and cities. is defined by two simple factors: prison population has decreased by how many people are sent to prison Based on available data, men account 22 per cent,11 reflecting large falls in and how long they are kept there. for 80 per cent of homicide victims prison populations in Russia (45 per Explanations for an increase in the globally, with young men particularly cent) and also in Central and Eastern

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 7 CRIME AND IMPRISONMENT

use of imprisonment that outpaces An interesting case in point is Worldwide, the common thread is that the increase in the global population Kazakhstan, where the prison prisoners disproportionately come from need to be sought at local levels. population fell from 57,000 in 2011 poor and marginalised backgrounds. They are likely to include a highly to 35,000 in 2018.13 This was achieved A large number come into conflict with complex mix of criminal justice policies in part by reducing the length of prison the law due to reasons connected to and practices (such as ‘tough on terms, with the average sentence poverty. Once in the system, they lack crime’ policies and longer sentences) decreasing from nine and a half years the financial resources to afford proper and social, cultural and economic to eight and a half, and in part by legal representation or monetary factors (such as rising inequalities). the increased use of non-custodial bail and are more likely to be given Evidence of a relationship between sanctions for minor offences. Along prison sentences than non-custodial levels of imprisonment and rates with this fall in the prison population, options. A cycle of deprivation is then of criminal activity remains highly measures to encourage the recording created, from which people struggle contested and many researchers of crimes were strengthened in to break free. This cycle perpetuates assert that there is very little evidence Kazakhstan – but the overall crime rate itself through generations, as evidence that the use of imprisonment effectively has still declined.14 suggests that children of prisoners lowers criminal offending. are also more likely to end up in the criminal justice system themselves.15

Prison overcrowding Prison overcrowding persists as recently that 518 men were crowded to release up to 3,000 prisoners in a global concern, and in large part into a space meant for 170, and that .23 In Côte d’Ivoire, more is caused by the excessive use of on at least one shift, there was only than 4,000 prisoners accused of pre-trial detention. Data from the one correctional officer on duty for non-political crimes were pardoned ICPR shows that in 121 countries, every 528 prisoners.18 The Philippines in January 2018 and a further 4,000 the number of prisoners exceeds the Commission on Audit stated that: were pardoned in September,24 while official prison capacity.16 This is likely ‘congestion in jails leads not only to in Egypt over 700 prisoners received to be an underestimate of the true health and sanitation problems but a presidential pardon.25 picture, not least because particular also to increased gang affiliation of In there were plans to release prisons or sections of prisons can be inmates. To sustain survival, inmates prisoners early26 in response to a overcrowded even if the prison system hold on to gangs or “pangkat” where 2017 High Court ruling that the as a whole is not. they find protection, network of social state should provide at least three support and most importantly, access The impact of overcrowding on the square metres of living space for to material benefits.’19 lives of prisoners can be enormous, prisoners; in some prisons in Israel, leading to insanitary and violent Strategies for addressing overcrowding prisoners only have 2.2 square metres conditions that are harmful to their are set out in comprehensive detail per person – while the standard physical and mental well-being and in different international and regional set by the European Committee which do not support rehabilitation. guidelines and tools.20 On the whole, for the Prevention of Torture and Staff working in overcrowded prisons they entail strengthening crime Inhuman or Degrading Treatment are also at risk and are more likely prevention measures, expanding the or Punishment (CPT) is six square to face potential violence, the risk use of alternatives to both pre- and metres for a single-occupancy cell of contracting infectious diseases, post-trial detention (see Pre-trial and four square metres per and increased stress and mental detention, page 12 and Alternatives for a multiple-occupancy cell.27 health issues. When prisons are to imprisonment, page 40), reviewing Another common solution to overcrowded, prison management the length of sentences, limiting the overcrowding is to build more prison and resources are so stretched that use of recall of prisoners on capacity. For example, a new prison they are only able to provide the basic or , and ensuring consistent is due to be opened this year in necessities for those under their care. sentencing practices. Cambodia, where prisoners can The Philippines has the most Amnesties and pardons continue pay to be detained in a building overcrowded prisons in the world, to be used as a short-term solution with additional space.28 In Slovakia, and its institutions are currently to overcrowding, as well as for the Justice Ministry plans to build operating at 463 per cent capacity.17 other more politicised purposes. In a new prison with capacity for This can be largely attributed to September 2018, over 2,000 prisoners 832 prisoners,29 while in President ’s ‘war on were released in Rwanda, including there were proposals for temporary drugs’ that has resulted in a huge some high-profile political detainees.21 sheds to be built to accommodate increase in arrests in recent years. A new amnesty law was introduced the expanding prison population.30 In City jail, it was reported in Bolivia,22 and there were plans

8 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 CRIME AND IMPRISONMENT

A prisoner sleeps on the top of a bunk bed placed in the communal area outside cells due to overcrowding, US.

Prison overcrowding persists as a global concern, and in large part is caused by the excessive use of pre-trial detention

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 9 CRIME AND IMPRISONMENT

Elsewhere, there were moves towards to decriminalise petty offences in RECOMMENDATION 01 a more sustainable and long-term order to address prison overcrowding Prison overcrowding needs approach to reducing overcrowding. and in recognition of the fact to be addressed as a key factor In Nigeria, a Presidential Advisory that criminalising such offences affecting the physical and Committee was established in order ‘contributes to discrimination and mental health of prisoners to focus efforts on decongesting marginalisation by criminalising and staff. States should put the country’s prisons, which have poverty, homelessness and measures in place to strengthen 31 a 136 per cent occupancy rate. unemployment, and impact[s] the crime prevention, decriminalise In 2018 the African Commission on poorest and most marginalised petty offences, review the 32 Human and Peoples’ Rights produced persons in our communities’. proportionality of sentencing guidelines urging states and increase the use of alternatives to imprisonment.

Closing space for civil society Civil society organisations33 play a vital mandated to conduct regular visits have grown more confident’.37 Civil role within criminal justice and prison to all types of places where persons society actors that engage in politically systems. They act as watchdogs are deprived of their liberty.34 Civil sensitive or human-rights related and highlight human rights abuses society organisations often have activities are particularly targeted, and corruption; provide a specific role as part of NPMs. and restrictions are in part driven by services to defendants and prisoners; According to the Association for the heightened international focus on monitor conditions and treatment the Prevention of Torture (APT), the counter-terrorism. inside prisons through formal and benefit of this is to supplement the Such restrictions have affected informal mechanisms; link prisoners resources and expertise of existing how civil society organisations with their families and communities; institutions and to ‘help to legitimize can access funding and how support prison staff; advocate for both an NPM’s mandate and its they engage with governments. transparency and accountability; share credibility as an institution, not least For instance, since 2012 Russia information, knowledge and skills to because civil society organisations has obliged foreign-funded civil build consensus on evidence-based are often structurally independent society organisations engaged in law and policy; and offer services from government’.35 ‘political activities’ to register as and programmes that are essential Whether working within NPMs or ‘foreign agents’, while in Ethiopia, for prisoners’ rehabilitation and providing reintegration support, civil the government has prohibited reintegration into society on release. society needs to be able to operate organisations working on human Crucially they bridge the gap between within an enabling environment. rights issues from receiving more communities and prisons and bring This means working in favourable than 10 per cent of their funding a sense of normality to prison settings economic, political, social, cultural from abroad (it should be noted that that are often far from normal. and legal conditions that allow citizens this law is currently being revised). Civil society organisations also to engage with civil society. In the In Egypt, a 2017 law governing civil play a role in the work of external past decade, there has been an society prohibits engagement ‘in prison monitoring bodies, such as alarming trend towards restricting the any work of political nature’ and national human rights institutions, space that civil society can operate requires organisations to seek prior Ombudspersons, health inspectorates in. According to data from the permission before cooperating with or anti-corruption bodies. As of International Center for Not-for-Profit any foreign entity.38 October 2018, 88 United Nations Law, between 2004 and 2010 more Restrictions on the legal and regulatory (UN) member states had ratified the than 50 countries considered or environment in which organisations Optional Protocol to the Convention enacted measures restricting civil operate have also constrained their against Torture and other Cruel, society.36 The global alliance CIVICUS ability to fulfil their role properly. The Inhuman or Degrading Treatment reported that in 2018 there were UN Special Rapporteur on the rights or Punishment, and 70 of these serious systemic problems with the to freedom of peaceful assembly states have now designated National space for civil society in 109 countries, and of association describes how Preventive Mechanisms (NPMs) – and concluded that ‘the enemies having a complex legal environment torture prevention monitoring bodies of human rights and social justice

10 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 CRIME AND IMPRISONMENT

relating to the functioning of civil harassment, criminal prosecution RECOMMENDATION 02 society ‘has the effect of destabilizing and intimidation. In other cases, it Civil society organisations and intimidating associations by has resulted in organisations closing, working in prisons and generating confusion and increasing moving or adapting to the new advocating for criminal justice the administrative burden of continuing environment. The impact is often and prison reform need to their activities, while instilling fear of felt more acutely in countries where operate in a secure space, free 39 action among their members’. prison systems are under-resourced from attacks and without the and rely on civil society to provide The impact of closing space for civil imposition of unnecessary or material support for prisoners. It is society of course varies from country arbitrary restrictions. States more intangible when organisations to country and sector to sector. should ensure a safe and internalise a sort of self-censorship However, organisations working on enabling environment for civil and move away from working on more issues around criminal justice and society that is supported by a sensitive issues (such as exposing the prison reform are often impacted robust national legal framework use of torture in detention facilities) the most, because of the human and which is grounded in to working on less sensitive ones rights focus of their work. In some international human rights law. (such as the provision of services cases, this has resulted in attacks, to prisoners leaving prison).

Restorative justice Restorative justice processes include conflicts between prisoners or reducing the number of children in mediation, conciliation, conferencing between prisoners and prison officers) detention across the criminal justice and sentencing circles, and are and ‘proactive applications’ (such as system more widely.48 defined as any process in which the building relationships within criminal A number of other countries have victim, offender and other relevant justice institutions or communities). announced new initiatives. The Ministry individuals or community members Restorative justice principles also of Justice in Jamaica is looking to affected by a crime actively participate feature as part of the implementation establish more restorative justice together in the resolution of matters of the European Union (EU) Victims’ centres to complement the nine arising from that crime, generally with Rights Directive.42 centres that have been established the help of a facilitator. Restorative Civil society organisations and other since the adoption of the Restorative justice has long been used in informal stakeholders are now looking at Justice Act in 2016.49 The Justice legal systems and, in recent years, ways in which the Recommendation Department in Alberta, Canada, there has been a significant expansion can be successfully implemented.43 pledged an additional CAD$4.5 million in its use within formal legal systems. In Scotland, the government has to its victims of crime fund, which Although there are barriers to its committed to making restorative includes funds to pay for restorative uptake – such as concerns about due justice services widely available justice measures.50 Since November process and net-widening – there is across the country by 202344 and 2018, survivors of domestic or sexual a growing evidence base that it can to publishing a Restorative Justice violence in Australia have, for the first be cost-effective, aid in victim recovery, Action Plan in 2019, and has also time, been able to access restorative and help reduce . It is now issued statutory guidance for service justice services, although given the commonly used in several countries providers and facilitators.45 serious risk of traumatising individuals and regions such as Australia, North who have experienced abuse, America, Europe, and Central and In the last few years, there has been mediated sessions will only take place Eastern Asia, whether as part of a trend in several Eastern European under strict conditions.51 sentencing or at other points within and Central Asian countries towards criminal justice proceedings. the development of new codes on justice for children, many of which RECOMMENDATION 03 A key development in the use of have incorporated progressive Policymakers, practitioners and restorative justice was the adoption of restorative justice principles. The other professionals involved in a Council of Europe Recommendation Albanian Code of Juvenile Justice criminal justice should promote in 201840 stating that it should be a for example requires that alternative and use restorative justice ‘generally available service’, rather than measures aimed at the enforcement processes in a way that is safe, being contingent on the type of crime, of restorative justice be considered effective and evidence-based. the age of the offender, the stage of as a first option.46 In Georgia, the the criminal justice process or the Juvenile Justice Code, adopted in geographical location of the victim.41 2015, makes specific provision for The Recommendation also promotes diversion and mediation programmes the use of restorative justice outside of that are supervised by social workers criminal justice procedures in ‘reactive employed by the National Probation applications’ (such as resolving Agency.47 This has been pivotal in

Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 11 TRENDS IN THE USE OF IMPRISONMENT

