Spain

NPM overview

Facts and figures

Recommendations

Solitary confinement, isolation

• Review the application of isolation measures from a gender perspective.

Means of coercion

• Review of the application of means of coercion from a gender perspective.

• Incorporate the sex variable in computerised data collection and produce sex-disaggregated data statistics.

Mental healthcare

• Incorporate a gender perspective in psychological assessment protocols and semi-structured interviews to give greater visibility to the differences observed.

• Incorporate a gender perspective in the Suicide Prevention Protocol.

• Ensure accessibility of gender-sensitive psychiatric and psychological care for women in prison.

• Incorporate a gender perspective in the Comprehensive Care Programme for Persons with Mental Health Conditions.

• Ensure training of technical and health personnel on gender identity and sexual orientation, gender-based violence and its effects on physical, psychological and emotional health.

• Ensure a multidisciplinary response with psychiatric, therapeutic and health involvement that assumes that gender-based violence is a serious health problem that affects women and greatly affects their social reintegration.

Violence prevention

• Establish a protocol for prevention, detection, action and care for possible victims of gender-based violence, which regulates the victim's access to the relevant health, psychological and legal care.

Prison information

• Incorporate the variable of Roma minority women in the collection of data and elaborate statistics.

• Ensure that the gender identity of transgender people is correctly reflected in data collection and statistical work.

Pregnant and breastfeeding women

• Draw up a protocol for the care of pregnant women.

Women with children in prison

• Ensure that women in prison in the Canary and Balearic archipelagos, as well as in Ceuta and Melilla, have adequate facilities for serving their sentences with their children under three years of age in prison.

Mental healthcare

• Incorporate a gender perspective in psychological assessment protocols and semi-structured interviews to give greater visibility to the differences observed.

• Incorporate a gender perspective in the Suicide Prevention Protocol.

• Ensure accessibility of gender-sensitive psychiatric and psychological care for women in prison.

• Incorporate a gender perspective in the Comprehensive Care Programme for Persons with Mental Health Conditions.

• Ensure training of technical and health personnel on gender identity and sexual orientation, gender-based violence and its effects on physical, psychological and emotional health.

• Ensure a multidisciplinary response with psychiatric, therapeutic and health involvement that assumes that gender-based violence is a serious health problem that affects women and greatly affects their social reintegration.

Violence prevention

• Establish a protocol for prevention, detection, action and care for possible victims of gender-based violence, which regulates the victim's access to the relevant health, psychological and legal care.

Prison information

• Incorporate the variable of Roma minority women in the collection of data and elaborate statistics.

• Ensure that the gender identity of transgender people is correctly reflected in data collection and statistical work.

Pregnant and breastfeeding women

• Draw up a protocol for the care of pregnant women.

Women with children in prison

• Ensure that women in prison in the Canary and Balearic archipelagos, as well as in Ceuta and Melilla, have adequate facilities for serving their sentences with their children under three years of age in prison.

Detention issues

The Spanish NPM has been carrying out specific gender-focused visits since 2018. The reports carried out by the NPM and its recommendations have had a positive impact in bringing about changes in the situation of women in prison. These include the parliamentary initiative approved in Congress in June 2020, whereby Congress urged the Government to prepare a report on the situation of women in State prisons.

As a result of the visits carried out to date to the prisons run by the State Administration (Secretariat General of Penitentiary Institutions), it was found that discrimination against women is structural, and therefore recommendations were made that are applicable to all prisons, and not only to the prison visited. The NPM requests action protocols that address gender in a cross-cutting manner, but the usual response is that these issues are dealt with on a case-by-case basis, thus preventing a general prison regulation for the rights of women. In particular, the NPM has recommended the creation of an action protocol for health, technical and civil servant staff to guarantee an adequate and protective response to a potential victim of gender-based violence due to physical or sexual aggression in the centre. In 2022, Organic Law 10/2022 on guaranteeing sexual freedom,6 in line with the NPM recommendation, establishes the obligation for prisons to have such a protocol.

