5. ADDITIONAL MATTERS 122. The Commission wishes to draw 4 additional matters to the Committee’s attention:  mental health in detention;  legislative recognition of economic, social and cultural rights;  the optional protocol to ICESCR; and  the realisation of economic, social and cultural rights in Tokelau. A. Mental Health in detention 123. The high prevalence of mental health issues amongst people in detention, and their access to care and treatment in detention are longstanding issues. Sixty to seventy percent of people in prison have either a learning disability or mental illness. 124. In 2012 the Ombudsman completed an investigation into prison healthcare,90 identifying deficiencies in the management of mentally unwell prisoners, and finding that aspects of the management of prisoners at risk of self-harm could be detrimental to their long term mental health. In general, it was found that services were insufficiently responsive to the diverse needs of prisoners requiring mental health care. 125. Also in 2012, the IPCA carried out a review of deaths in police custody,91 highlighting the effect of alcohol, drugs and mental health issues on people in Police custody as areas requiring attention. The 20 recommendations made by the IPCA included “to work towards establishing detoxification centres to provide appropriate care for heavily intoxicated people, and expansion of the watch-house nurse programme to help identify and manage detainees with mental health, alcohol or other drug issues.”92 126. Despite some very positive developments, such as increased adolescent mental health services, improved screening for mental health issues in prisons, efforts to reduce seclusion, and a successful pilot initiative placing mental health nurses in Police watch houses, overall, mental health issues in detention remain a concern. An ongoing concern is that detainees experiencing mental illness should be professionally treated in a therapeutic environment, rather than managed in a custodial setting. 127. According to the New Zealand Police Mental Health Team, Police dealt with around 5,000 mental health related jobs in 1995/96. By contrast in 2103/14 Police responded to over 25,500 mental health related calls for assistance.93 90 http://www.ombudsman.parliament.nz/system/paperclip/document_files/document_files/456/original/own_mo tion_prisoner_health.pdf?1349735789 91 http://ipca.govt.nz/Site/media/2012/2012-June-30-Deaths-in-Custody.aspx 92 Ibid. 93 New Zealand Police, Mental Health Team Newsletter, November 2014, p2. 32