PART TWO Trends in the use of imprisonment

Pre-trial detention Pre-trial detention should be an guilty. In addition, they are often held suggests that its over-use has led exceptional measure – only to be used for long periods in pre-trial detention to a widespread perception that the when necessary and proportionate and and subsequently acquitted or given justice system is broken. Cynicism and in compliance with the presumption of a community-based sanction. For disdain for the rule of law has in turn innocence and the right to liberty.52 Its example, research conducted by Penal contributed to popular support for the use is only acceptable as a measure Reform International (PRI) in 2016 on belief that citizens should take matters of last resort and in very limited women serving community sentences into their own hands and respond circumstances.53 Around 30 per cent in Kenya showed that of 97 women themselves to criminality.62 of prisoners globally have not been offenders interviewed, 87 per cent had Lack of access to legal representation convicted and in some countries over been in pre-trial detention before being and inability to pay monetary bail are 60 per cent of people in prison are in given community sanctions. Most had common drivers of the excessive use pre-trial detention.54 There were close not been granted bail and those who of pre-trial detention and are closely to three million people held in pre-trial were could not meet the monetary bail linked to poverty. A 2018 audit by detention and other forms of terms or security required.59 the Office of the Director of Public imprisonment throughout the world on The impact on individual prisoners Prosecutions in Kenya revealed that any given day in 2016, when the most of any period of time spent in pre-trial nine out of 10 pre-trial prisoners had recent figures were published.55 This detention can be devastating, but it been granted bail or bond but could figure is likely to be an underestimate, is worse if the detention is protracted. simply not afford the terms, and as it does not include detention in People taken into pre-trial detention approximately the same proportion custody. The total number are uprooted from their community had no legal representation.63 In June remanded into custody each year is and social and family connections 2018, California became the first of course much higher, reaching a total are disrupted. They are also at risk of state in the US to abolish the cash of approximately 14 million people.56 feeling pressured into pleading guilty bail system for suspects awaiting Since 2000, the numbers of pre-trial in order to obtain lesser sentences. criminal trial; defendants will instead prisoners have grown rapidly in the According to the Open Society be released if they are deemed likely Americas (an increase of 60 per Foundation, prisoners in pre-trial to appear for court hearings and pose cent) and Asia (34 per cent), while in detention are commonly held in worse little danger to the public – this will Oceania the pre-trial population has conditions than convicted prisoners be determined by a risk assessment grown by as much as 175 per cent.57 and are at increased risk of being process that uses data and Africa and Asia have seen a far more tortured.60 A 2018 global report on mathematical formulas to generate modest rise, but pre-trial prisoners children held in pre-trial detention risk scores.64 Some organisations still constitute over 40 per cent of the found that time spent in pre-trial have argued that the new process will prison population in much of Africa detention results in an increased risk not sufficiently address racial bias in and in many countries in southern and of torture; false confessions and unfair decision-making and may in fact result western Asia. In Europe by contrast, plea bargains; increased corruption; in an overall increase in the rate of the pre-trial prisoner population has physical and mental abuse; prison pre-trial detention.65 fallen by 42 per cent since 2000.58 overcrowding; long-term social Other reasons behind the excessive and developmental impacts; and Data on the length of time people use of pre-trial detention include a lack increased recidivism.61 spend in pre-trial detention is hard to of adherence to time limits, which are find. However, research suggests that Excessive and prolonged pre-trial imposed in order to regulate the time remand prisoners can be detained detention can also have a wider spent in pre-trial detention. Where for excessive periods of time that detrimental impact on public such time limits do exist, there can be are often disproportionate to the perceptions of the justice system. a lack of appropriate record-keeping sentence they would receive if found Recent research in the Philippines to help ascertain how long detainees

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have been in custody; little clarity as , kidnapping and several other In New Zealand, the number of to who is responsible for ensuring crimes, and draft legislation is currently people held in pre-trial detention was adherence to custody time limits; and before parliament to widen this range reduced over a relatively short period a lack of mechanisms to identify when of offences to include home burglary of time during 2018, by introducing detainees have been held in excess and possession of weapons.68 In efficiencies to the system – such of the custody time limit. In a recent Ghana, by contrast, levels of pre-trial as having bail advisors in prisons ruling, the European Court of Human detention fell from 30 per cent in 2007 who proactively work with new Rights found that Hungary had violated to 12 per cent in 2018.69 A contributory remand prisoners in order to support the right to liberty when it kept a man measure to this was a Supreme Court applications for electronic monitoring; in pre-trial detention for over three ruling that made all criminal offences providing bail support services at years without properly assessing the subject to bail.70 court hearings, including connecting reasons for extending his detention people with and drug abuse One tool that is used to address both each time it was reviewed.66 A 2018 programmes; and providing a mobile overcrowding and pre-trial detention global report on children in pre-trial phone application for people on bail is the introduction of plea bargaining. detention surveyed 118 countries in order to provide them with updated Widespread in the US, the practice and revealed that 26 per cent of these information regarding their hearings has increased significantly elsewhere countries have no pre-trial detention and available support.73 around the world in recent years. limit for children; 43 per cent have a The NGO Fair Trials reported on this pre-trial detention limit that applies to in 2017 and found that there has RECOMMENDATION 04 children only; and 31 per cent have a been a 300 per cent increase in plea Pre-trial detention should generally applicable pre-trial detention bargains worldwide since 1990.71 The be used as a last resort and limit that applies to both adults and same report also found that without only where necessary and children. The report concludes that a adequate procedural safeguards, there proportionate. Legal aid and new international time limit should be are considerable concerns about its assistance should be provided introduced that restricts the amount use and expansion: innocent people and, where monetary bail of time children can spend in pre-trial can be persuaded or pressured to is used, this should be set detention to a maximum of 30 days.67 plead guilty; easier convictions can according to the circumstances Some states operate a system of encourage over-criminalisation and of the individual defendant. mandatory denial of pre-trial release drive harsher sentences; there can be The use of non-custodial for certain crimes. This is a particular an inequality between the negotiating measures should be increased issue in Mexico, where 40 per cent partners and a lack of transparency and states should develop of the total prison population are held where ‘deals’ are done by prosecutors effective systems to help ensure in pre-trial detention. The Mexican and defence counsels behind closed that detainees spend no longer constitution already requires mandatory doors; and public trust in justice can in pre-trial detention than is pre-trial detention in cases of murder, be undermined.72 strictly required by law.

Sentencing Sentencing decisions are shaped new precedents on sentencing; and Meanwhile, research from Italy found by a complex mix of objectives. As perceptions about new or different that increases in sentence length, well as punishment, these objectives patterns of offending. either through mandatory minimums, include rehabilitation, the protection sentence enhancements or more The public is often thought to favour of society and deterrence. The severity severe sentencing, are unlikely to a tough approach to sentencing, in and length of sentences imposed have much deterrent effect when which prison is viewed as the only for similar crimes across the globe the baseline sentence is already long.77 ‘real’ punishment and is easier to vary enormously, suggesting that understand than community-based Several countries have developed the assessment of these objectives sanctions. In practice, this assessment sentencing guidelines and/or is interpreted very differently. Even of public opinion may not always be established an advisory sentencing within jurisdictions, the rationale for accurate or up to date. Research council or commission to assist sentencing can vary from case to demonstrates that when more in sentencing decisions. This is case and from judge to judge. There information is provided to members of often done to address a perceived is some evidence to suggest that the public about a case, their opinions lack of confidence or fairness in in many jurisdictions, sentences align more closely with the sentences the sentencing process or wide of imprisonment are getting longer actually imposed by the courts.75 A inconsistencies in sentencing – particularly for serious offences.74 recent review of over 50 public opinion practice. For example, in 2018 Tougher sentencing practice arises surveys and polls in the US found that Scotland introduced sentencing through the interplay of several there has been ‘a significant thaw’ guidelines for the first time, which set factors: an increasingly punitive in terms of punitiveness that could, out ‘fairness and proportionality’ as climate of political and media over time, produce a paradigm shift core principles for sentencing and debate about punishment; legislative towards prevention, rehabilitation and defined the purposes of sentencing changes; new sentencing guidelines; reintegration as policy objectives.76 as rehabilitation, protection of the

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public, punishment, giving the offender peoples in prison and to facilitate the often developed by private businesses, the opportunity to make amends, use of appropriate community-based which keep their algorithms and and expressing disapproval of and restorative sentences. underlying research a proprietary offending behaviour.78 secret, even from the courts or Effective sentencing requires that the government agencies that use them.88 Elsewhere, countries have moved court has access to assessments of The NGO ProPublica conducted away from using imprisonment as a the risk an offender poses to public an investigation of one such risk sentence for minor offences. In Cape security, the factors that lie behind their assessment algorithm, COMPAS, Town, , a High Court judge offending, and the support they can which is used as an aid to judicial ruled that all people given sentences draw on to move away from crime. decision-making, its conclusions being of less than two years should instead The UN Standard Minimum Rules for only one of the variables considered perform community service, given Non-custodial Measures, also known by the judge when deciding on that defendants are ‘generally poor as the Tokyo Rules, explicitly note the the sentence. Defendants answer and casualties of socio-economic value of such assessments.84 Their 137 questions, including whether they conditions’.79 In Scotland, judges are importance was highlighted in research have a telephone at home, difficulty now prevented from sentencing people that found that the use of community paying bills, family history and criminal to less than six months’ imprisonment sentences has fallen recently in history. COMPAS then rates the in all but exceptional cases. In England England, which may be linked to an person on a scale from one (low risk) and , the government expressed accompanying decline in the extent to 10 (high risk). ProPublica found a commitment to scrapping sentences to which pre-sentence reports are that the formula used was particularly of less than six months in order to provided to judges.85 likely to flag black defendants as future reduce overcrowding, and also as In some jurisdictions there has been offenders, labelling them at almost recognition of evidence that short a move towards more evidence-based twice the rate as white defendants.89 sentences are less effective at cutting sentencing practices, which aim to In addition, the scores generated reoffending than community sentences improve sentencing decisions by by the algorithm were unreliable in – they are ‘long enough to damage giving courts access to an empirical forecasting violent crime and only you and not long enough to heal assessment of the static and dynamic 20 per cent of the people predicted you’.80 The language being used is of factors that make it more or less to commit violent crimes actually went ‘smart’ sentencing – a choice between likely that an offender will reoffend. on to do so.90 effective and ineffective justice rather An offender is typically assigned a than between ‘hard’ and ‘soft’ justice. At present, this kind of artificial risk ‘score’ that is also used to inform (See Alternatives to imprisonment, intelligence has not been widely rehabilitation interventions.86 A low-risk page 40). adopted in other regions. In Europe, offender may receive a non-custodial for example, only the UK has piloted Gender bias exists in sentencing sentence, while those deemed to be predictive tools for judges to assess decisions. A report on women on at a higher risk may be more likely to the risk of reoffending. However, in found that criminal justice be imprisoned. The argument is that recognition of the associated risks, the actors frequently see women as these risk assessment instruments can European Commission for the Efficiency victims and survivors, rather than as predict the risk of reoffending with a of Justice published an ethical charter perpetrators of crime.81 While this high degree of accuracy, impartiality on the use of artificial intelligence in assumption can benefit some women and objectivity. judicial systems.91 This promotes a who receive reduced sentences, Such risk assessments are often precautionary approach and spells out ‘[a]t the same time, women who are produced by probation or court key standards that need to be in place, seen as violating entrenched norms of welfare officers. However, a including ensuring that the design and gender behaviour may be sentenced fast-moving trend in the US is the use implementation of artificial intelligence more harshly’.82 (See Women, page 20). of computer-based criminal justice tools and services are compatible Other biases related to an offender’s algorithms that generate risk models with fundamental rights; preventing ethnic or racial minority background for courts based on vast quantities of the development or intensification of are also evident. (See Foreign national data. Many of these risk assessment any discrimination between individuals prisoners, minorities and Indigenous algorithms take into account personal or groups of individuals; making data peoples, page 21). In 2017, the US characteristics of the offender, such processing methods accessible and Sentencing Commission found that as age, sex, geography, family understandable; and ensuring that despite the purpose of the federal background and employment status. users are informed actors and are in sentencing guidelines to promote They are used to inform decisions not control of their choices.92 sentencing uniformity across just about sentencing but also about geographic and socio-economic lines, bail. In practice, they mean that two RECOMMENDATION 05 black defendants received longer people accused or convicted of the States should review the sentences than white defendants same crime may receive quite different proportionality of sentencing convicted of similar offences, even bail or sentencing outcomes. policy and practice. Mandatory when factors such as criminal history, The use of these tools has been minimum sentences should be age, education and citizenship were heavily criticised on the basis that they discontinued – particularly for controlled.83 In Australia, Canada and are unreliable and can lead to racial non-violent crimes – and the use New Zealand, Indigenous sentencing profiling, and that there is little clarity or of alternatives to imprisonment courts have been established transparency about how the algorithms should be promoted specifically to address the issue of weigh different variables.87 They are and strengthened. overrepresentation of Indigenous

