italy_2021.jpg

Italy

Capital city — Rome

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Panorama

Health

Organisation of health care

Ministry in charge

Ministry of Health and Local Health Authorities

Since 2008, access to health care has been entrusted to the National Health Service (Servizio Sanitario Nazionale, SSN) and local health authorities (Aziende Sanitarie Locale, ASL).

Every prison facility has a health care unit

yes

Each facility has an infirmary and a pharmacy (Article 11 of the Prison Rules).

Number of medical staff (FTE)

3,162

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2008
/ World Health Organization, Health in Prisons, 2019

The most recent national data is from 2008. Health in prisons thereafter became the responsibility of local services, which do not publish statistics for the entire nation.

Nurses, a general practitioner, and a psychiatrist are required in each facility. Specialists (such as cardiologists, dentists, and ophthalmologists) can have regular office hours or can come to the prison for consultations. A prisoner can call upon an outside doctor at his or her own cost. 1

Material differences exist from one region to another. In 2019, the CPT noted the alarming state of numerous infirmary sites.2

  1. CPT, Report to the Italian government on the Visit from 12–22 March 2019, p. 40 (in English). ↩

  2. ibid. ↩

Prisoners for whom the pathology requires can be transferred to a regional civilian hospital.
Certain hospitals have a service adapted to receiving prisoners.

Access to health care

Health care is free

yes

A medical examination is performed upon admission

yes

Physical and mental examinations, including taking blood, are performed for each admission.

A medical file is opened upon admission

yes

Prisoners can access health care units after

a written request or an oral request

A prisoner may request a consultation by means of a form. He or she can request an emergency consultation by telling the guard on duty.

Medical examinations are carried out on a confidential basis

no

The NPM and the CPT note the presence of guards during many medical consultations.1

  1. Garante nazionale dei diritti delle persone detenute o private della libertà personale, Report to Parliament - Relazione al Parlamento, 2019, p. 72; CPT, Report to the Italian government on the Visit from 12–22 March 2019, p. 47 (in Italian). ↩

Article 11 of the Prison Rules provides for a continuity of care, despite transfers and changes in status. The respect for this continuity is, however, hindered by the limited number of health professionals.

Each prison has a pharmacy. Health care personnel are responsible for distributing medication. Access to medications not stocked within the pharmacy is limited.
As of 2019, prisoners taking psychotropic medications (antidepressants, sleep aids, anti-anxiety medicine) represent 30% of the incarcerated population.

Hospitalisation is provided when care cannot be administered in prison. Transfers to and consultations in a hospital are often slowed by the lack of penitentiary police staff.1

  1. European Prison Observatory, Prison Conditions in Italy, 2019, p. 24 (in English). ↩

Physical health care

Around 70% of prisoners suffer from one or more illnesses.
Drug addictions, psychiatric disorders, dental problems, respiratory or cardiovascular problems, and hepatitis C are the most common. Tuberculosis and HIV/AIDS both affect a relatively large part of the prison population. Health professionals regularly point to the pathogenic nature of the prison environment.

  • The Antigone association kept a record of the number of coronavirus contaminations and related deaths in prisons. During the first wave of the pandemic, 160 prisoners tested positive and the prison service registered four deaths. Two people died in December 2020, and the total of positive cases exceeded 1000. The number of contaminations decreased again between February and March 2021, when it reached 480 new cases. Two other persons died within the same period, thus bringing the total COVID-19 death toll in prisons to 18.

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    2021
    / Antigone

Sick prisoners generally receive proper treatment. Disparities exist among the various regions, and transfers can cause breakdowns in care.
Antigone notes the lack of psychological support in the handling of certain treatments.

There are regular prevention campaigns waged against HIV/AIDS, hepatitis C, and other communicable diseases.

  • Alessandro Luciani, of the Prison Employees Union (SINAPPE), denounced the “lack of organisation” regarding the management of the virus. The measures taken to ensure that prison employees were protected remained insufficient as the number of infected inmates kept increasing. The supply of sanitizers was still very limited.

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    24/02/2021
    / Rete 8

  • The Naples Bar Association requested that the Italian authorities give priority to prisoners in COVID-19 vaccination campaigns. At that stage, only prison officers were classed as priority.

    i
    06/01/2021
    / Il Riformista

  • Daniela Caputo, secretary of the National association of penitentiary police civil servants and executives (Associazione Nazionale Funzionari e Dirigenti di Polizia Penitenziaria), called for the vaccination of prisoners against COVID-19 as a priority, instead of resorting to early release measures.

    i
    29/01/2021
    / ADN Kronos

Measures for reducing risk (condoms, syringes, etc.) are not implemented.

Mental health care

Carceral mental health facilities (ospedali psichiatrici giudiziari, OPG) were permanently closed in 2015. They were replaced by residences for the execution of security measures (residenze per l’esecuzione delle misure di sicurezza, REMS), under the authority of the Ministry of Justice. Those prisoners deemed to not be in control of their actions and to be dangerous are placed there.
Twenty-five prisons have dedicated areas for those with mental health problems (articolazioni per la tutella della salute mentale, ATSM).
A sizable portion of the incarcerated population suffers from psychological problems, and many of those affected are kept in unfurnished disciplinary cells (celle liscie) or in the general population.

  • As of 2018, there were 629 prisoners placed in REMS.

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    Antigone, Fifteenth Report on Prison Conditions

Several prison unions have denounced the over-representation of people suffering from psychological disorders and the lack of personnel training.
Antigone notes the lack of specialised medical personnel.

ASLs suggest methadone-based substitution treatments for drug-addicted prisoners.