1. Estonian Prison System
Kristel Ojala
Ministry of Justice/ Medical adviser

3. Specialization of prisons
Tallinn Prison – unit for women, special unit separately
for inmates with tuberculosis;
Tartu Prison – sexual offenders, drug rehabilitation unit,
stationary psychiatric unit for 18 inmates;
Viru Prison – juveniles unit for year old inmates,
„super-max“ unit with higher security measures.

4. Prison healthcare system
Healthcare system in prisons as part of Estonian healthcare;
Financed from the Ministry of Justice budget (yearly budget around 3 million EUR, incl personnel costs);
General medical care in prisons:
Medical care is given by general practitioners and nurses (24 h), on average 1 healthcare worker for 29 prisoners;
Intensive care is not provided in prisons, but in civil hospital;
Initial medical check up for every prisoner on their arrival (incl HIV test, x-ray of lungs etc);
Specialist care in prisons:
Neurologist, surgeon, ophthalmologist, infectionist, dermatologist, psychiatrist, radiologist, gynecologist, gastroenterologist and dentist.

5. Inpatient services:
All prisons have special after-care wards for inpatient services (24- hour health care provision);
Central tuberculosis ward;
Central psychiatric ward.
Central prison pharmacy – all medications available 24 h.

6. Main reasons for hospitalization
Emergency situations with addiction disorders (alcoholic delirium, acute alcohol or drug detox);
Severe mood disorders (depression, problems with adjustment inside prison setting, anxiety disordes);
Schizophrenia and delusional disorders (clarification of diagnosis and assessment of need for coercive or involuntary treatment);
Mental retardation assessment and behavioural disorder treatment.

7. Infectious diseases HIV – approx 15% of all inmates are HIV+;
Hep-C – almost 1000 prisoners (1/3 of prison population) are diagnosed with Hep-C (outside prisons it is estimated overall people are HepC+)
Tuberculosis – few cases a year;

8. Drug dependents in prison system
878 prisoners (32%) have been diagnosed with mental and behavioural disorders due to psychoactive substance use:
Approx. half of them have been diagnosed with mental and behavioural disorders due to use of opioids (F11);
Quite common are mental and behavioural disorders due to multiple drug use and use of other psychoactive substances (F19).
Drug rehabilitation is an important part in prison healthcare – specialized unit with holistic approach for acute dependants in Tartu, other prisons small units plus councelling and medical aid.

9. Thank you for your attention!
Kristel Ojala