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Death penalty Progress continues towards the global 2,500 people faced active death of respondents called for the death abolition of the death penalty, and a sentences.105 Washington became penalty for rape under the influence record number of UN member states the 20th state to abolish the death of drugs, only 33 per cent supported – 120 out of 193 – voted in favour of penalty, on the grounds that it was it for other serious crimes related a moratorium on its use at the UN imposed in an ‘arbitrary and racially to illegal drugs. Among those who General Assembly in December 2018. biased manner and fails to serve any disagreed with the death penalty, Thirty-five states voted against a legitimate penological goal’.106 The at least 42 per cent cited religious moratorium and 32 abstained.93 This Governor of California introduced a reasons and 21 per cent thought is an improvement from December moratorium on executions that will last it possible for rehabilitation to 2016, when 117 states supported as long as his current term of office take place.116 the resolution.94 Several countries (until 2023).107 In Belarus, 13 people were executed changed their vote in favour of the Despite these positive trends, there while their cases were under resolution for the first time, including were reports of a resumption of examination by the UN Human Rights , Dominica, Libya and executions in Botswana,108 and in Committee (the Optional Protocol to Malaysia. Currently, 103 of 193 states June 2018, Thailand executed a the ICCPR recognises the competence have abolished the death penalty for 26-year-old man for aggravated of the UN Human Rights Committee all crimes and 139 have abolished the murder in the country’s first execution in considering individual cases of death penalty in law or practice.95 since August 2009.109 According to alleged violations of rights contained Other positive developments in , Japan saw an in the ICCPR).117 In all of these the past year were Burkina Faso96 ‘unprecedented spate of executions’ cases, the Committee had issued and Malaysia97 moving towards the in July 2018, with the execution of interim measures of protection to halt abolition of the death penalty, and in 13 members of the religious cult Aum executions from taking place while the September 2018, The Gambia ratified Shinrikyo (Aum), who were found cases were being considered. the Second Optional Protocol to the responsible for a deadly sarin gas While waiting for their execution – often International Covenant on Civil and attack in Tokyo in 1995.110 In August for years on end – death row prisoners Political Rights (ICCPR), committing 2018, Taiwan carried out its first are frequently detained in particularly to the full abolition of the death execution since 2016, thereby putting harsh conditions, irrespective of penalty.98 As of March 2019, 86 states an end to its de facto moratorium.111 whether or not they present an actual had ratified the Second Optional There were several reports in 2018 security risk. The severe emotional Protocol to the ICCPR.99 In June 2018, of death sentences being handed distress prisoners experience during the Caribbean Court of Justice in down to foreign nationals in Iraq the lengthy wait for execution has Barbados unanimously declared the for terrorism-related activities. For been found to violate the international mandatory death penalty for murder example, in May 2018, a Belgian prohibition against torture. In 2018, unconstitutional.100 national was given a death sentence the Pope joined the debate, stating by the court in Iraq.112 (See Foreign International found a that executions were unacceptable in national prisoners, minorities and positive downward trend in executions all cases as they were ‘an attack’ on Indigenous peoples, page 21). worldwide for drug offences, reporting human dignity.118 a decrease of 90 per cent since 2015. New laws in several countries resulted In Japan, prisoners are given just a This was driven in part by a significant in an expansion of the scope of the few hours’ notice before execution.119 fall in the use of the death penalty for death penalty for certain crimes. In In the state of Virginia in the US, drug offences in .101 Currently, at April 2018, Mauritania adopted a law conditions were so bad on death row least 35 countries and territories still making the death penalty mandatory that a federal district court issued maintain the death penalty for drug for ‘blasphemous speech’ and an injunction in 2018 to remedy the offences and four of these carried out ‘sacrilegious acts’.113 In April 2018, situation after a lawsuit challenging the executions in 2018: Iran, China, Saudi passed an executive ordinance conditions was filed.120 The applicants Arabia and Singapore.102 In a worrying approving the death penalty for anyone – prisoners on death row – argued trend, the Sri Lanka Cabinet approved convicted of raping a child under the that their conditions violated the a move to bring back the death age of 12 years.114 constitutional prohibition against cruel penalty for drug-related crimes,103 and The use of the death penalty continues and unusual punishment. Conditions the Bangladeshi government approved to divide public opinion. Though it was included 23 hours a day alone in cells a draft bill – the Narcotics Control Act abolished in the Philippines in 2006, of 6.6 metres; no contact visits; no 2018 – which made the manufacture there have been calls to reinstate it – congregate meals; no congregate and distribution of particularly in the context of President recreation, religious, educational punishable by death.104 (See Drugs Duterte’s ‘’. In a national or social programming; only three and imprisonment, page 18). survey, the Commission on Human showers a week; and just five hours In the US, death sentences and Rights of the Philippines interviewed of outdoor recreation per week in executions decreased in number for approximately 2,000 people about separate, isolated cages.121 the 18th consecutive year and, for the use of the death penalty in relation the first time in 25 years, fewer than to drug crime.115 While 47 per cent

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A report in early 2018 by the Cornell Center on the Death Penalty Women and the violence and it is exceedingly rare Worldwide examined the risk factors for family violence to be treated as and systemic flaws that led to wrongful death penalty a mitigating factor during sentencing proceedings for death penalty convictions and use of the death Available data indicates that there are cases. In some countries, the death 122 approximately 500 women on death penalty in six countries. Common penalty is mandatory for certain row globally. Most of these women factors included ineffective assistance offences, in which case there is have been sentenced to death for of legal counsel; torture and coercion no possibility for a woman’s prior the crime of murder, often of a close leading to false confessions; mistaken history of abuse to be considered. family member following a history of Even in countries with discretionary eyewitness identification; misconduct gender-based violence.123 Drug-related capital sentencing, courts often by officials; lengthy pre-trial detention; offences are the next largest category ignore or discount the significance of crimes that women are sentenced fair trial violations; obstacles to of gender-based violence. This was to death for, particularly in the Middle appeal and post-conviction review; highlighted by the case of Noura East and Asia.124 racial and ethnic discrimination; Hussein, a 19-year-old Sudanese and false or misleading forensic There are striking similarities woman who was sentenced to death evidence. Short of abolition, the report around the world among women in May 2018 for killing the man she concludes that basic procedural sentenced to death for murder, was forced to marry at the age of 16, as he and his accomplices tried safeguards are required to minimise and most cases involve long-term abuse by a family member and the to rape her for the second time. An the risk of wrongful convictions and absence of effective outside help.125 appeals court eventually overturned death sentences. Economic dependence, fear of losing her death sentence and replaced it custody of a child, widespread with a five-year sentence.127 Her case RECOMMENDATION 06 societal tolerance of violence against received international attention, but women, and the difficulty and stigma many other similar cases do not. Countries that still retain involved in obtaining a divorce Detention conditions in most of the the death penalty should exacerbate the effects of family states that retain the death penalty abuse. Several women sentenced move progressively towards fall far short of minimum standards, to death, particularly in Iran and its abolition. Countries that although there is little research Nigeria, had been forcibly married implement the death penalty about the living conditions of women at a young age.126 should uphold the highest fair specifically. In general, the situation trial standards and make efforts When prosecuting women, courts for women on death row is an to improve the conditions of routinely fail to consider their under-researched area which merits 128 prisoners on death row. history as survivors of gender-based more attention.

Life imprisonment The global trend towards the abolition Life without parole sentences (LWOP) There are still 67 countries that retain and restriction of the death penalty mean that the prisoner has no life imprisonment as a penalty for has resulted in many states adopting possibility of having their sentence offences committed under the age life imprisonment as their most reviewed, so will be imprisoned until of 18. A further 49 countries permit serious sanction. (See Death penalty, his or her death. There has been a sentences of 15 years or longer, page 15). In 2014, there were an significant increase in the numbers of and 90 countries permit sentences estimated half a million people serving prisoners serving LWOP in the US, of 10 years or longer.134 There is a life sentences globally.129 Recent which accounts for half of all prisoners growing movement for the prohibition ground-breaking research revealed serving whole life sentences around of all forms of life imprisonment for that between 2000 and 2014, there the world.132 Other countries, such as children and the UN Human Rights was an increase of almost 84 per cent India and China, have recently adopted Council has called on member states in the number of people serving formal LWOP as a formal statutory sanction. repeatedly to prohibit it in law and life sentences worldwide, and formal practice.135 The UN Special Rapporteur The only country to still allow LWOP sentences of life imprisonment exist in on torture has also stated that ‘life for crimes committed under the age of 183 out of 216 countries.130 The same imprisonment and lengthy sentences, 18 years is the US. In October 2018, study also highlighted the increased such as consecutive sentencing, are the Washington State Supreme Court prevalence and growth in de facto life grossly disproportionate and therefore ruled that these sentences violate sentences, such as long, fixed terms of cruel, inhuman or degrading when the state constitution and found that imprisonment for as much as 99 years. imposed on a child. Life sentences or ‘children are less criminally culpable There are at least 64 countries that sentences of an extreme length have than adults, and the characteristics of have provisions for de facto life a disproportionate impact on children youth do not support the penological sentences, including 15 that do not and cause physical and psychological goals of a life without parole impose formal life sentences at all.131 harm that amounts to cruel, inhuman sentence’. In total, 26 US states and For instance, in the federal system in or degrading punishment.’136 the District of Columbia now prohibit Mexico, prisoners can face maximum or do not use life without parole fixed-term sentences of up to for children.133 140 years.

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The global trend towards the abolition and restriction of the death penalty has resulted in many states adopting life imprisonment as their most serious sanction

Prisoners in their cell in a female prison, Sierra Leone. © Boaz Riesel / AdvocAid.

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Prisoners sentenced to life In March 2018, the Constitutional ‘three strikes’ penalty. In 2018, the imprisonment face ongoing and Court in Malta added to the body of Caribbean Court of Justice upheld the severe human rights violations and ‘right to hope’ jurisprudence when it Belize Court of Appeal’s decision that their treatment is often worse than the ruled that a person sentenced to life in mandatory life sentences for murder treatment received by other prisoners. jail could be considered for parole after are unconstitutional. This means that They can experience poor living serving a minimum of 25 years.139 The judges have the discretion to impose conditions, restricted human contact Court stated that ‘the person who is a fixed-term sentence for individuals and little or no access to meaningful found guilty of the worst crimes must convicted of murder, rather than activities or rehabilitation programmes. not lose its dignity and must retain its mandatory life imprisonment or the They also face ongoing challenges right to hope that, after having paid for death penalty.143 As a result of this accepting the length of their sentence. its actions, be considered as having decision, at least 44 life-sentenced According to a recent study in Ireland, learned from the shortcoming and prisoners will be re-sentenced. political factors and fears of an change the path it had taken’.140 adverse public reaction played a key Following the Supreme Court of RECOMMENDATION 07 role in determining whether to release Kenya’s 2017 ruling that the mandatory The number of offences that long-serving prisoners.137 death penalty was unconstitutional, the attract life sentences or de The ‘right to hope’ has been government established a taskforce facto life sentences should recognised by the European Court which recommended that various be reduced, in line with the of Human Rights as a ‘fundamental offences that had previously carried principle of proportionality. aspect of...humanity’.138 The Court a death sentence should instead States should take measures has ruled that a life sentence in which be punishable by a penalty of life to abolish life sentences the prisoner has no hope of release imprisonment, including treason, without parole, which can is inhuman and degrading and thus murder and aggravated robbery.141 never meet fundamental human infringes Article 3 of the European In the US, the Senate passed the First rights standards. All forms Convention of Human Rights. It has Step Act in 2018,142 which brings to of life imprisonment should also emphasised the importance of the an end automatic life sentences for be prohibited as a penalty for rehabilitative purpose of imprisonment. certain federal offences under the offences committed under the age of 18.

Drugs and imprisonment In its World Drug Report for 2018, The global drug strategy for the next global drug control. Although some the UN Office on Drugs and Crime decade needs to be reshaped. Civil progress was made in acknowledging (UNODC)144 states that the range of society organisations have called for the failures of the past 10 years of drugs available and the size of the a focus on improving health outcomes, global drug control, the newly agreed drugs market continue to expand and compliance with human rights norms, Ministerial Declaration was criticised diversify robustly. While this is due to and promotion of peace, security and for re-committing the international the persistence of traditional drugs, development, in line with both the UN community to another decade of new psychoactive substances are Sustainable Development Goals and focusing on the elimination of the also emerging and the non-medical the outcome document of the UN drug market.149 use of prescription drugs has reached General Assembly Special Session The impact of on the epidemic proportions in some parts on drugs.146 In September 2018, the use of imprisonment is significant, of the world. Office of the UN High Commissioner and a report published in October for Human Rights (OHCHR) Implementation of the decade-long 2018 by the International Drug Policy contributed to the debate with a call UN Political Declaration and Plan of Consortium notes that ‘the sheer for more proportionate sentencing; Action on drug control comes to an number of people incarcerated a repeal of mandatory minimum end in 2019. The Declaration aimed for drug offences, as well as sentences for drug-related offences; to enhance international cooperation the proportion of people held in appropriate drug policies for women, and eradicate – or significantly pre-trial detention for drug crimes children, youth and vulnerable groups; reduce – the supply and demand for have contributed to severe prison the abolition of the death penalty for illicit drugs. An overall assessment overcrowding and dire conditions all crimes, including for drug offences; shows that governments have not in many parts of the world’.150 (See and a call to end human rights only failed to achieve the targets Pre-trial detention, page 12 and Prison abuses in the name of drug control.147 and commitments made in 2009, overcrowding, page 8). At the regional OHCHR also expressed concern at but in many cases have introduced level, the European Council adopted the increase in the militarisation of counterproductive policies that have its conclusions on the alternatives to civilian law enforcement agents and directly or indirectly resulted in human coercive sanctions in March 2018, the engagement of the military in ‘war rights violations.145 which recommend that EU member on drugs’ efforts.148 In March 2019, states make non-custodial measures the UN agreed a new framework for

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more widely available for drug and Southeast Asia in particular, to harm reduction – a key measure in offenders and that they implement governments have emulated the preventing harms associated with drug them effectively and monitor and punitive drug control approach taken use, including the transmission of HIV evaluate their effectiveness.151 by President Duterte in the Philippines, – is so limited that the prevalence of which has resulted in the killings infectious diseases is two to 10 times At the national level, there is growing of an estimated 27,000 suspected higher than in the community.161 polarisation in the approach to drug drug offenders, mass arrests and According to Harm Reduction policy, and so far 26 countries have arbitrary detention in overcrowded International, only 10 countries adopted a decriminalisation model.152 and unsanitary conditions.156 In implemented needle and syringe In late 2018, the South African May 2018, the Prime Minister of programmes in at least one prison in Constitutional Court ruled that a law Bangladesh launched a nationwide 2018.162 The same study reports that banning marijuana use in private anti-drugs campaign that led to the substitution is provided was ‘unconstitutional and therefore arrest of approximately 7,000 people in prisons in only 54 countries and invalid’.153 Also in 2018, several and resulted in the deaths of 200 women prisoners in general have no countries enacted laws allowing people at the hands of the police.157 access to such services. (See Special or expanding the medical use of The country also took steps to Focus, centrefold). marijuana – including New Zealand, reinstate the death penalty for ‘patrons Thailand, Luxembourg, Portugal and of drug traders, drug syndicates, Greece. In a bid to address prison RECOMMENDATION 08 and godfathers’.158 overcrowding, Thailand took steps Drug policies should be to amend its drug laws to ensure Similarly, the President of Sri Lanka evidence-based and include more proportionate penalties for drug declared that he was ‘ready to sign the decriminalisation of minor offences, and to allow for the licensed the death warrants of repeat drug offences, proportionality of medical use of marijuana and kratom offenders’ as part of the country’s sentencing, and non-custodial (a local plant used as a and efforts to combat drug-related crime.159 alternatives to imprisonment. painkiller).154 Myanmar is in the process Following presidential elections in Measurements of the outcomes of reviewing its drug legislation to Colombia and Brazil, both countries of drug policies should include address the ongoing imprisonment cracked down on people involved their impact on human rights, of large numbers of people involved in illicit drug activities, resulting in health, peace, and security in the illicit drug market. Canada increased levels of violence, human and development. adopted a legally regulated market for rights abuses and, in the case of in July 2018, and various Brazil, an exacerbation of its prison Caribbean countries are considering overcrowding crisis.160 similar initiatives.155 The ongoing criminalisation of Elsewhere, countries impose strict people who use drugs and the zero-tolerance drugs policies that stigma associated with drug use directly or indirectly result in increases is a significant barrier to prisoners’ in the use of imprisonment. In South right to health. In prisons, access