Solitary confinement, isolation

a) Legal framework

In Organic Law 1/1979, of 26 September, General Penitentiary Law, there is a detailed regulation of isolation as a sanction (Article 42), as a protective measure (Articles 42 to 45) and as a living regime (Article 10). The system of safeguards is adequate (Articles 76 to 78 on the supervising judge). 

Only women over 18 years of age serve time in prison. The law prohibits the isolation of pregnant women and women up to six months after the termination of pregnancy, nursing mothers and those who have children with them (Article 43). There is no mention of those who require psychosocial support. 

Provision is made for women to request to be protected in cases where there is conflict with other inmates, and they may also be protected even in the absence of an express request (Article 75 of the Prison Rules).

b) The use of solitary confinement, isolation in practice

Isolation cells are similar to the other cells, although they have less furniture, limited belongings and a smaller yard.   

The Administration has an extensive system of control and registration: register, prison file and computerised register.   

In some visits carried out by the NPM, it was noted that women suffer a disproportionately higher percentage of isolation, and for longer periods of time, than men. It was therefore suggested that the application of these standards be reviewed. At the NPM's insistence, the Administration acknowledges this discrimination and cites as reasons the issue of women's mental health and the smaller number of residential departments for women, which is the case in all other prisons. These two issues, instead of being solved by the Administration in a gender-sensitive manner, are precisely the cause of physical and psychological harm due to the application of isolation measures. 

The NPM requested annual data on isolation measures applied in mixed prisons disaggregated by sex, and found that, in 2020, of the 43 mixed prisons, 19 of them applied isolation measures more often to women than to men, and in 2021, the number rose to 21 prisons. Moreover, in both years, the percentage of women is much higher than that of men. Following up on its 2023 Recommendation to review gender-sensitive isolation measures, the NPM continues to request annual sex-disaggregated data and statistics on the application of isolation, and continues to insist on a common culture of gender-sensitive isolation in prisons. 

Use of means of coercion 

a) Legal framework 

Physical restraints are regulated in Article 72 of the Prison Rules. Medical sedation is not regulated in the prison protocols, the criteria of good medical practice are used. The use of physical restraints is regulated.   

In prison, means of restraint are prohibited – and are not used in practice – for pregnant women, during labour, during childbirth and after childbirth.

b) The use of means of coercion in practice

There are systems in place to record the use of coercive means in personal files and other recording media. CCTV recordings are subject to general and specific rules of capture, extraction and preservation.

During some visits carried out by the NPM in 2018 and 2021[1], it was found that, despite being less dangerous and having worse living conditions in prison (exclusion from mental health and drug addiction programmes, spaces, etc.), women were more likely to be subjected to authorised belts and physical force, even those with mental health issues. Therefore, in 2023 the NPM recommended a gender-sensitive review of the application of coercive means. Although this recommendation was accepted by the relevant authorities, it has not yet been implemented. 

The NPM recommended the inclusion of the sex variable in computerised data collection and producing sex-disaggregated data statistics, which was accepted by the Administration. However, five years later, the Administration still has no statistical use of coercive means.

Mental healthcare

Among women in prison, according to information provided by the Spanish Society of Legal Psychiatry, the prevalence rate of psychotic disorders is estimated at 3.9%, major depression at 14.1%, post-traumatic stress disorder at 21.1% and drug abuse at 30% to 60%. In 2020, it is estimated that 4.65% of female inmates in Spanish prisons had SMD [severe mental disorders], while in 2021 this percentage increased by 1.84%, despite the decrease in the total female prison population.7

The initial medical examination includes information on depression at the time of admission, recent suicidal thoughts and previous suicide attempts, mental disorder, bereavement and relationship breakdown. 

There is a lack of awareness of the mental health of women detainees, family members and prison staff, and a failure to regularly assess the mental health needs of women during their imprisonment. 

Mental healthcare is precarious due to the lack of human and structural resources, as well as the fragility of the social and health care network, as stated in the Libro Blanco sobre la atención sanitaria a las personas con trastornos mentales graves en los centros penitenciarios de España  [White Paper on health care for people with serious mental disorders in prisons in Spain].8

During the first gender-specific visit in 2018, the NPM found that the suicide prevention assessment scale and other protocols related to women's mental health lacked a gender perspective and recommended that a gender perspective be included in the psychological assessment protocols and semi-structured interviews to make the differences observed more visible. In view of the fact that the accepted Recommendation was not implemented, the NPM specifically recommended in a 2020 visit to incorporate a gender perspective in the Suicide Prevention Protocol.9 This Recommendation, accepted by the Administration, was implemented in 2022 through Instruction I-9-2022. 

