Public Safety Committee on Oct. 27th, 2009

[The Chair, Conservative, Garry Breitkreuz]

Thank you.

Mr. Christopherson, please.

[David Christopherson, NDP, Hamilton Centre, ON]

Thank you very much, Chair.

I appreciate the opportunity to speak. I'm obviously filling in for Mr. Davies, who's required in the House to speak.

Thank you for your presentation. I was here for most of it. I read your report. As a former Ontario corrections minister, I'm certainly familiar at the provincial level. At that time the provincial system in Ontario was as big as the federal. I don't know if that's still the case, but I suspect that.... At least so far it's like that. Who knows what will happen now.

But also, prior to that, being on Hamilton city council as an alderman back in the 1980s, I headed up a task force looking at mental health services in the community for those who pretty much were on the street. What we found—and I was referring to what you mentioned on page 2, the revolving door—was that there would be an incident of some sort. The police would be called. They would take them to the hospital. That would hold for a while. They may get out, or they may not. Eventually, they end up in jail for a short period of time. Then they're back out on the street. Then the police, then the hospital, then the jail, and there's just a revolving door. I haven't seen anything since then, either in my time as the minister or since, that suggests that's getting any better.

We know the shame of it, certainly in Ontario. I don't know about the rest of the country, but in Ontario, when the decision was made to deinstitutionalize the psychiatric hospitals in the late 1960s and 1970s, as the back wards were opened up and people were allowed out on the street, that money that was saved was supposed to be reinvested into the services that would be required in the community, since these people were now being removed from those back wards—and they were back wards: locked, dark, forgotten-about places in our society. And that money was just soaked up by the government of the day and taken into general revenue. So what was a problem in the prisons and in the hospitals became a problem on our streets and in what we in Hamilton call second-level lodging homes, which provided services for them. Anyway, all of that is to give a context for the Ontario experience.

The American example is the closest we have in terms of an acceleration of the number of inmates increasing in a short period of time. The American system, as I understand it, is still predicated on private prisons. For a while, in the last decade, the biggest growth industry in the United States was building and operating prisons. If you're running prisons for a profit, it makes sense that the more prisoners there are--guess what?--more profit.

I'm curious: in that system and in that experience that they've gone through, that we're about to head into, are there any lessons at all to be learned in terms of services for drug and other substance abuse programs, the hiring of professional services? In other words, did the privatized system take care of this problem in a way that can provide us with any examples that we want to follow? Or are there some lessons there on the downside that we need to take into account?

[Craig Jones]

I have a short answer and then I'd like to turn it over to Graham.

My research on the American example is if the United States does A, Canada should do “not A”.

[Graham Stewart]

I think the question of whether a prison can provide a good psychiatric treatment environment has to be answered with a no. First of all, psychiatry is generally referred to across the country, as Senator Kirby said, as the poor cousin. So psychiatry within corrections would be equally low. It's not a high priority. The institutions that we have for psychiatry are prisons first and treatment facilities second.

If you compare our psychiatric facilities in prisons with community psychiatric hospitals like the Philippe Pinel Institute in Montreal--which I hope you could visit--it's a completely different environment. When you go into the Pinel Institute there are no custody staff on the ranges, whereas in our federal institutions there are more custody staff than mental health workers. Staff are assigned to particular inmates and they work with them continuously, in the day, at night, in their yards, and in their recreational areas. It's a completely different model, and I hope you have a chance to see what the difference is when you're a hospital first as opposed to a prison first.

The fact is that a psychiatric institution within a large correctional system is still a small problem. The policies that are going to take precedence deal with the big issues, the budget issues, the working of the federal institutions generally, and very seldom are the mental health issues accommodated. For instance, in the current context we're talking about the abolition of statutory release. Well, statutory release abolition will have a huge disproportionate impact on anyone who's disadvantaged, and particularly the mentally ill. What we will be doing in effect is releasing more and more people into the community with serious mental illnesses and without either support or supervision. That kind of criminal justice approach for the mentally ill is simply incompatible with what we know is the best way to address mental health issues.

We do have examples of different models in this country that I think would be very instructive for you to consider. Otherwise, we end up with systems that simply recycle people, as Mr. Christopherson was mentioning.

If we don't make a change, if we can't bring together the proper treatment, if we don't have the proper reintegration support for people re-entering the community, you can be sure that being as vulnerable as they are, having the difficulty they have day by day in their lives, they will be back at the door in short order--and not necessarily for serious crimes. Interestingly, the research department has shown that actual criminal recidivism is not any higher among those with mental illness than for those who are not designated with mental illness, but it's because of the social environment.

[David Christopherson, NDP, Hamilton Centre, ON]

Thank you.

[The Chair, Conservative, Garry Breitkreuz]

You have 10 seconds for a closing remark.

[David Christopherson, NDP, Hamilton Centre, ON]

Thank you very much for that.

I would concur, Mr. Jones, and that's why I mentioned it the way I did, that the whole notion of building prisons--and the more prisoners you have, somebody's making more money--is the exact opposite direction and purpose from what hopefully the Canadian system will be looking at, because that's not what we're about as Canadians.