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PART THREE Prison populations

Women Women and girls are a minority within also means that women are unlikely Many women prisoners are single prison systems, making up just 6.9 per to benefit from legal systems where mothers and are responsible for cent of the global prison population.163 financial restitution can lead to a children and other dependents. However, female prisoners are rapidly reduction in sentence (including Research in the UK revealed that only increasing in number: from 2000 to avoiding detention). five per cent of children remain in the 2017, the number of women and girls family home when a mother goes to The World Health Organization in prison globally increased by more prison and they may encounter other has reported alarmingly high than 50 per cent, while the male prison significant changes such as moving rates of mental health problems population increased by around 20 per school and being separated from amongst female prisoners, such cent.164 Eastern and Southeast Asian siblings.174 The Council of Europe as post-traumatic stress disorder, states have the biggest proportions has issued policy guidelines aimed at depression, anxiety and a tendency of women prisoners, including Hong safeguarding the rights and interests to attempt self-harm and suicide.171 Kong (approximately 21 per cent), of the 2.1 million children in Europe Women prisoners have often been Qatar (15 per cent), Kuwait (14 per who have imprisoned parents. The victims of violence; research from cent) and the United Arab Emirates guidelines include avoiding the arrest the UK found high levels of brain (11 per cent).165 of parents in front of children; using injury amongst women prisoners. measures such as home leave, open Women are frequently convicted Of 173 female offenders screened prisons and electronic monitoring; of non-violent offences. They also using a brain injury screening index allowing children to visit their parents continue to be imprisoned for ‘morality’ tool, 64 per cent reported a history within a week following arrest; offences such as failing a indicative of a brain injury and regular visits without interference with test166 and for suspected abortion.167 many had sustained the injury as a education; child-sensitive searches Harsh enforcement and sentencing consequence of .172 and visiting environments; the use policies for drug offences, particularly The clinical supervisor for the study of technology to keep parents and for low-level trafficking offences, have stated that people who have suffered children in contact; and specialised a disproportionate impact on women brain damage ‘may be more prone training for detention staff.175 offenders.168 Eighty-two per cent to being impulsive and have less of all women in prison in Thailand emotional resources to deal with Women from Indigenous communities are imprisoned for a drug offence; anxiety or anger’, putting them at and ethnic minorities face significant in the Philippines, the proportion of a higher risk of criminal offending. disadvantages in the criminal women in prison for a drug offence Similar research in New Zealand justice system, due to the double is 53 per cent and in Peru and Costa found that 94 per cent of women discrimination of gender and race Rica it is more than 60 per cent.169 In prisoners presented with a history – which is usually coupled with Brazil, 63 per cent of women in prison of brain injury.173 poor socio-economic status and in 2014 were there because of minor education. The rate of criminalisation The implications of this are significant, drug-related offences – compared to and imprisonment of Indigenous both in terms of treatment by the a quarter of men.170 women is particularly concerning in criminal justice system but also Canada, Australia and New Zealand. Poverty is a significant driver of within prisons, where women with In Australia, Aboriginal and Torres women’s offending. Their backgrounds brain injuries should be identified Strait Islander women comprise 34 per are typically marked by economic and provided with personalised and cent of women in prison but only two deprivation and household disruption, therapeutic interventions to manage per cent of the adult female Australian which points to longstanding failures the health, cognitive, behavioural, population.176 In New Zealand, of social policies and policies to social and emotional consequences adult Indigenous Maˉori women are counter discrimination in society of their injury, including aggressive disproportionately imprisoned; they and employment. Their inability to behaviour. They may also need comprised 67 per cent of women access economic resources has additional support with related sentenced to imprisonment in 2017, implications for their ability to access secondary conditions such as drug despite only 15 per cent of New bail and legal representation. This or alcohol dependency. Zealand’s population identifying

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as Maˉori.177 Drug policies can also Australia for example, a woman was crimes. The judgment gave authorities disproportionately impact minority left to give birth alone in her cell.180 60 days to apply the order, which will women. In Canada for example, In Russia, inspectors found that affect at least 4,500 women who are more than half of all women serving women were working 18 hours a day currently detained.183 The government sentences for drug-related offences stitching garments.181 in Zimbabwe announced plans for an in federal prisons are Indigenous and for women in prison with Various progressive initiatives have black women.178 (See Foreign national their children.184 In most countries been introduced to implement the prisoners, minorities and Indigenous however, efforts to implement the UN Rules for the Treatment of Women peoples, below). Bangkok Rules remain fragmented Prisoners and Non-custodial Measures and gradual. It is well-documented that prisons for Women Offenders (the Bangkok are designed and run for the majority Rules). In Florida, in the US, the Dignity male prison population – from prisons’ for Incarcerated Women Act was RECOMMENDATION 09 architecture and security procedures passed which, inter alia, guarantees When women are sentenced, to healthcare, family contact, work that women have free and unlimited the court should take the and training. A report by the United access to products and context of the criminal conduct States Department of Justice found prohibits male staff from performing into account, as well as any three main areas where the needs strip and cavity searches on women.182 experience of victimisation or of women held in federal prisons The Brazilian Federal Supreme Court any caretaking responsibilities. are still not being met: trauma decided that pregnant women and States should ensure that treatment programming, pregnancy mothers with children under the age prison policy and practice programming, and feminine hygiene.179 of 12 will be placed under house comply consistently with the Women continued to experience arrest instead of in pre-trial detention, Bangkok Rules. abusive conditions during birth; in if they are accused of non-violent

Foreign national prisoners, minorities and Indigenous peoples

People from minority groups continue Foreign nationals’ experience of The FORINER project was funded to be discriminated against within prison is characterised by isolation, by the European Commission and criminal justice systems and are language barriers, limited or no lasted for two years. It provided foreign disproportionately represented within family contact, discrimination and national prisoners from EU countries prison populations worldwide. a limited understanding of the prison with access to education offered by regime and broader criminal justice their home country. An evaluation Foreign nationals are a growing procedures. In addition, they face found that the majority of participants population in many prison systems, challenges linked to their believed that these courses would although there is considerable variation status – such as deportation – as well reduce the likelihood of recidivism between countries. For example, as difficulty in accessing rehabilitation and make it easier for them to find they represent 87 per cent of all programmes. One distinctive right that a job after prison. More than half the prisoners in the United Arab Emirates foreign nationals have is access to students indicated that they hoped and just 0.3 per cent of prisoners in consular support, although diplomatic participation in the course would the Philippines.185 This variation can missions are often not able or willing to improve their relationship with their largely be attributed to factors such as provide this.187 family and friends.190 geographical location and immigration policies. In Europe, foreign nationals Countries have addressed these There is a large proportion of foreign make up 21 per cent of the prison challenges in different ways, including national women prisoners held in population, on average.186 Foreign the provision of a picture book for various countries and regions globally, nationals are over-represented in prisoners to aid communication,188 mainly for drug-related offences and comparison to their numbers in the prisoners of the same nationality for breaching immigration laws – general population in part because mentoring new arrivals, the provision including many migrant workers. For of disadvantages they face during of video conferencing to enable example, in the United Arab Emirates, the criminal justice process, such as contact with family abroad, and as of June 2018 there were nine increased targeting by police, language training in different languages for staff. women under sentence of death; barriers, a lack of access to legal aid, In Austria, which has a large number all but one were foreign nationals, and and discriminatory sentencing, as well of prisoners who are non-German most were migrant workers.191 In Hong as increasingly punitive approaches to speakers, a private company supplies Kong and Macau, which have the immigration-related offences. online interpretation services to prison largest proportions of female prisoners staff between 8am and 6pm for a globally, the majority of women are handful of pre-defined languages.189 foreign nationals; most have been

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convicted for either drug trafficking 2016–17 – an eight-point increase the provision of tailored courses, such or immigration violations (common from 10 years ago. In New Zealand, as the Indigenous Higher Education among foreign sex workers).192 Maˉori people are 11 times more likely Pathways Program.198 than other offenders to face prison While the experience of women Ethnic and racial minority prisoners are time once convicted.195 foreign nationals in prison has been also often over-represented in prison overlooked, research in Portugal found In late 2017, the Australian Law systems and are particularly likely to that they reported problems with Reform Commission produced a have multiple needs due to their social managing family relationships, and report setting out how to achieve not and economic marginalisation. When their inability to care for children and just formal but substantive equality they are released from prison, these relatives was particularly distressing. before the law for Aboriginal and groups may face particular barriers The women also felt they had fewer Torres Strait Islanders. It took a ‘justice to rehabilitation, and existing support rights in the criminal justice process reinvestment’ approach — broadly, services may not take into account on account of their gender and the notion that there should be a their special cultural needs. They are nationality.193 redirection of criminal justice resources also likely to face discrimination when away from imprisonment and towards seeking housing, employment and Indigenous peoples are heavily over- strategies that can better address social support. represented in prison populations – the causes of offending. However, particularly in Australia, Canada and the government has been criticised New Zealand – and this is a persistent RECOMMENDATION 10 for not taking steps to implement and growing problem, especially for States should closely monitor this approach.196 women. (See Women, page 20). In the representation of foreign Australia, Aboriginal and Torres Strait When in prison, Indigenous nationals and people from Islander adults comprise 27 per cent peoples do not always receive the ethnic and racial minority or of the national prison population individualised treatment they require. Indigenous backgrounds in but only approximately two per cent In New Zealand, only five out of criminal justice systems. They of the national population, which the country’s 18 prisons offer Te should review sentencing has been described as a ‘national Tirohanga, a rehabilitation course policies or practices to disgrace’ and is attributed to social tailored for Maˉori people that has been determine if they are and historical factors.194 Although successful in reducing reoffending.197 discriminatory, and develop they comprise about five per cent In Australia however, technology has specific measures to meet the of Canada’s population, Indigenous been used to support Indigenous rehabilitation and reintegration peoples accounted for 27 per cent peoples to access education through needs of these prisoners. of the population in

Children and young people In 2018, there was both sustained Justice, to bring it up to date and to raise the age of criminal responsibility and positive progress in many reinforce key provisions; it is expected from eight to 12 years was approved countries in establishing specialised to be finalised during 2019.200 in principle by Parliament.204 justice systems for children, as Recently there has been ongoing Ethiopia was commended by the well as alarming reports of serious discussion in some countries African Committee of Experts on the violations – particularly in the context regarding the minimum age of criminal Rights and Welfare of the Child for of counter-terrorism operations responsibility. In the Philippines, it establishing over 70 child-friendly and for children in detention. At the is currently fixed at 15 years of age courts.205 In Thailand, there were plans international level, work on the UN but a congressional committee has to replicate the success of the Baan Global Study on Children Deprived now approved a bill lowering it to 12, Kanchanapisek facility for children, of Liberty continued; the report is using widely discredited arguments which has recidivism rates of just five expected to be available in late 2019. that children need protection from per cent – compared with 15 per cent It will provide up-to-date research, being forced to commit crimes by in other facilities.206 In Malawi, civil data and information on the situation adults.201 In Australia, the minimum society organisations were successful of children deprived of their liberty, age of criminal responsibility is low in litigating for a High Court ruling not just in the criminal justice system at 10 years old, and as many as 600 that 267 children held in adult prisons but also in the context of immigration, children under 14 are imprisoned each should be immediately moved to armed conflict, national security year;202 however, following a Royal juvenile reform centres, particularly and when children live in places of Commission recommendation, there given the food shortages, disease risk detention with their parents.199 The UN are moves towards raising it to 12 and overcrowding that the children Committee on the Rights of the Child years of age in at least two states and were exposed to in the adult prisons.207 is also in the process of revising the territories.203 In Scotland, legislation to 2007 General Comment on Juvenile

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Recently there has been ongoing discussion in some countries regarding the minimum age of criminal responsibility

Children in detention sleep on plywood beds in a cell, the Philippines.

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Children, neuro-disability rights or engaging in interviews); in identifying the indicators of and limit the effectiveness of many prominent neurodevelopmental and the criminal justice rehabilitative interventions.208 disorders and in understanding the implications for behaviour and system Research in the UK regarding the engagement. Appropriate language prevalence of such disabilities Neuro-disability – also referred to should be used to interview a child consistently demonstrates as neurodevelopmental disorders or with neuro-disability, and they should disproportionately higher rates disabilities – encompasses a range otherwise be treated by justice among young people in youth justice of conditions, including attention professionals who are trained and custodial institutions, compared to the deficit hyperactivity disorder, autism supported in understanding the general population.209 For example, spectrum disorders, learning/ ways in which neuro-disability might while reported rates of learning or intellectual disability, foetal alcohol affect a child’s capacity to engage in intellectual disability among young spectrum disorders, and acquired justice processes. people in detention vary greatly – from brain injuries. These conditions are 10 to 32 per cent210 – such rates are Judicial officers responsible for caused by a wide range of factors that much greater than the two to four per sentencing should take account compromise brain development and cent reported in comparable general of the relevance of neuro-disability function, including genetic factors, population studies.211 Experiences of to offending behaviour, including pregnancy-related complications traumatic brain injury appear to be the potential impact on the child of (including in-utero alcohol and drug particularly common.212 difficulties with reading, processing exposure), birth trauma, acute injury and memory, maturity of judgement, and illness. Children with neuro-disabilities face impulsivity and an understanding of a ‘double disadvantage’ in the justice Neuro-disabilities can result in the perspectives of others. Diversion system – they are both children and problems with cognition, memory and/or community-based sentences individuals with disabilities. They are and concentration, emotional should be preferred. Detention particularly vulnerable to violations of functioning, impulse control and facility employees, probation officers, their rights and have additional needs social judgement, and communication. social workers and others engaged that need to be protected through These associated problems have been in a child’s rehabilitation and stringent and effective safeguards. frequently identified as factors that reintegration should be aware of a increase the risk of offending; create Children in conflict with the law child’s neuro-disability and should barriers to effective engagement in should be screened for the presence provide appropriate management and judicial proceedings (for example, of neuro-disability, and justice rehabilitation support, to ensure that due to difficulties in understanding professionals should be supported the rights of the child are respected, protected and fulfilled.

