omissions in the area of health care can, thus, trigger state responsibility to effectively prevent a violation of Article 3 ECHR by state provision of adequate medical treatment. Failure to do so, then, constitutes a violation of Article 3 ECHR.247 If a lack of health care does not reach the threshold of degrading or inhuman treatment, then access to and financing of medically necessary treatment falls, in any case, within the scope of protection of physical integrity from Article 8 ECHR.248 This applies in particular if the person is dependent on the state. Otherwise, they would not be able to gain access to health care and would be dependent on the state to provide it. Based on this, access to necessary medical care must be ensured, at least for the group of asylum seekers living in the camps, according to the requirements of the ECHR. If it is not provided, the physical and psychological integrity of the person would be violated. This is especially the case if an individual’s state of health deteriorates in state care or if an illness first arises because of living conditions – for example, chronic lung disease or mental illness due to hopelessness. In certain cases, there may also be a violation of Article 3 ECHR if the lack of health care reaches the standard of degrading treatment.249 It is unsettled whether a failure to provide health care combined with state sponsored (reception) conditions that contribute to the deterioration of health culminate in a violation of physical integrity under Article 8 ECHR. According to the case law of the ECtHR, a certain relevance threshold must be exceeded in such cases. The Court assumes that Article 8 protection applies if persons are “directly and seriously” affected.250 Accordingly, a violation of Article 8 ECHR through lack of access to health care is not within the typical scope of application of the provision. However, in view of the regulatory content developed by the Court and the requirements of Article 8 ECHR, such an understanding is warranted: that a violation of physical integrity and thus of Article 8 ECHR is possible in the absence of treatment of a condition that is known or should have been known. ii. Mental Health The Court has consistently held that Article 3 ECHR251 requires States to ensure that the mental well-being of prisoners is adequately secured.252 Firstly, the psychological condition of detainees needs to be assessed properly by taking into account the individual’s health and the effect of the manner of detention on him or her. The Court has recognised that detainees with mental disorders are more vulnerable than ordinary detainees, and that certain requirements of prison life pose a greater risk that their health will suffer.253 The state’s assessment of a person’s situation must include the person’s vulnerability, including their inability to complain coherently or at all about how they are affected by any particular treatment.254 247 248 249 250 Thus explicitly ECtHR, Judgment of 26/05/2011 - No. 27617/04 - RR, para. 152. ECtHR, Judgment of 04/01/2005 - No. 14462/03 - Pentiacova, under B. In conclusion, the Court finds no violation of Art. 8. For the scale, see above under D.I.4. ECtHR, Judgment of 08/07/2003 - No. 36022/97 - Hatton et. al, para. 96 f.; For application to health care and physical integrity see Hesselhaus, Art. 3 GRC, in Pechstein/Nowak/Häde, Frankfurter Kommentar, 1st edition 2017, para. 14. 251 Mental Health related questions may also arise with regard to Art. 2 ECHR (prevention of suicide). Furthermore, the conditions in which a person suffering from a mental disorder receives treatment are also relevant in assessing the lawfulness of his or her detention within the meaning of Art. 5 ECHR, See ECtHR, Judgement of 31/01/2019, No. 18052/11, Rooman v. Belgium [GC], para 194, 208. 252 ECtHR, Judgement of 20/01/2009, No. 28300/06, Sławomir Musiał v. Poland, para. 87. 253 ECtHR, Judgement of 31/01/2019, No. 18052/11, Rooman v. Belgium [GC], para. 145. 254 ECtHR, Judgement of 26/04/2016, No. 10511/10, Murray v. the Netherlands [GC], para. 106; See also, ECtHR, Judgement of 24/09/1992, No. 10533/83, Herczegfalvy v. Austria, para. 82, ECtHR, Judgement of 30/07/1998, No. 61/1997/845/1051, Aerts v. Belgium, para. 66. 40 DETENTION OF MIGRANTS ON THE ISLAND OF KOS