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

Prisons
A significant portion of the prison population suffers from mental illness. The NGO Antigone reports, in 2021, that 7% of prisoners had a serious psychiatric diagnosis and that 26% used mood stabilisers, antipsychotics or antidepressants.
Many patients are locked up in disciplinary cells without furniture (celle liscie) or in ordinary wards.¹ Twenty-five “ATSM” (articolazioni per la tutella della salute mentale) wards are dedicated to the care of people with severe mental disorders. These wards, located within prisons, have teams composed of nurses and social workers. Diagnosis of “mental infirmity” can be carried out to detect the presence of mental disorders in a detainee. Few therapies are provided; medication is the preferred treatment.
The ATSMs are under the authority of the Ministry of Justice, while the medical staff is under the Ministry of Health. The prison administration has the authority to decide whether to transfer an inmate to an ATSM.
Prisoners may be placed in continuous isolation or in the infirmary while awaiting a place in an ATSM. These measures are frequently used. Two members of the association Antigone visited, in 2021, the prison of Turin (Il Sestante). They deplore the disastrous conditions of detention in the psychiatric ward and report a strong shortage of psychiatrists. Seventeen people were placed there at the time of the visit. The ward had 20 cells that were narrow and dirty. The beds were fixed to the floor with little or no bedding. The inmates had no privacy to shower. One inmate had no light for several days. Another had no access to his lawyer. One young inmate was not supposed to be in the facility as he was awaiting transfer to a REMS residence.

Dedicated psychiatric facilities
Persons deemed irresponsible and dangerous are placed in “residences for the execution of security measures” (residenze per l’esecuzione delle misure di sicurezza, REMS). REMS are under the authority of local health agencies, under the Ministry of Health.² There were 31 in the territory in 2020.³ The number of people placed in REMS as of January 31, 2020 was 616.
These institutions were created after the gradual abolition, until 2015, of the judicial psychiatric hospitals (ospedali psichiatrici giudiziari, OPG). According to the CPT, the Italian authorities and NGOs are concerned about the significant increase in violent behavior by detainees. Attacks on guards, self-harm and inter-prisoner violence have been common since the closure of the OPGs.⁴

General psychiatric hospitals
Detainees can be transferred in emergency to the “protected medicine” departments of general hospitals, dedicated to detainees, or to the “Psychiatric Unit for Diagnosis and Care” (SPDC) in Turin.

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