The effectiveness of diverting children are Indigenous, yet Aboriginal and exposed to torture and enforced away from formal judicial proceedings Torres Strait Islander young people disappearance.220 In the UK, a serious at the police stage was emphasised aged 10 to 19 years only make up case review into abuse of children in in a 2018 global systematic review of 1.6 per cent of the state’s population. a secure training centre stressed the 19 high-quality studies. The review An inquiry has been launched to importance of organisations managing concluded that, relative to formal explore the reasons for this disparity.216 facilities to be vigilant in identifying, judicial processing, police-led diversion Nearly half of all youth who were responding to and monitoring modestly reduces future offending of in custody in Canada in 2016–17 allegations of abuse, and stated that low-risk youth, and recommended that were Indigenous, despite making a ‘culture of listening to, consulting police departments and policymakers up only eight per cent of the youth with and giving children a voice is should consider diversionary population.217 (See Foreign national crucial to developing safe cultures programmes as part of the range of prisoners, minorities and Indigenous within organisations’.221 solutions for addressing youth crime.213 peoples, page 21). A growing phenomenon is the Children from certain groups continue In the past year, serious violations of investigation, detention and to be disproportionately represented children’s rights occurred in detention prosecution of children in the context in justice systems around the world. facilities around the world. Ninety per of counter-terrorist operations. In In the US, 44 per cent of imprisoned cent of the participants of a 2018 2018, children with alleged ties to youth in 2015 were African American, study of children and young adults Al-Shabaab in Somalia were arrested despite African Americans comprising detained in São Paulo State, Brazil, and at times prosecuted in military only 16 per cent of all youth in the said the military police had mistreated courts, while in Lebanon, children country.214 In addition, the juvenile them during arrest, and 25 per cent were also tried in military courts for justice agency of the United said that juvenile detention staff had terrorist-related offences.222 Human States Department of Justice has beaten them.218 In Papua New Guinea, Rights Watch also reported on the discontinued a number of important it was reported that police often beat abuse of children in detention by the research projects designed to assist children in detention and housed them Kurdistan regional government.223 In states in reducing the disproportionate with adults, despite a child justice law its Handbook on Children Recruited imprisonment of black and other that states that they should be kept and Exploited by Terrorist Groups, minority young people.215 In Australia, separate from adults during all stages the UNODC argues that when children approximately 16 per cent of young of the criminal justice process.219 have been recruited and exploited by people either held in youth prisons or Reports emerged from Egypt in terrorist and violent extremist groups, serving a corrections order in Victoria 2018 that children in detention were they should be treated primarily

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as victims. If they are arrested and convicted of. The prohibition on the RECOMMENDATION 11 prosecuted, their victimisation should execution of child offenders is so There are clear and explicit be taken into account and they widely observed that it has attained international standards on should be dealt with in accordance the status of a peremptory norm of justice for children which should with international standards on child international law. However, a very apply in all contexts, including 224 justice at all times. Research on small number of countries continue for children (allegedly) involved these issues in Europe concluded to retain the death penalty for crimes in terrorist or violent extremist that children were being unnecessarily committed by children. During 2018, offences. Children should be and disproportionately criminalised it was reported that Iran executed detained only as a measure of for expressing opinions, often online, at least five individuals who were last resort, and there is growing that are viewed as glorifying or sentenced to death for crimes they evidence of the effectiveness of 225 226 inciting terrorism. allegedly committed as children, diverting children away from while South also executed a The ICCPR and the Convention on formal judicial proceedings – child.227 Several people remained on the Rights of the Child both expressly which should be done as much death row in Saudi Arabia for crimes forbid capital punishment for offenders as possible. committed when they were children.228 who were under the age of 18 at (See Death penalty, page 15). the time of the offences they were

Elderly people The definition of when someone pre-trial proceedings, long sentences Another threat to the health of becomes ‘elderly’ is unclear, although and barriers to early release, as well elderly prisoners is long-term abuse consensus is emerging that, for as elderly prisoners being charged of substances, which is common prisoners, it is at around 50 years with historical offences, such as amongst this population, as well as and over. This is because the prison sexual abuse offences.234 In Japan social and psychological issues related environment itself is associated with and Singapore, there have been to ageing – such as managing the an accelerated ageing process, with reports that old age itself is a trigger loss of a partner or friends. These prisoners’ health status generally for offending because it results in additional needs generate financial considered to be equivalent to that increased levels of poverty and a lack burdens on already under-resourced of people 10 years older in the of family and social support.235 The prison systems. According to the general population. Japanese Ministry of Justice reported American Civil Liberties Union, it costs that in 2017 the proportion of elderly twice as much to imprison someone The world’s population is continuing to former offenders returning to prison over the age of 50 and in some cases, age: nearly every country in the world was notably high, with many facing it may cost up to five times more when is experiencing growth in the number unstable prospects outside jail due to medical costs are added.239 and proportion of older people in their inadequate support from their families population.229 In many countries, the Efforts have been made to specifically and difficulty in finding employment.236 proportion of elderly prisoners also address the needs of . In the US, the ‘greying’ of prisons is follows this upward trend; at present, In Japan, a new policy to detect accounted for by both an increase in this has been identified mainly in dementia in prisoners will be rolled admissions of older people to prison high-income countries, although this out in 2019 with the aim of detecting and the use of longer sentences as may be a result of the availability of the condition at an early stage a public safety strategy.237 data. Across the European region, and providing treatment to ensure the proportion of the prison population The increase of elderly prisoners effective reintegration on release.240 who are over the age of 50 is an creates new and difficult challenges The Singapore Prison Service has average of 11.7 per cent, ranging from for prison authorities. Older people retrofitted some prison cells with 44 per cent in Lichtenstein to three per in prison face health conditions senior-friendly features such as cent in Russia.230 In Japan, the number associated with the advancement handrails.241 Prison officers in Scotland of prisoners aged 60 or older rose of age, such as falls, increased frailty, have been given training on how from seven per cent of the total prison dementia, incontinence and sensory to work with people suffering from population in 2008 to 19 per cent in impairment. A report on social care in Alzheimer’s and dementia.242 2016,231 and in Singapore, the number jails in the UK highlighted some of the In Kenya, an appeal court questioned of prisoners over 60 doubled between practical issues that can arise when the use of mandatory sentences for 2012 and 2016.232 In the UK, the caring for older prisoners: ‘Many older elderly people ‘as the compulsory proportion of prisoners aged over 50 jails are ill-equipped for prisoners in sentences amounted to committing increased from seven per cent in 2002 wheelchairs, or with mobility problems. them to a slow death behind bars.’243 to 16 per cent in March 2018.233 Some prisoners struggle to wash and In some jurisdictions, there is the look after themselves and others who In a new publication on the issue, possibility for elderly prisons to be have fallen cannot get help during the International Committee of the given early release on compassionate the night.’238 Red Cross (ICRC) attributes the grounds; for example, in Cambodia rise in elderly prisoners to lengthy prisoners over the age of 65 are

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eligible to request a royal pardon.244 to care for them; improving their levels policy framework on the treatment However, research in the US has of safety given their vulnerability and of older people in detention – either found that early release programmes risks of victimisation; and promoting as a stand-alone document or as part on compassionate grounds are not their rehabilitation, given that this age of a broader policy on ageing’. in fact widely used for older people. group is highly unlikely to reoffend.246 They exclude many prisoners who Prison authorities have been slow to RECOMMENDATION 12 are not eligible because of the type recognise and address the needs of States need to collect data and of sentence or the crime committed, elderly prisoners. The ICRC report information regarding the needs and some only allow release for on ageing and detention concludes of older prisoners and explicitly people who are terminally ill – but lack that to deliver the kind of reforms address these in strategy and an efficient process for application required, policymakers need to have policy documents, with a focus and approval, leaving sick prisoners explicit strategies – with existing plans on safety, healthcare needs and to die before they can complete and resources falling short of what is rehabilitation. Early release the process.245 required to guarantee basic dignity for mechanisms should be adopted older detainees. The report notes that Researchers in the US have identified and used for older prisoners. ‘in all likelihood, this would be better three key areas of reform: placing older achieved by drawing up an official prisoners in facilities designed explicitly

Lesbian, gay, bisexual, transgender and intersex people There has been progress with regard the Independent Expert on sexual denies their human dignity but also to the rights of lesbian, gay, bisexual, orientation and gender identity have allows authorities to ignore and avoid transgender and intersex (LGBTI) urged states to repeal such laws.252 their obligations to respect and fulfil people over the past few years – these rights.’255 Data regarding LGBTI prisoners is but only in some parts of the world. scarce. Where it is available, it reveals Transgender prisoners are highly Notably, during 2018, the Supreme that they tend to be disproportionately vulnerable in detention settings and Court of India unanimously ruled to imprisoned, even in jurisdictions where a number of jurisdictions are starting decriminalise same-sex relationships same-sex relations and expression to respond to this. In 2018, the Israel and in early 2019, Angola did the of diverse gender identities are not Prison Service produced a new same. However, in many places criminalised.253 In prison, LGBTI policy on transgender prisoners that LGBTI people still face widespread prisoners are more likely to be should halt the practice of keeping stigmatisation and persecution. There sexually victimised, report mental them in isolation.256 In the US, are 73 countries – mostly in the health problems, experience solitary Connecticut became the first state Middle East, Africa and Asia – where confinement and be subjected to give transgender prisoners the same-sex activity between consenting to sanctions. They are frequently legal right to be housed according adults is illegal,247 and there are still discriminated against because of their to their gender identity.257 However, a number of countries where it is sexual orientation or gender identity across the US there has been a subject to the death penalty, including and expression, and are harassed rollback of LGBTI rights under the , Iran, Pakistan, Sudan, and face violence because they do administration of President Donald Saudi Arabia, the United Arab Emirates not conform to gender expectations. Trump, including removing protections and Yemen.248 At the same time they are not actively for transgender prisoners.258 According to the UN Subcommittee encouraged to speak out about their for the Prevention of Torture, a clear experiences, nor do many prison RECOMMENDATION 13 causal link has been established authorities consider their needs. In Placement decisions for between the criminalisation of lesbian, 2018, the APT produced a guide for LGBTI prisoners should keep gay, bisexual and transgender persons monitoring bodies which provides an them safe and avoid further and increased exposure to violence, overview of how authorities should marginalisation on the basis including by law enforcement, prison identify patterns of abuse against of sexual orientation or gender staff and healthcare personnel.249 LGBTI people and proposes measures identity. LGBTI prisoners should For example, many people have to prevent ill-treatment and torture.254 be given adequate access to been detained in a new crackdown In a recent blog for PRI, the APT medical care and counselling on gay men in Chechnya,250 and made the point that: ‘“Don’t ask, and any protective measures sexual violence – mainly in detention don’t tell” policies in prison settings, should not restrict their rights. settings – is cited by LGBTI civilians which essentially demand that as a primary reason for fleeing the LGBTI prisoners “make no noise” Syrian Arab Republic.251 Both the UN and render themselves invisible, is Special Rapporteur on torture and a disturbing one, which not only

26 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 GLOBAL PRISON TRENDS SPECIAL FOCUS 2019

HEALTHCARE IN PRISONS

This Special Focus examines:

The importance of providing health services in prison that are independent of the prison administration and equivalent to those provided in the country as a whole.

Ways of reducing risks to health and promoting well-being.

Ensuring the right to health for groups of prisoners with specific needs.

Pull-out section SPECIAL FOCUS

Healthcare in prisons

This Special Focus explores the potential that prisons have to be settings for the prevention of disease, the promotion of health, and for identifying and treating physical and mental health needs for the benefit of individual prisoners, staff and communities as a whole. It draws on international standards, such as the UN Sustainable Development Goals (the SDGs). It also draws on the Guidance Document on the Nelson Mandela Rules, produced by the OSCE Office for Democratic Institutions and Human Rights and Penal Reform International (PRI), as well as PRI’s Mental health in prison: A short guide for prison staff.

