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International law recognises the right of everyone, including people deprived of their liberty, to the enjoyment of the highest attainable standard of physical and mental health. However, in practice, many prisoners receive healthcare of a far inferior standard to that available outside in the community, if they receive treatment at all.

Prisoners with existing healthcare conditions may have their health needs ignored or neglected, and others may develop health problems whilst in prison thanks to unhealthy and unhygienic prison conditions and poor control of infectious diseases.

Health protection in prisons is a serious public health issue, which states ignore at their peril, as the vast majority of people in prison will return to the community at the end of their sentence.

Prisons can be a breeding ground for HIV/AIDS, tuberculosis (TB) and other infectious diseases. The incidence of TB, which thrives in cramped, overcrowded conditions, in European prisons for example can be up to 81 times higher in prisons than among the general population (WHO). Studies have shown that in most countries in Europe and in Central Asia, rates of HIV infection are much higher in prisons than outside, because of, for example, high rates of drug dependency and dangerous practices such as needle sharing.

Drug dependency in prisons is widespread. In the European Union, regular drug use or dependence prior to imprisonment ranges between 16% and 79%. Addressing the needs of prisoners with drug problems is a critical challenge for successful rehabilitation, in terms of both public health and preventing reoffending. Treatment should be preferred over incarceration where possible, but prison can be an opportunity to help inmates address dependency. However, returning to drug use on release is a common problem and success depends on continuing treatment and support in the community.

Prison populations have a disproportionately high rate of people suffering with mental health or behavioural problems, many pre-dating prison and others developing or worsening when inside due to poor conditions and lack of mental healthcare. In many countries, people with mental health problems who have not committed a crime, or who have committed a minor offence, are sent to prison rather than given appropriate care.

The revised UN Standard Minimum Rules for the Treatment of Prisoners (2015) state that people with severe mental health issues should not be imprisoned, but receive treatment. Where people with mental health problems are detained, prison management should focus on their treatment. Responding to mental health problems in prison not only improves the quality of life of the individual prisoner and prison population in general, but also relieves the strain on prison staff who must otherwise deal with untreated mental health issues unsupported.

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