Thank you, Mr. Chair.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much.

We'll go over to Mr. Norlock now, please, for seven minutes.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you very much.

And thank you, witnesses, for coming today.

I'd like to look at this in a positive as opposed to negative vein. If we keep telling ourselves all the negative stuff, we'll never get to the positive stuff; in other words, where we want to be.

I could go through some of the great steps we've taken over the last while, with the Mental Health Commission of Canada and some of our budgets and the amounts of money we have placed there. I could tell you the stories of dealing with some of the folks in my own riding and their comments about the closing of the institutions we referred to--they look at that as a good thing--and how we need to build community support.

I could tell you some of the good stories there, but that's not dealing with the issue today. The issue we're dealing with is as a result of government members wanting to take a look at this, because we do realize it is a problem. I'd like to not look at it from the perspective of whipping the people whose approach you don't necessarily philosophically agree with.

In particular, I'd like to ask Mr. Jones a question, because he's the current representative of the John Howard Society. Would you describe the kind of institution in which there would be what you would consider the appropriate delivery of substance abuse treatments/mental health abuse treatments? Could you describe that? You could describe it under the present context of our system, because we have to start somewhere. I'd like to hear about some of the changes that need to be made, that you believe could be made, and that would be reasonable and accepted by ordinary people on the street. In the end, they're the people every member of Parliament is responsible to.

Could you describe that? I'm not asking for nirvana, just something that's practicable, deliverable, and that has changes from the way we're doing it currently.

[Craig Jones]

Thank you for that--

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

And if it can't be practical, then maybe think outside the box.

[Craig Jones]

Thank you for that modest question. There's a three-sentence answer, and there's a three-volume answer.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Give me the five-minute answer.

[Craig Jones]

You pose a huge challenge.

Number one, I would have to distinguish between the ordinary person on the street who actually knows something about this and the ordinary person who doesn't know anything about this except what he or she--

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Assume he or she is knowledgeable.

[Craig Jones]

Okay.

Dollar for dollar, the evidence is that you are going to get much better treatment outcomes, including crime reduction, in community-based settings than in prisons. However, if you have to rely on prisons--and I think by the time you're talking about prisons, it's too late for a lot of these guys--then you have to make prisons as humane and just as possible. That means you have to keep your rate of incarceration low and you have to staff your institutions with state-of-the-art psychiatric and psychological staff.

I have to tell you, that is a huge challenge for the service at this time. The way I've had it explained to me is that the service is unable to pay competitive wages for the people they would like to retain. They are routinely poached by the provinces. I talked to a psychiatrist in Vancouver, who is a young mother. She drives one hour to work and from work every day because her family lives in downtown Vancouver and she works an hour out of town. These are the kinds of routine, but very salient human resource challenges that the service encounters.

I've also talked to people in the service, some with long careers, who claim that Canadian practices are among the best in the world if there are resources to deliver them.

But what I have to come back to is that if you want the best outcomes in terms of crime reduction and the actual recovery model of mental illness, then the prison is not your best institution. Dollar for dollar, community-based settings are the most effective.

[The Chair, Conservative, Garry Breitkreuz]

You have one and a half minutes.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

I guess in five minutes you need to be generalized.

There is a system set up currently within prisons whereby x number of people see a person, etc. I listened to what you said. You said 80% of the people in our prisons have a substance abuse problem or mental illness issue. For the members of the public who would be reading the blues of this, are you inferring that 80% of the people currently in our prisons should be out receiving community-based treatment rather than be in the current federal penitentiary system?

[Craig Jones]

No, I'm not suggesting that.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

That is the interpretation that some people will be getting.

[Craig Jones]

One can draw that implication.

Certainly part of the problem in Canadian society, and not only in Canadian society, is that we have a long history of stigmatizing the mentally ill. What we know from that experience is that the more we stigmatize the mentally ill, the more we drive them underground. We should not be surprised when some of them are criminalized. We're talking about a cultural change here, which is to greatly ramp down the level of stigmatization in our society.

I just have to draw your attention to the Prime Minister's remarks when he debuted the national anti-drug strategy. He reproduced a form of stigmatization that is at complete variance with the evidence on how we understand the concurrence of mental illness and substance abuse. It comes from the very top. That's the project that we are seeking to turn around and that the Mental Health Commission of Canada is seeking to turn around.

[The Chair, Conservative, Garry Breitkreuz]

We'll end it there.

We've got about six or seven minutes left, we'll try to split that.

Three or four minutes, Mr. Kania, please.

[Andrew Kania, Liberal, Brampton West, ON]

Thank you for coming here.

I have a number of propositions that I'd like to take you through based on what you're saying. You indicated that approximately 80% of the population suffers from mental illness or some form of concurrent disorders, correct?

[Craig Jones]

Yes.

[Andrew Kania, Liberal, Brampton West, ON]

It goes without saying that these people need to receive adequate treatment in prison before release, correct?