Introduction

Rates of disease, substance They may also have substance Poor sanitary conditions increase dependency and mental illness dependence and be suffering the chances of skin or parasitic among prisoners are much from withdrawal symptoms. diseases, and the lack of sunlight, higher than in the community. fresh air, heating or ventilation Once in prison, the conditions in People in prison often come from can also seriously affect which prisoners live in can create impoverished and marginalised prisoners’ health. serious risks to their physical and backgrounds where they mental health. Prison populations The transmission of diseases may have been exposed to have a disproportionately high is rife in overcrowded facilities, transmissible diseases and rate of people suffering from placing the lives of both prisoners inadequate nutrition, and their mental health or behavioural and staff at risk. Communicable access to good quality health problems, many pre-dating diseases are a particular services will have been limited. prison and others developing, concern, with rates for Some prisoners may have or worsening, when in prison due between 10 and neglected their health and may to poor conditions and a lack 100 times higher than in the never have been treated by a of mental healthcare. A lack of community.1 Prisoners are five qualified doctor before their access to sufficient nutritious times more likely to be living with imprisonment, particularly if they food and safe drinking water HIV than adults in the general come from rural or remote areas. and inadequate opportunities population, and they have been Additionally, people in prison for physical exercise – all of identified by UNAIDS as a key may have a history of abuse. which are common in prison population that has been left settings – can also contribute behind in responses to the to the deterioration of health. AIDS epidemic.2

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Every human being has the right to the highest attainable Useful resources on the World Health Organization, standard of physical and mental Moscow Declaration: Prison health health. When a state deprives right to health in prison as part of Public Health, 2003. someone of their liberty, it takes OSCE Office for Democratic World Health Organization and on the duty of care to provide Institutions and Human Rights the International Committee for medical treatment and to and Penal Reform International, the Red Cross, Information Sheet: Guidance Document on the Nelson protect and promote his or her Mental Health and Prisons, 2005. Mandela Rules: Implementing the physical and mental health and United Nations Revised Standard World Health Organization, Good well-being.3 This duty of care Minimum Rules for the Treatment governance for prison health in the is critical, because prisoners of Prisoners, 2018. 21st century. A policy brief on the organization of prison health, 2013. have no alternative but to rely Penal Reform International, Mental on the authorities to promote health in prison: A short guide for World Health Organization, Prisons and protect their health. prison staff, 2018. and Health, 2014. The revised UN Standard UN Office on Drugs and Crime, The Worldwide Prison Health Minimum Rules for the Treatment Handbook on Prisoners with Research and Engagement Special Needs, 2009. Network (WEPHREN) provides of Prisoners (known as the a forum for all stakeholders 4 Nelson Mandela Rules) also UN Office on Drugs and Crime, interested in prison health across emphasise state responsibility Handbook on Women and the world to exchange ideas and for healthcare and confirm that Imprisonment, 2nd edition, 2014. develop collaborative, multi-centre people in prison should enjoy the research. (www.wephren.org). same standards of healthcare that are available in the community. The Rules elaborate be obtained; and up-to-date and health for people deprived of further on obligations relating confidential medical records their liberty continues to be to prisoners’ health: people in should be maintained and should deprioritised. Prison can be an prison should have access to accompany each prisoner important setting for preventing necessary healthcare services on their journey through the and addressing physical and free of charge and without prison system. mental health inequalities among discrimination on the grounds the prison population. Identifying of their legal status; health staff In general, the provision of and responding to ill-health working in prisons should have healthcare in prison settings and mental health needs is a clinical independence; continuity across the world is underfunded, vitally important component in healthcare is important; understaffed and of a lower of a prisoner’s journey towards prisoners need prompt access standard than in the wider rehabilitation and reintegration to healthcare in emergencies; community. Looking at the on release, which in turn can informed consent of the SDGs, Goal 3 on health will reduce reoffending. prisoner to treatment should not be achieved if the right to

Provision of healthcare: a ‘whole-of-government’ approach

Independence approach is the requirement If healthcare staff are directly of healthcare staff for healthcare staff to operate employed by the prison service, independently of the prison or if they appear to be overly The World Health Organization administration, so that any friendly with regular prison staff, (WHO) and the UN Office on clinical and health assessments prisoners are unlikely to trust Drugs and Crime (UNODC) of detainees are based solely them – particularly if the prisoners state that ‘the management on medical criteria. This have been ill-treated by prison and coordination of all relevant independence is important for staff. If they are not independent, agencies and resources prisoners so that they feel they healthcare staff may experience contributing to the health can trust the healthcare provider a conflict of interest and feel a and wellbeing of prisoners regarding their health conditions, greater sense of duty towards is a whole-of-government and can also speak to them the prison administration as 5 responsibility’. A crucial aspect openly in order to report torture their employer, than towards of this ‘whole-of-government’ or other ill-treatment. the patient.

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They may also operate in fear of and conditions are attractive, in Training negative consequences, including order to recruit and retain prison dismissal, if they do not comply healthcare staff. To adequately respond to with requests from prison staff, healthcare needs in prisons, and may themselves be subjected Continuity of care both staff and healthcare to retaliatory actions. providers may require specific Continuity of care is important, training opportunities and To guarantee this independence, not only on admission to prison support services. For example, direct hierarchical or even but also upon release, and is they should receive training on contractual relationships with generally easier to manage when how to report torture or other prison management should be prisoners are allocated to a prison ill-treatment within the prison avoided. Irrespective of their close to their usual place of system, including in cases where conditions of employment residence. When individuals with it may have occurred outside (whether they are a civil servant, specific medical conditions are prison and is identified upon a public employee or private released from prison, healthcare prisoner’s arrival. To this end, contractor), medical staff should professionals in the prison should all healthcare staff should be always be independent of police consider whether they need to provided with a copy of the or prison authorities. The WHO provide them with medication to Manual on Effective Investigation and the UNODC argue that account for the time it may take and Documentation of Torture the best way to safeguard the them to arrange further medical and Other Cruel, Inhuman independence of healthcare staff is consultations and receive a or Degrading Treatment or to ensure that they are employed regular supply of medication. The Punishment (known as the by healthcare authorities rather requirement to provide continuity Istanbul Protocol), and should than by correctional authorities.6 of care also includes a duty to be trained in applying it.9 They properly manage and transfer should also receive training on Equivalence of care a prisoner’s medical files. When human rights and . a prisoner is transferred, their Healthcare professionals have All prison staff should receive medical files should be transferred a duty to provide equivalence training on first aid.10 This is to the healthcare service of the of care, meaning that they should important because they are often receiving institution and should be provide the same standard of the first responders in the event subject to medical confidentiality.8 healthcare that a prisoner could of an emergency health situation. expect to receive in the outside The most effective way of Nelson Mandela Rule 76(d) also world.7 To achieve equivalence ensuring continuity of care is to requires that all staff receive of care, it is vitally important to assign responsibility for providing training on the psychosocial adequately resource and fund healthcare in prisons to the needs of prisoners and on social prison health services and to national health authority. If this care and assistance, including employ sufficient numbers of is not possible, there should be early detection of mental suitably trained staff. This will be close links between community health conditions. possible only if salaries and terms and providers.

Reducing the risks to health and promoting well-being

Assessment Initial medical screening enables unlikely to have medication with health personnel to detect and them, or may be too disoriented Newly arrived prisoners may have record any injuries, including and stressed to remember to pre-existing, untreated health potential signs of torture and take their medication as required. conditions and/or undiagnosed other ill-treatment. Access to a Prison medical services may mental health conditions. Physical medical professional as soon as also need time to acquire and and mental health conditions possible upon admission ensures provide the specific type and are likely to be exacerbated that prisoners with pre-existing quantities of medical supplies by imprisonment and should health conditions continue to needed by individual prisoners. therefore be identified as soon receive the care they need and Communicable diseases also as possible after admission, so have access to appropriate need to be identified and that the prisoner can receive medication and other treatment. treatment provided, with any appropriate treatment. Newly arrived prisoners are

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Temperatures in prison A number of reports surfaced I could afford. There was a tiny hole in 2018 that revealed the harms in the wall, but can you imagine Extreme temperatures in prisons caused by extreme temperatures. how much air you would absorb in can result in unacceptable and In the US, hundreds of prisoners such a crowded space? We made inhumane conditions that threaten were locked in their cells during a request for an electric fan, but it the health and well-being of a week-long power blackout, never arrived.’16 both staff and prisoners, some during which prisoners were left The Nelson Mandela Rules state of whom will be especially in darkness, without heat and that a should regularly vulnerable, including children, hot water for some of the coldest inspect the temperature of a prison older people and those in poor days of the winter.12 Conversely, in and that accommodation and health. This will become an Arizona in the summer, prison logs clothing should be appropriate for increasingly important issue as showed temperatures of up to 119 climatic conditions,17 while the global temperatures increase. degrees Fahrenheit (48 degrees European Prison Rules stipulate Exposure to high heat can lead Celsius).13 In the UK, prisons built in that all accommodation for prisoners to an increase in aggression, the 1800s proved inadequate during should have adequate heating.18 The overall poor mental health and, a summer heatwave and the lack European Court of Human Rights19 in serious cases, to death. In 2011, of ventilation resulted in ‘oven-like’ has also recognised adequate 10 people imprisoned in the US conditions.14 In Fuchu prison in temperature as a basic requirement died from heat-related causes, Japan, heating routinely does not for acceptable prison conditions. triggering lawsuits that resulted function and frostbite is a common Prison systems now need to adapt in the state agreeing to place complaint.15 permanent air conditioning units to the impending challenge of in facilities.11 Equally, prisoners In Cambodia, a former prisoner climate change, by reducing prison exposed to excessive cold may described living in a crowded prison overcrowding, closing or retrofitting suffer hypothermia, particularly if with her newborn baby: ‘It was inadequate facilities, and building they do not have adequate bedding actually a steaming room. I was sustainable and resilient facilities and clothing. using a fan made of a palm leaf to that ensure the health and cool my baby down – that was what well-being of prisoners.

necessary measures put in place health problems as soon as sanctions. Prisoners should have in order to prevent such diseases possible after admission means the opportunity to seek medical from spreading within the prison. that prison administrations can care and be able to access save resources by preventing healthcare services confidentially. The initial medical screening of illness or the deterioration The involvement of ‘gatekeepers’ a prisoner provides an important of health conditions, and by – such as cell leaders or prison opportunity to identify prisoners preventing communicable staff – in the process for obtaining at risk of suicide or self-harm. diseases from spreading to other a medical appointment should It is particularly important to prisoners or staff. By being aware be avoided. detect these signs at an early of the health situation of each stage, since the risk of suicide or Medical care should be available prisoner, prison administrations self-harm is much greater during at all times, including when cells can better plan for individualised the first days of imprisonment. are locked and staffing levels are rehabilitation programmes, Additionally, early identification of reduced. This may be a particular including appropriate training and such risks can help to determine concern at night, during weekends work opportunities. Prisoners with what the safe and appropriate and on national holidays. The health problems may be unable placement and supervision requirement for health services to to participate in established work should be for prisoners that be available at all times is linked programmes, or such programmes have been placed on suicide/ to the need for adequate staffing may need to be tailored to their self-harm alert. It is good practice levels of both prison officers and particular situation. to involve a psychologist in initial healthcare personnel. medical assessments. Ongoing healthcare Facilities should be easily Identifying health needs soon provision accessible, including for those after admission helps prison with physical disabilities. In administrations to plan relevant The Nelson Mandela Rules facilities that hold both male and healthcare provision, staffing make it clear that healthcare female prisoners or both adult and other resource requirements, professionals should talk with and child prisoners, there should including the special dietary and examine every prisoner, not either be separate facilities or needs of prisoners. It also only on admission but also as designated times when women assists prison management in necessary afterwards. To have full and child prisoners can access planning transport, staffing and access to all prisoners, medical healthcare services separately. other logistical arrangements staff should be informed about for scheduled hospital visits. where they are located, including Identifying existing or potential those undergoing disciplinary

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Healthcare for specific groups

Women menstrual products being used by well as women’s diverse cultural prison staff as bargaining chips to backgrounds.28 Where relevant Women in prison have different exercise power over women.23 programmes do not exist in and more acute healthcare prison, there is an increased It is estimated that around 75 per needs than men. This is partly duty on authorities to facilitate cent of women arriving in prison due to physiological differences, access of prisoners to relevant had some sort of drug-related and partly because of their programmes in the community.29 problem at the time of arrest.24 typical backgrounds, which Studies have shown that women The need for specialised can include drug use, physical prisoners who participate in such treatment programmes for or sexual abuse, sex work and programmes are more likely to be women substance abusers is unsafe sexual practices. Health successfully rehabilitated.30 conditions of women prisoners recognised by the UN Rules may have been untreated before for the Treatment of Women Women prisoners are a high-risk admission, due to discriminatory Prisoners and Non-custodial group for sexual and reproductive practices that prevent women Measures for Women Offenders health diseases, including from accessing adequate (the Bangkok Rules).25 A major cancer and sexually transmitted healthcare in the community. concern is that prison systems , particularly due to often do not guarantee access to their typical backgrounds – which Women prisoners have such treatment and discriminate often include drug use, sexual specific needs related to against women when it comes to abuse and violence, sex work reproductive health issues, such substance dependency treatment, and unsafe sexual practices.31 as menstruation, pregnancy or do not tailor programmes Although women prisoners 20 and menopause. In order to for women.26 In relation to the are more likely to contract adequately respond to these, provision of opioid substitution HIV in prison than men, they female-specific healthcare therapy, a recent study found have less access to preventive services need to be provided, that women ‘generally have no and treatment programmes including sexual and reproductive access to these programmes than their male counterparts.32 care and while incarcerated’.27 The Gender-specific treatment such as pap smears and Bangkok Rules are clear that and care for HIV is required by screening for breast and prison health authorities should Bangkok Rule 14, acknowledging 21 gynaecological cancer. Many provide or facilitate specialised that medical treatment for women prisons fail to deal properly even treatment programmes for women with HIV should be different from 22 with women’s menstruation. substance abusers, taking into treatment for men. ‘Period poverty’ continues to account prior victimisation, the Alarmingly high rates of mental be an issue, with reports of special needs of pregnant women health problems are reported and women with children, as amongst women prisoners,

Case study substance misuse or sex work, • How to register and access as well as women who have primary care. from England chaotic lifestyles. • How to register and access The National Health Service (NHS) It is run and managed by mental health well-being services. in England has launched a healthcare teams in the prison, • Emotional self-care. programme in a women’s prison. with a view to handing over The programme was set up to responsibility for each case to The sessions include input from break the cycle of reoffending and probation services when the former women prisoners who talk to improve the mental and physical offender is released. about their experiences before and after release. The women are health of women in the prison. The programme offers participants also offered individual follow-up There are strict criteria for 12 two-hour facilitated group sessions if necessary. Initial prisoners to be admitted into sessions as well as one-to-one outcomes have been positive and the programme, and women meetings on a range of health NHS England plans to develop and must be in the last six months of topics, including: evaluate the enhanced skills pilot, their sentence. The programme • Sexual health and with the intention of embedding it accepts prisoners who are repeat healthy relationships. into commissioned health services offenders and prisoners who have • Well-being, including healthy in prison in the near future. experiences of domestic violence, diet and exercise.

