Few hospitals have specific units for prisoners.

Civil society organisations report a systemic failure to provide adequate health services and respond to prisoners’ health needs in a timely and effective manner, leading to delayed diagnosis and deteriorating health conditions.¹² The CPT also reported significant shortcomings in these regards, in 2017 and in 2019.³⁴ Prisoners suffering from chronic medical conditions such as chronic back pain do not receive necessary treatment or appropriate follow-up. The frequency at which prisoners are seen by medical practitioners varies significantly from one prison to another.

CİSST frequently receives complaints from prisoners concerning short consultations and an experienced lack of regard from doctors.⁵ It received 400 complaints regarding a lack of continuity of care in 2022.⁶ The CPT reported in 2017 that some consultations lasted as little as one minute.⁷ The Human Rights and Equality Institution of Türkiye (HREIT) noted in 2020 that prisoners at Bandırma N° 2 T Type Closed Prison could see a doctor once every three weeks.⁸

Medication is usually dispensed by a medical practitioner, one dose at a time. Given the shortage of medical staff, treatment is frequently interrupted and medication is not taken at the prescribed intervals.

CİSST also reports that prescribed medication is not always supplied on time, if at all. Some prisoners have their treatment interrupted due to long delays in renewing prescriptions.¹ Prescribed medication that is considered highly addictive may be banned by the prison administration. Alternative medication is not always provided. Prisoners then have to return to the hospital to obtain a new prescription. Appointments to do so can also take a long time.

During a visit made by the HREIT to Çanakkale E-Type Closed Prison in December 2022, prisoners reported that doctors do not take their considerations seriously and rather scold them. Doctors also reportedly prescribed medication without conducting thorough examinations.² The CPT had previously reported in 2017 that some prisoners received prescriptions for medication despite not having been seen by the doctor.³

Prisoners with specific health problems presenting a risk to their own or to other people’s health, and that refuse examination or treatment, may be subject to mandatory medical evaluations, hospitalisation, specific treatment or nutrition measures, on advice of a medical practitioner, or without in case of emergency. Coercive measures may be applied (Law n° 5275 on the Enforcement of Sentences and Security Measures, Article 82).

Scabies, tuberculosis, HIV+/AIDS and hepatitis are prevalent in prison. Prisoners with symptoms of these conditions are often isolated from others. The prison administration does not release data on illnesses in prison.¹

Medical treatment must be provided for sick prisoners with communicable diseases such as pulmonary tuberculosis, HIV/AIDS, scabies, or hepatitis B and C (Regulation n° 2324 on the Management of Penal Institutions and the Enforcement of Sentences and Security Measures, Article 96).

In practice, prisoners that contract tuberculosis do not receive any treatment or benefit from any sort of special medical release. Prisoners with other diseases requiring care, such as cancer, do not receive proper treatment either. When interventions do take place, they do so very late, allowing the disease to progress dangerously. These may take place as late as six to eight months after initial detection. People with simple health issues often see their conditions deteriorate into more serious conditions due to lack of adequate medical care.¹ Overcrowding, humidity and poor hygiene within prisons also contribute to the spread communicable diseases. Low temperatures favour cases of recurring flu, and lack of physical exercise is at the source of numerous blood circulation problems.

HIV-positive prisoners may be isolated or required to wear personal protective medical equipment at certain times, such as during transfers or during telephone calls, but also in open air spaces. Individuals with HIV/AIDS are rarely identified and properly treated.

Many prisoners sentenced to aggravated life imprisonment suffer from chronic illnesses such as respiratory problems. These prisoners are often excluded from sentence adjustments for medical reasons.

Some seriously ill prisoners are unable to care for themselves and have to rely on other prisoners to look after them. Some of these ‘care-giving prisoners’ may refrain from going to the hospital so as not to leave the seriously ill prisoner alone, leading to a deterioration in their own health. Seriously ill prisoners are sometimes held in the same wards.

