Table 1 International guidelines on mental health and people detained within the justice system

WHO mental health action plan 2013–2020 (2013) [72]

An action plan for Member States which outlines ways to promote mental health, prevent mental disorders, protect human rights of persons affected by mental health conditions and to reduce mortality, morbidity and disability for people with mental disorders

Mental health: Large focus on four objectives: strengthening leadership and governance for mental health; expanding service coverage for mental disorders; implementing strategies for promotion and prevention in mental health, and strengthening the evidence base for mental health research

Detention: Mentions that inappropriate detention is more common for people with mental disorders and encourages collaboration with judicial sectors in all four objectives. Little is said about addressing the mental health of those that are specifically detained

Time to deliver, report of the who independent high-level commission on noncommunicable diseases (2018) [73]

Report aims to facilitate the implementation of Sustainable Development Goal 3.4, ‘reducing premature mortality from NCDs’, as progress so far has been inadequate

Mental health: Recognizes the global impact of mental disorders and specifically discusses mental health in each of its recommendations

Detention: No mention of people detained within the justice system

World Health Organization assessment instrument for mental health systems (AIMS 2.2) (2005) [74]

Document provides guidance on data collection for WHO AIMS 2.2, a tool for collecting information on key components of a mental health system

Mental health: Assessment tool assesses the following: policy and legislation, mental health services, mental health in primary health care, human resources, public education and links with other sectors, and monitoring and research

Detention: Includes the assessment of prison mental health services and forensic inpatient units

WHO mental health and development: targeting people with mental health conditions as a vulnerable group (2010) [75]

Report presents evidence showing that people with mental health conditions comprise a vulnerable group and provides recommendations for the implementation of policies that aim to protect this marginalized group

Mental health: Highlights the need for development programs to pay more attention to people with mental health conditions as they are among the most marginalized and vulnerable groups in society but are often overlooked

Detention: Recognizes that there is a significant problem to be addressed—people with mental health conditions are directed towards prisons, where they often do not have access to adequate mental health provisions and services

WHO checklist for evaluating a mental health policy (2005) [76]

A checklist for evaluating mental health policies

Mental health: Evaluates the process of policy development and the policy’s contents. Emphasizes a multisectoral, human-rights approach to developing policies

Detention: Suggests consulting with the justice system when developing policies but otherwise does not consider the mental health of detained people

UN General Assembly, Report of the United Nations High Commissioner for human rights: mental health and human rights (2017) [77]

To identify some of the main challenges faced by people with mental health conditions or psychosocial disabilities and recommends policies which would support the full realization of human rights of this population

Mental health: Emphasizes that human rights of persons with mental illnesses are vastly neglected in society. It stresses the importance of changing policies and law to protect the human rights of this vulnerable population

Detention: No mention of people detained within the justice system

UNOPS technical guidance on prison planning (2016) [78]

A guide to prison infrastructure development based on a human rights approach

Mental health: Recognizes that people detained in prisons with mental health conditions constitute a vulnerable group that may require separate accommodation

Health in prisons: Recognizes that there is a lack of practical guidance on prison infrastructure development which takes into consideration the Standard Minimum Rules for the Treatment of Prisoners

UNODC handbook on prisoners with special needs (2009) [79]

Outlines the special needs of eight groups of adults in prisons which have a particularly vulnerable status and provides recommendations for policymakers

Mental health: Thoroughly describes the needs of people in prisons with mental health conditions and recognizes them as a vulnerable group. Highlights that promotion of mental well-being should be a key element of prison management and policies

Health in prisons: Recognizes that imprisonment is a disproportionately harsh punishment for many people in vulnerable groups. Suggests that their special needs are better addressed away from prisons, as the harsh prison environment would likely exacerbate any existing problems

United Nations expert group meeting on mental well-being, disability and disaster risk reduction (2014) [80]

Provides guidelines for countries’ Disaster Risk Reduction (DRR) policies so that they include mental health and disability as a priority

Mental health: States the need to include mental well-being and mental disabilities in all DRR frameworks, as it optimizes resilience to disasters

Detention: No mention of people detained within the justice system

United Nations standard minimum rules for the treatment of prisoners (the Nelson Mandela Rules) (2015) [81]

Revised version of rules that set out the minimum standards for the treatment of people detained in prisons

Mental health: Highlights that all individuals with mental conditions in prisons should have access to the same care they would have in the community and should be transferred to a hospital if required

Health in prisons: Reaffirms that the punishment caused by imprisonment is by depriving individuals of liberty, so prison systems should not aggravate their suffering further