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such as post-traumatic stress and are usually the primary or Children in detention may come disorder, depression, anxiety, and sole caregivers for their children. from difficult family or social a tendency to attempt self-harm The Bangkok Rules make specific backgrounds and may have and suicide,33 much of which is provision for healthcare and been subjected to sexual abuse linked to trauma from previous psychological support needs and other violence. Some will violence they have suffered.34 for children living with a parent have been victims of sexual As a result, many women are in prison.37 exploitation. Young prisoners are believed to be a security risk and also at high risk of ill-treatment, The specific needs of women are are over-classified. Most women including sexual abuse, often not met by prison systems, who are admitted to prison are within prisons. which have been largely designed mothers, and the separation by and for men. There needs All children in prison should from their children, as well as to be ‘explicit recognition that be properly interviewed and from the rest of their family, can women and men are different, physically examined by a have a severely negative impact and that equal treatment of men medical doctor (preferably a on their mental well-being.35 and women does not result paediatrician), or by a qualified Bangkok Rule 12 acknowledges in equal outcomes’.38 Prisons nurse reporting to a doctor, as that successful treatment of should have good mental soon as possible upon admission mental health issues requires an healthcare in place for prisoners to a detention facility, preferably individualised gender-sensitive with existing conditions, and all on the day of arrival. In the case approach, addressing the root policies, regimes, routines and of girls, access to gynaecologists causes and taking into account practices in prisons should be and education on women’s any trauma that the female trauma-informed. In addition, the healthcare should be provided. prisoner may have experienced. individual needs of vulnerable Rules 38 and 39 of the Bangkok If a female prisoner requests groups such as women need to Rules address the specific to be examined by a female be taken into account to ensure healthcare needs of juvenile healthcare professional, then a that the SDGs are met, primarily female prisoners, including the female physician or nurse should in regard to healthcare (Goal 3) need for age- and gender-specific be made available wherever and (Goal 5). programmes and services, such possible. If a female physician as counselling for sexual abuse. or nurse is not available, then a Children This is particularly important female staff member should be given that the needs of girls in present during any examination Placing children in detention can detention are often overlooked by a male healthcare professional. cause long-term psychological due to their small numbers within Sufficient female healthcare staff and physical harm. The UN many prison systems. should be appointed to work in Special Rapporteur on torture prisons housing female prisoners. has noted that ‘regardless of the People in prison with conditions in which children are Although pregnant women and held, detention has a profound mental health needs women with young children and negative impact on child Research has found that should not be imprisoned unless health and development. Even approximately one in seven 36 absolutely necessary, most very short periods of detention prisoners has a serious mental women in prison are mothers can undermine the child’s health condition; these figures psychological and physical have not changed significantly well-being and compromise in the past 30 years.41 Protecting cognitive development.’39 mental well-being and addressing Case study Children held in detention are at mental ill-health are two of from Thailand risk of developing post-traumatic the most challenging issues stress disorder, and may exhibit in prisons worldwide, yet In Thailand, yoga and t’ai symptoms such as insomnia, many prisons do not have the chi practices were used in nightmares and bed-wetting. resources to provide adequate two projects that aimed to Feelings of hopelessness and mental healthcare for either improve the health of women prisoners or staff. Prison staff prisoners. Ten women frustration can be manifested have an important role to play in prisoners from Ratchaburi in acts of violence against Central Prison became themselves or others. Reports supporting all people in prison instructors and travelled to on the effect of detention on with mental health conditions and Koh Samui women’s prison children have found higher rates staff who communicate positively to teach yoga. The project of suicide, suicide attempts and with prisoners may be well also boosted the morale of placed to identify warning signs prison staff and built better self-harm, and and developmental problems, and potential triggers for mental relationships between 42 prisoners and between including severe attachment health decline. prisoners and staff.43 disorder.40

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There are some situations related to mental ill-health Case study of addiction and drug-related that require urgent responses, offending. It aims to provide a including if prisoners pose a from Australia ‘safe, healthy, supportive and threat to themselves or others Wandoo is a dedicated alcohol respectful space to recover and make positive lasting changes’. or to the safety and security of and prison the facility.44 People with mental for women in Perth, and the Wandoo offers dedicated and first female prison in Western illness can be at greater risk of intensive trauma-informed Australia to run an intense treatment within a therapeutic suicide and/or self-harm. The rehabilitation programme known community. Women are WHO notes that suicide is ‘often as a ‘therapeutic community’. The supported via multi-disciplinary the single most common cause facility can treat up to 77 selected case-management to reduce of death in correctional settings’45 minimum- and medium-security addiction, improve mental and and it accounts for about half prisoners, who must demonstrate physical health and reduce the of all prison deaths.46 There is a a desire to treat their addiction. chances of reoffending. Women particularly high rate of suicide The focus of Wandoo is to offer at Wandoo are also offered a supportive environment where transitional and post-release among women prisoners, children support for their ongoing 47 women can break the cycle and newly released prisoners. rehabilitation. An international study conducted by the University of Oxford in 24 high-income countries between 2011–201448 found that Access to safer sex measures the risk of suicide was three People in prison who times higher for male prisoners use drugs Many prison administrations have allowed the distribution compared to the general Prisons can provide a range of condoms to prisoners, male population, and at least of evidence-based rehabilitation offering them access to the nine times higher for women. treatment programmes to same protection that is available Interestingly, the study did not break the cycle of substance outside prison. Further measures find any correlation between the dependence and crime. have included information, rates of and rates The IDPC Drug Policy Guide education and communication of overcrowding. from the International Drug programmes for prisoners, Policy Consortium53 sets out States should take all reasonable and prison staff on sexually a series of recommendations steps to prevent deaths in prison, transmitted diseases; these have for prison authorities for including suicide. The question included voluntary counselling, delivering treatment to prisoners of ‘reasonable steps’ has been testing for prisoners, and who use drugs, which are considered by the European measures to prevent rape, sexual summarised below. Court of Human Rights in its violence and coercion. jurisprudence, and as a minimum Education and information these should include:49 Needle and syringe Simple information on the programmes • The transfer of prisoners risks of infection and the Programmes involving the to mental healthcare settings steps prisoners can take to distribution of clean injecting if required. protect themselves and others equipment to people who inject should be widely distributed • Screening as soon as possible drugs have been effective at to prisoners in a format that is after admission, including an preventing HIV and hepatitis appropriate to their language assessment of suicide risk. infections. However, there skills and education. Some prison has been great reluctance to • All prisons having a suicide administrations have also used introduce these public health prevention strategy. educational videos or lectures programmes in prison settings. to deliver the same messages, • Where a suicide does occur, an leading to higher levels Preventing independent investigation should of awareness. be undertaken.50 Prisoners who use drugs are Vaccination programmes a very high-risk group for Prison healthcare staff also accidental overdose, particularly There are effective vaccinations have a critical role to play in in the period immediately after to protect against hepatitis B, , although release. Overdose prevention and a period of imprisonment this is not a matter for them programmes therefore need to 51 is an opportunity to encourage alone. Awareness raising on the be targeted at prisoners, and people (many of whom do not prevention of suicide should take should involve information and 52 use preventive health services place across the entire prison. awareness raising. in the community) to have the vaccination.

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Prison staff an effect not only on staff but also anti-bullying initiatives, and on their families and their access good working terms and Prison staff work in dangerous to schools, medical facilities and conditions.55 In addition, reward and difficult environments and other social activities. It is also and recognition schemes, are regularly exposed to work common for prison staff to be opportunities for career stress, lack of contact with expected to transfer frequently progression and occupational family, long hours, bullying and from one prison to another.54 health services are necessary intimidation, and exposure to To support the health and well- components in strategies traumatic incidents. In many being of staff, a number of to address stress and poor countries, prisons are in very measures can be taken, including working conditions.56 isolated locations, far from the provision of counselling, population centres. This has

Conclusions

Prisoners are a vulnerable and complex endeavour. It requires health of prisoners themselves underserved group who have a ‘whole-of-government’ but also to the protection of complex health needs that are approach whereby prison public health, since the vast frequently unmet. The right healthcare is integrated into majority of prisoners will return to health for specific groups wider public health and social to the community. The more within the prison population care systems and is of a standard their health needs are met, the is also violated, including for equivalent to healthcare in the greater the chances are that they women, children, prisoners community. There also needs to will assume a constructive role who have mental health be a continuity of care between in society. issues and those who use community and prison. Providing drugs. Delivering healthcare adequate standards of medical in a prison setting is a highly care not only contributes to the

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Endnotes

All website links cited were accurate 15 ‘A place of discipline, frostbite and hard 31 World Health Organisation, Prisons and at the time of going to press in April 2018. labour’, The Independent, 20 March Health, 2014, p161. 2013, www.independent.ie/irish-news/a- 32 Penal Reform International submission to place-of-discipline-frostbite-and-hard- OHCHR call for inputs: Mental health and 1 World Health Organisation (WHO), Prisons labour-29141778.html. and Health, 2014. human rights, Written submission from Penal 16 ‘Heat: the next big inequality issue’, Reform International, p5. 2 UN AIDS, The Prevention Gap Report, , 13 August 2018, 2016, p7. 33 Brenda J van den Bergh et al, World Health www.theguardian.com/cities/2018/ Organisation (WHO), Women’s health in 3 Key international standards on the aug/13/heat-next-big-inequality- prison: urgent need for improvement in right to health can be found in the issue-heatwaves-world. gender equity and social justice, June 2009. International Covenant on Economic, 17 United Nations Standard Minimum Rules Social and Cultural Rights (1966) and 34 United Nations Office on Drugs and Crime, for the Treatment of Prisoners (the Nelson Handbook on Women and Imprisonment, UN Committee on Economic, Social and Mandela Rules), Rules 13,19, 35 and 42. Cultural Rights, General Comment No. 2nd edition, with reference to the United 14: The Right to the Highest Attainable 18 Council of Europe, Recommendation of the Nations Rules for the Treatment of Women Standard of Health (Art 12), adopted Committee of Ministers to member states on Prisoners and Non-custodial Measures for at the Twenty-second Session of the the European Prison Rules (European Prison Women Offenders, March 2014, p7. Committee on Economic, Social and Cultural Rules), Article 18(1), June 2006. 35 Penal Reform International, Mental health Rights, on 11 August 2000 (Contained 19 European Court of Human Rights, in prison: A short guide for prison staff, in Document E/C.12/2000/4). See also, Ananyev and Others v Russian Federation, April 2018, p12. the UN Basic Principles for the treatment Application nos. 42525/07 and 60800/08, 36 Penal Reform International, Safeguarding of Prisoners; the UN Standard Minimum 10 January 2012. Children in Detention: Independent Rules for the Treatment of Prisoners (the 20 World Health Organisation (WHO), Data Monitoring Mechanisms for Children Nelson Mandela Rules); the UN Rules and Statistics, www.euro.who.int/en/health- in Detention in MENA, 2011, p55. for the Treatment of Women Prisoners topics/health-determinants/prisons-and- 37 The United Nations Rules for the Treatment and Non-custodial Measures for Women health/data-and-statistics. of Women Prisoners and Non-custodial Offenders (the Bangkok Rules) and the UN 21 The United Nations Rules for the Treatment Measures for Women Offenders Convention on the Rights of Persons with of Women Prisoners and Non-custodial (the Bangkok Rules), Rules 9 and 51. Disabilities (CRPD). Measures for Women Offenders 38 World Health Organisation, Prisons and 4 See in particular the United Nations Standard (the Bangkok Rules), Rule 18. Health, 2014, p163. Minimum Rules for the Treatment of 22 World Health Organisation (WHO), Prisons Prisoners (the Nelson Mandela Rules), Rules 39 UN Human Rights Council, Pathways and Health, 2014, p161. 24, 25, 27, 30, 31 and 33. to, conditions and consequences of 23 ‘The Hidden Impact of Period Poverty in incarceration for women, Report of the 5 United Nations Office on Drugs and Crime Prisons’, Lunapads, 12 December 2018, Special Rapporteur on torture, Juan Mendez, (UNODC) and World Health Organization lunapads.com/blogs/all/the-hidden-impact- 5 March 2015, A/HRC/28/68, para 33. (WHO), Good Governance for Prison of-period-poverty-in-prisons; ‘Home Office Health in the 21st Century: A policy brief 40 Ibid. plans to strengthen safeguards for women on the organization of prison health, 2013, in custody’, Home Office, 21 August 2018, 41 For example, a review of research found Executive Summary. www.gov.uk/government/news/home-office- that post-traumatic stress disorder affected 6 Ibid. plans-to-strengthen-safeguards-for-women- up to a fifth of prisoners, and rates of self- harm range from 7–15 per cent for men, with 7 UN General Assembly, Principles of Medical in-custody. higher rates recorded for women, at up to Ethics Relevant to the Role of Health 24 World Health Organisation (WHO), Prisons 27 per cent; Dr Seena Fazel et al, ‘The health Personnel, Particularly , in the and Health, 2014, p160. of prisoners’, The Lancet , Volume Protection of Prisoners and Detainees 25 The United Nations Rules for the Treatment 377, Issue 9769, March 12 2011, pp956–965. against Torture and Other Cruel, Inhuman of Women Prisoners and Non-custodial or Degrading Treatment or Punishment, 42 Penal Reform International, Mental health Measures for Women Offenders resolution 37/194, 18 December 1982, in prison: a short guide for prison staff, (the Bangkok Rules), Rule 15. Principle 1. April 2018, p21. 26 World Health Organisation (WHO), Prisons 8 United Nations Standard Minimum Rules 43 Napaporn Havanon et al. Using Participatory and Health, 2014, p160; Penal Reform for the Treatment of Prisoners (the Nelson Action Research to put the Bangkok Rules International, Women in criminal justice Mandela Rules), Rule 26(2). into practice – The Thai Prison Case study, systems and the added value of the UN Research under the auspices of the Inspire 9 UN Office of the High Commissioner for Bangkok Rules, 2015, p4. Project under the Initiative of HRH Princess Human Rights (OHCHR), Manual on the 27 International Drug Policy Consortium, Bajrakitiyabha, 2012, p49. Effective Investigation and Documentation Taking Stock: A Decade of Drug of Torture and Other Cruel, Inhuman or 44 For more information on preventing Policy: A civil society shadow report, Degrading Treatment or Punishment suicide and self-harm, see: World Health 21 October 2018, p48. (‘Istanbul Protocol’), 2004, HR/P/PT/8/Rev.1. Organisation (WHO), Preventing Suicide: 28 The United Nations Rules for the Treatment a resource series, www.who.int/mental_ 10 United Nations Standard Minimum Rules of Women Prisoners and Non-custodial health/resources/preventingsuicide/en. for the Treatment of Prisoners (the Nelson Measures for Women Offenders Mandela Rules), Rule 76(d). 45 World Health Organisation, Preventing (the Bangkok Rules), Rule 15. Suicide in Jails and Prisons, 2007, p1. 11 ‘Why Temperatures In Prisons and Jails 29 In line with the United Nations Standard Matter’, Vera Institute, 10 August 2018, 46 Sunita Stürup-Toft et al, ‘Looking behind Minimum Rules for the Treatment of www.vera.org/blog/why-temperatures-in- the bars: emerging health issues for people Prisoners (the Nelson Mandela Rules), prisons-and-jails-matter. in prison’, British Medical Bulletin, Volume Rule 24 and The United Nations Rules 125, Issue 1, 1 March 2018, pp1-9; 2018; 12 ‘It’s Cold as Hell’: Inside a Brooklyn for the Treatment of Women Prisoners Mary Rogan, ‘Human Rights approaches Jail’s Weeklong Collapse’, The and Non-custodial Measures for Women to suicide in prison: implications for policy, New York Times, 9 February 2019, Offenders (the Bangkok Rules), Rule 62. practice and research’, Health & Justice, www.nytimes.com/2019/02/09/nyregion/ 30 For example, one Canadian study found Volume 6, Issue 15, 14 September 2018. brooklyn-jail-no-heat-inmates.html. that women offenders who were released 47 World Health Organisation (WHO), Preventing 13 ‘Some Arizona Prison Logs Show and who did not participate in a drug Suicide in Jails and Prisons, 2007, pp7-8. Temperatures up to 119 Degrees; Others treatment programme were 10 times more Falsified’,, 3 September likely to return to prison within one year than 48 See: ‘Suicide in prison: a new study on risk 2018, www.prisonlegalnews.org/news/2018/ the prisoners who did participate; Flora I. factors in the prison environment’ PRI Blog, sep/3/some-arizona-prison-logs-show- Matheson, Sherri Doherty and Brian A. Grant, 13 June 2018, www.penalreform.org/blog/ temperatures-119-degrees-others-falsified. ‘Community-based aftercare and return to suicide-in-prison-a-new-study-on-risk. 14 ‘Prison Tensions Risk Boiling Over custody in a national sample of substance- 49 European Court of Human Rights, Edwards v As Heatwave Hits ‘Oven-Like’ Jails’, abusing women offenders’, American Journal United Kingdom, Application no. 46477/99, Huffington Post, 25 July 2018, of Public Health, Volume 101, Issue 6, June 14 March 2002; Keenan v United Kingdom, www.huffingtonpost.co.uk/entry/heatwave- 2011, p1129. 33 EHRR 38, 5 April 2001 jails_uk_5b5759fde4b0b15aba92d159.