Civil Society in the Penal System Association (CİSST) reports that some seriously ill prisoners are sent back to prison due to a lack of hospital space, sometimes leading to multiple round trips due to the rapid deterioration of health upon return to prison. Prisoners in hospitals have to be accompanied by gendarmerie. Due to staff shortages and the need for security officers to return to the prison, some prisoners do not stay long enough to receive proper treatment. Civil society organisations report that many prisoners die from their illnesses in prison or are released after their condition has reached a critical state, dying soon after. Among the complaints received by CISST in 2022 regarding illnesses, most of them were from prisoners with cancer. The Human Rights Association (İHD) reported that in April 2022 there were 1,517 ill prisoners, 651 of whom were seriously ill.²³

A person who cannot understand the meaning and legal consequences of the act they have committed, but whose ability to control their behaviour was not significantly impaired, may be sentenced to imprisonment. The total prison sentence may be reduced by a maximum of one sixth. Those sentenced to aggravated life imprisonment will see their sentence reduced to 25 years (Penal Code, Article 32). They must be held in special sections (Law n° 5275 on the Enforcement of Sentences and Security Measures, Article 18).

Prisoners with severe mental health needs may be held in R-Type prisons¹ or transferred to a psychiatric hospital. Prisoners with less severe mental health needs are generally treated with medication.² The Ministry of Justice and the prison administration have developed a programme for the early detection of mental health conditions and the training of psychosocial assistance and health service staff. Individual intervention plans have been drawn up for 26 different mental and behavioural problems commonly encountered in prisons.³

In practice, some prisoners suffering from mental illnesses are placed in prison without adequate treatment or follow-up, leading to a deterioration of their mental health.⁴ Prisoners suffering from mental illnesses have difficulty accessing psychiatrists and are not referred to other relevant specialists. This also makes access to medication difficult. Prisoners are reluctant to be diagnosed because they may be placed in a designated cell or unit, with minimal social activity as a result. They may also be with or near other mentally ill prisoners, whose behaviour may exacerbate their own mental conditions. They are also reluctant to be placed in psychiatric hospitals because of the poor conditions in which they are likely to find themselves. People suffering from mental health problems also have more difficulty filing complaints in the event of a violation of their rights. These conditions increase their likelihood to commit suicide. There is very little transparency or data on the number of prisoners suffering from mental health problems and the types of illnesses they suffer from.

The European Committee for the Prevention of Torture (CPT) reported, after its visits in 2017, a shortage of psychiatrists and an absence of adequate follow-up in several facilities. In one case, a prisoner suffering from a severe mental illness had not been examined by a psychiatrist for seven months. In other prisons visited, psychiatrists came between once a week and once every three weeks, for up to three hours. At Istanbul-Metris R-Type Prison, prisoners expressed dissatisfaction with their experience, describing some consultations taking place at their cell door and in the presence of prison officers. No individual treatment plan was provided apart from medication. Work arrangements were not adapted to the needs of prisoners with chronic psychiatric illnesses.⁵

Access to mental health care varies from one facility to another. The Human Rights and Equality Institution of Türkiye (HREIT) reported in 2018 that prisoners at İzmir Children and Youth Closed Penitentiary Institution could be placed in anger management programmes.⁶ It also reported limited access to psychological care in Bandırma T-Type Closed Prison N° 1 in 2020 due to overcrowding.⁷ In 2022, HREIT reported that psychological assessments were carried out within three days of admission to Çanakkale E-Type Closed Prison. Appropriate follow-up was put in place if suicidal and/or self-harming behaviour is identified.⁸

In 2024, an international fact-finding mission found that some prisoners were required to attend mandatory psychological consultations. Failure to do so resulted in loss of privileges and disciplinary sanctions.⁹

Psychosocial assistance and health service staff can receive specific training for handling prisoners with mental illnesses ¹. The extent to which prison officers receive training in dealing with people with mental health problems is unclear. Prisoners at the Bayburt M-Type Closed Prison reported a high turnover of prison officers, making it difficult to ensure that they have received psychosocial training.²