During the visits, it was noted that psychological care is perceived by many of the inmates as scarce and of little use, a fact which the Administration blames on a lack of staff. In view of the fact that this situation is repeated during prison visits, the NPM recommends guaranteeing accessibility to gender-sensitive psychiatric and psychological care for inmates.10

In one prison11 it was found that the proportion of women with psychosocial or intellectual disabilities was very high compared to men. The treatment response discriminated against women, so a recommendation was made to develop a gender-sensitive treatment response to disability, which was accepted by the administration.       

Similarly, there is a general lack of inclusion of women in the Programme of Comprehensive Care for Persons with Mental Health Conditions in 2019 and 2020, despite the higher rate of mental health conditions among women, and the NPM repeatedly recommends non-discriminatory treatment during the visits. In Ceuta prison,12 women detainees are included in the Programme, which has a gender focus, which is identified as a good practice, and the NPM recommends the Administration to incorporate the gender perspective in the Comprehensive Care Programme for Persons with Mental Health Conditions, a recommendation accepted by the Administration, but not yet implemented. 

With regard to gender training, in 2019 the NPM recommended guaranteeing training for technical and health personnel on gender identity and sexual orientation, gender-based violence and its effects on physical, psychological and emotional health, which was accepted by the Administration but not implemented in practice, as is evident from the visits. This Recommendation is currently a legal obligation.13

In all the territory managed by the General Secretariat of Penitentiary Institutions, there is only one women's module, which is in the Psychiatric Penitentiary Hospital of Alicante,14 where the percentage of women in internment is double that of the prisons. The poverty and gender violence suffered by these women throughout their lives is evident. There is no multidisciplinary approach to mental health, and gender violence is not addressed as a health problem, neither in diagnosis nor in intervention. There is no care from a gender perspective, even though it is known that women have been victims of mistreatment and abuse of all kinds, which is why they have hardly any relationship with their families. The NPM made the recommendation to guarantee a multidisciplinary response with psychiatric, therapeutic and health involvement that assumes that gender-based violence is a serious health problem that affects women and affects to a large extent their social reintegration, which is accepted but not implemented. 

In addition, the lack of clinical psychology staff and the lack of psychiatric treatment make it very difficult for women to attend treatment regularly, with a clear predominance of pharmacological therapies. 

Women in Special Situations of Vulnerability

Roma women 
Roma women are over-represented in the prison population. According to information provided by the Spanish Society of Legal Psychiatry, 4 out of 10 Spanish women inmates belong to the Roma ethnic group.15 According to information provided to the NPM by the General Secretariat of Penitentiary Institutions in January 2023, Roma women in prison represent 13.8% of the total Roma prison population.16
In 2019, during the visit to Madrid I prison,17 given the high number of Roma women, in this prison as in others, the NPM recommended that the variable of Roma minority women be included in the collection of data and compilation of statistics. The Recommendation was finally accepted by the Administration, but four years after the visit, the Administration still does not use this information for statistical purposes.
Older women 

In its visits,18 the NPM noted functional limitations resulting from sensory deficits and age-related loss of capacities and recommended that these limitations be assessed and that occupational activities and destinations be adapted accordingly.

LGBTIQ+ women 

There is no official information available on LGBTIQ+ women in prisons. According to press information, prisons under the State Administration, all except those in the Basque Country and Catalonia, hold 79 transgender persons, of whom 22 are transgender women who are either held in all-female prisons or in women's modules within mixed prisons (6 are transgender men living in male facilities).

During its visits, the NPM was able to verify that there are misclassifications of inmates considered transgender, and it is therefore recommended that the gender identity of transgender persons be correctly reflected in data collection and statistics.19 In 2023, a new law on transgender status20 came into force, which will have an impact on prison practice. 

Other Relevant NPM Information on Women in Prison