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50 Mary Rogan, ‘Human Rights approaches to suicide in prison: implications for policy, practice and research’, Health & Justice, Volume 6, Issue 15, 14 September 2018, p9. 51 United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules); The United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules); Council of Europe, Recommendation of the Committee of Ministers to member states on the European Prison Rules (European Prison Rules). 52 Third General Report. 53 International Drug Policy Consortium, Drug and Policy Guide, 3rd edition, 2016, p101. 54 Helen Fair and Andrew Coyle, Institute for Criminal Policy Research at Birkbeck, University of London, A Human Rights Approach to Prison Management: Handbook for prison staff, Institute for Criminal Policy Research at Birkbeck, 3rd Edition, 2018, p33. 55 Penal Reform International, Mental health in prison: a short guide for prison staff, April 2018, p32. 56 World Health Organization, Prisons and Health, 2014, p186.

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Pull-out section

Penal Reform International www.penalreform.org Thailand Institute of Justice Twitter: @PenalReformInt www.tijthailand.org Facebook: @penalreforminternational Email: [email protected] PRISON MANAGEMENT

PART FOUR Prison management

Security and violence A safe and secure environment is prisoners dead and 14 injured,269 while riot at Pollsmoor Prison.276 Reports a prerequisite for rehabilitation, yet a left nine prisoners dead of torture and ill-treatment of people violence continues to be a problem and 19 on the run in the northern state in prison were documented in several in prisons all over the world. This is of Tocantins.270 There were also reports countries, including ,277 South due to many factors, including poor of in Sri Lanka,271 Africa,278 South Sudan,279 Iran280 conditions and overcrowding.259 For Russia,272 Tajikistan,273 Indonesia274 and and Saudi Arabia.281 Systemic instance, Sweden saw a 39 per cent Haiti.275 In South Africa, an inquiry was and widespread abuse was also increase in violence amongst prisoners launched by the Judicial Inspectorate documented in Russian prisons.282 at the same time as its prison capacity of Prisons into the conduct of police An investigation by Russia’s Federal grew from 85 per cent to 95 per cent and prison officials following a prison Prison Service found 42 cases where in four years.260 According to the Swedish Prison and Probation Service, ‘the violence is not growing linearly Deaths in prison of the deaths (55 from January along with the prison population. It is to April 2018) were attributed to growing exponentially.’261 A prisoner can die from so-called infectious diseases, poor prison ‘natural causes’ such as illness or conditions and a lack of healthcare Gangs are responsible for much of the old age. There can also be deaths professionals in the prison system. violence in prisons. In Canada there or serious injuries due to prison were reports that over 2,000 prisoners staff violence (including torture), Deaths in custody among Indigenous are known to belong to ‘security sexual abuse (including rape), communities was a key concern inter-prisoner violence, legitimate or in Australia, with 147 Indigenous threat groups’, including Indigenous, peoples reported to have died in 262 excessive use of force by prison staff, Asian, motorcycle and street gangs. 286 self-harm, inadequate medical care, the past decade. Mental health Gang-related violence at Leeuwkop drug overdoses, or work-related or or cognitive impairment was a prison, South Africa, left one dead and other accidents. Suicide is often the factor in 41 per cent of all deaths one critically injured.263 In Ireland, over single most common cause of death of Indigenous peoples in custody half of all prisoners in the country’s in prisons.283 All of these serious and many Indigenous peoples die in custody from treatable medical biggest prison, Mountjoy, are in incidents can constitute violations of one or more of the most fundamental conditions. There have been calls for protection regimes for their own safety Australia to establish an independent due to gang violence.264 human rights – in particular the right to life and the prohibition of torture system for monitoring these deaths; and other forms of ill-treatment. the Australian Social Justice There were efforts by some countries Commissioner stated that ‘These to address gang violence. Denmark Deaths in prison continued to be are not just statistics, they are the introduced a new prison intelligence a concern in many countries during human stories of what happens as service to deal with gang issues265 with 2018. In India, reports suggest a result of government inaction.’287 a ‘stronger internal investigative and that on average there were five deaths per day in custody during States are responsible for security organisation…to better assess 284 accounting for any death, injury or 266 2017–2018. There were calls by risks posed by individual prisoners’. the Asian Centre for Human Rights disappearance of persons it detains, The Ministry of Justice in Greece called for India to ratify the UN Convention regardless of how the incident 288 an emergency meeting with prison against Torture and for state agents occurred. All deaths in custody directors to discuss prisoner violence, (police, military and paramilitary) to must be registered and reported to be subject to criminal prosecution the competent authorities, including following a gang-related death of an deaths that appear to be due to 267 for committing torture in custody. Albanian prisoner. 289 According to reports by the Public natural causes or suicide. States are also under a positive duty to While there were prison riots in many Defender’s office for the state of Rio de Janeiro in Brazil, one prisoner investigate any . regions, they were most acute in Latin Further information is contained American countries, including Brazil, died every other day during the first four months of 2018;285 the majority in the ICRC’s Guidelines for Guatemala and Venezuela.268 A prison Investigating Deaths in Custody.290 riot in Goiânia in Brazil left nine

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guards ‘exceeded their authority or in extremely small and crowded of children and abused the dignity of prisoners’.291 One spaces and in poor and unsafe young offenders303 because of the of the most shocking cases was that of conditions, sometimes for prolonged serious risks of ‘long-term psychiatric Yevgeny Makarov, who was subjected periods. The Council of Europe and developmental harm’.304 There to repeated beatings with clubs by has produced a Recommendation were reports of children spending Russian prison guards; the events for member states to ensure that more than 22 hours per day in their were captured on video and published transportation is ‘always carried out in cells in the UK.305 (See Children and in the Novaya Gazeta,292 causing a humane, secure and safe manner’.297 young people, page 22). an international outcry. The Russian Prisoners continue to be held in solitary In India, the Uttarakhand High authorities have since investigated confinement, often for long periods Court found that keeping prisoners the case, leading to the suspension of time. In Spain, prisoners convicted in custodial segregation/solitary of 17 prison employees and seven of very serious offences are kept in confinement was unconstitutional.306 arrests.293 In an exceptional measure, solitary confinement for 21 hours In the US, the Supreme Court noted the UN Committee against Torture a day in an eight-square-metre that solitary confinement ‘comes called on Russia to report on efforts cell.298 The CPT called on Norway perilously close to a penal tomb’.307 to bring the perpetrators to justice.294 to improve its treatment of prisoners Following the 2018 ruling of the The Convention against Torture in solitary confinement following a British Columbia Supreme Court Initiative (CTI) brought together visit to the country in May 2018,299 that prolonged and indefinite solitary Council of Europe member states when prisoners were found to be confinement was unconstitutional,308 to discuss ways to address and locked up alone in their cells for the Canadian government has been respond to torture and other abuse 22 hours per day for prolonged given an extension until mid-June that take place during police custody periods, with only limited contact 2019 to change its practice of isolating and pre-trial detention.295 The CTI with staff. The CPT recommended prisoners for 22 hours or more a day also held a regional seminar to that prisoners who were subjected without meaningful human contact, discuss good practices regarding to ‘complete exclusion from company’ but only on the proviso that certain ratification and implementation of should benefit from more structured conditions are met immediately, the UN Convention against Torture, programmes, purposeful activities including daily medical visits and basic safeguards in respect of arrest and meaningful human contact on an extra 30 minutes outside of cells and detention of suspects, and good a daily basis. A report into the use each day.309 management approaches in relation of solitary confinement in Malawi, to law enforcement.296 States shared Kenya, Zambia and South Africa found RECOMMENDATION 14 good practice on torture prevention, that most of the countries failed to States should ensure the safety including strategies to strengthen the comply with the Nelson Mandela Rules of prisoners and staff at all role of the judiciary and prosecutors in and prison legislation dealing with times, including by improving preventing and responding to incidents solitary confinement was outdated in prison conditions and investing of torture and ill-treatment, increasing four out of the five countries.300 The in dynamic security approaches. professional standards in policing, and authors called on these countries to Countries that have not ratified improving the management of prisons ‘make substantial efforts to address the Optional Protocol to the to ensure the humane treatment of the lack of independent review Convention against Torture prisoners. States also emphasised the mechanisms of solitary confinement should do so. All states should importance of ‘checks and balances’ in their legislation’.301 avoid the use of solitary in monitoring places of detention Medical research from the US supports confinement where possible through complaints bodies and the case against solitary confinement and take steps towards its National Human Rights Institutions. on the basis that it can do severe and total abolition. During transfers from prison to long-lasting damage to the brain.302 court, medical facilities or elsewhere, In addition, there were calls by medical prisoners can find themselves confined professionals in the UK to ban the

Prison staff People working in prisons perform should reflect the difficult nature of the has seen an increase in attacks an important public service that is work. In reality, staff shortages and on prison staff, who are reported to often misunderstood or subject to budget cuts have led to an increase be suffering from ‘moral fatigue’.312 negative stereotyping. Their role is in dangerous and violent prison In 2018, prison staff in Bulgaria crucial for the effective rehabilitation environments and prison staff in went on strike owing to poor and reintegration of prisoners and many countries continue to risk their remuneration,313 and in England their job is complex and multi-faceted, physical and mental well-being.310 and Wales, prison staff protested demanding good interpersonal skills against working conditions and Assaults on prison staff increased as well as the ability to deal with ‘unprecedented violence’.314 In some by nearly a third from 2017 to 2018 extremely challenging situations. countries, prison staff are facing new in England and Wales.311 Russia Working conditions and remuneration risks to their health from exposure

28 | Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 PRISON MANAGEMENT

Prison officer during a training session for prisoners, US.

The role of prison staff is crucial for the effective rehabilitation and reintegration of prisoners and their job is complex and multi-faceted

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to psychoactive substances, including that the use of excessive force, During 2018, the Council of Europe synthetic cannabis – in the UK, nurses overcrowding and inappropriate continued its work on drafting have passed out from exposure relationships inside the prison system detailed guidelines for the recruitment, to the drug when responding to put the system at risk of ‘significant selection, training and development emergencies, and similar problems corruption’.320 of prison and probation staff. These have arisen for prison staff in the guidelines are expected to be While poor morale is rife amongst US.315 Perhaps not surprisingly, ther