Healthcare Behind Bars: Constitutional and Human Rights Challenges in the Italian Prison System

This essay examines the health conditions of people in prison in Italy and highlights the systemic shortcomings associated with healthcare providers responsible for protecting the physical and mental well-being of people in prison. This analysis, conducted through a multilevel regulatory framework, takes into account constitutional guarantees and international human rights law within the Italian penitentiary system. The right to healthcare is protected under Article 32 of the Italian Constitution and the principle of equivalence of care established by the latest reform, which requires people in prison to receive the same level of care as those at liberty. Yet, serious structural shortcomings persist, severely compromising the implementation of this right for people in prison. The article analyzes recent data and institutional reports, and traces the intersection between criminal law enforcement and prisoner treatment with public health, focusing on several key areas: chronic overcrowding, the deterioration of prison infrastructure, the alarming prevalence of mental illness, and the widespread use of psychotropic drugs as a potential form of behavioural control. The study addresses various factors, including the lack of resources for medical, psychiatric, and educational staff, the high incidence of suicide and self-harm, and the lack of care. It also assesses the impact these factors have on the most vulnerable groups, including individuals subjected to solitary confinement (such as Article 41-bis), minors, and undocumented immigrants held in CPRs (Repatriation Detention Centres). The article highlights that the general conditions of detainees in Italy not only appear to constitute a public health crisis but also appear to constitute a substantial violation of fundamental rights enshrined in the Constitution and the European Convention on Human Rights. The article finally outlines a list of solutions and criteria for reducing the negative impact of detention conditions on public health, which requires interventions by prison and healthcare administrations and a more modern, responsible, and constitutionally oriented penal policy.