Evidence of meeting #2 for Public Safety and National Security in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was health.
A recording is available from Parliament.
4:25 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chairman.
All three of you mentioned segregation. I just want you to drill down a little bit. Some people say you can't avoid it, that we just must have segregation. Is that the case?
4:25 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
Well, we've obviously seen this first-hand, through Brenda. Some might argue that it was a provincial situation and it can't apply federally, but I know of other instances internationally where they are using that same model.
For example, I visited Styal prison in the U.K., where there are 450 women of all different securities, from murderers down to those on remand, and that prison doesn't use segregation. They haven't for the last three years. They instituted that because of the high suicide rate. As a result, I think they've had only one suicide in three or four years with 450 women.
So it is possible to do. It has to be a paradigm shift in the way we look at doing corrections in Canada. It will take a major shift in terms of attitudes among the staff, as Brenda has experienced, but it is possible, and the results will speak for themselves.
Thank you.
4:25 p.m.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you very much.
We'll go over to the government side now.
For seven minutes, Mr. Rathgeber, please.
4:25 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Thank you, Mr. Chair.
Thank you to all the witnesses for your testimony and for travelling a great distance to do so.
Let's start with the paradigm shift, Dr. Martin. In your paper you indicate, and I think it's probably easy to defend the proposition, that we should actively discourage the use of solitary confinement. But what do we replace it with in cases of inmates who are acting out, who are violent, and cause a physical threat, potential or real, to other inmates or to staff?
4:25 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
I'm not an expert on this. I just know from a humane point of view and from a mental health point of that it makes sense. I can just speak to the experiences I've encountered in other countries.
My understanding is that many of the behaviour issues that we encounter are from mental health issues. As I talked about in my opening statement, the majority of people in prison do have some mental health difficulties.
First of all, sending them to segregation isn't the answer to actually help them with their problems. In one centre that I visited, instead of sending people to segregation they would actually have a special unit where there were more counsellors, more people to work with them, more psychiatric nurses, more community players, and they actually worked with them fairly intensely or closely so that actually they weren't left alone. It takes more resources in some ways, or more community involvement or more health involvement, but the premise is that actually people will do better by being with other people rather than being isolated and alone. So if you put people in isolation, as Amber has talked about and also as the studies say, and you deprive them of contact with other people, and you deprive them of many of the things that we would normally have as humans, they actually get worse. They get more angry, more aggressive, more violent, and then their mental health actually starts to take a quite serious turn for the worse.
4:25 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Okay. I appreciate that your expertise is limited to mental health and the treatment of prisoners.
Warden Tole, you have to deal with the safety of your staff and of the other prisoners. Perhaps you could pick up with Dr. Martin's suggestion that we need to look for creative alternatives to solitary confinement. I accept that cutting prisoners off from social contact does not do anything to benefit their mental health, but you, as a former warden, have to balance that with the safety of your staff and other inmates.
4:25 p.m.
Retired Warden of Alouette Correctional Centre for Women, As an Individual
Yes, and I'd like to clarify.
There are also different types of segregation. You have administrative segregation or segregation that has been used and is often used in systems for mental health issues or self-harm issues, and then you have segregation that is used for separation because of violence that is not related to mental health.
I would say that there are a lot of creative solutions that you can use from the mental health aspect, and Dr. Martin has spoken to a number of those. It's not that you don't, on occasion, have to separate people from the other population, it's the manner in which you do it and it's the timeframe in which you do it, because you cannot expect improvement when you put people in very severe conditions over very long periods of time. What you will end up doing is generating much more dangerous, much more violent individuals.
In the systems I worked in, both male institutions and female institutions, yes, there's segregation there, and on occasion there is a reason to segregate people. I think that the type of environment you build does not need to look as austere as usually it does because it basically deprives peoples of just basic human needs.
The other thing is the length of time. If you separate someone because of a disciplinary issue, because of violence, you don't need to keep them separate for great long periods of time. My experience in the male institutions was that it was something that was reviewed on a daily basis by management, and the sooner you could get that person out and into another environment, into a normalized environment, the safer the staff were. I know it's a very difficult thing to look to when you see this end product that's very violent and is acting out, but in reality, if you track back you'll see, in most cases, that this has been an ongoing process, that it didn't start out that way. When you segregate people for long periods of time you end up with a very violent and very dangerous population. It doesn't improve them; they don't get better.
If you relate it to kids, if you use extreme punishment on kids when they make mistakes or are difficult, you don't generate a positive reaction. And when you do that over periods of years, you're going to generate something that's very unfortunate.
4:30 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Thank you.
Dr. Martin, does the B.C. Solicitor General allow physicians to prescribe methadone to the prison population dealing with opiate addictions?
4:30 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
Yes.
4:30 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Do you track the success of the methadone prescription program from your population once they reintegrate into society?
4:30 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
I don't personally.
4:30 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Do you know if the B.C. Solicitor General does?
4:30 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
I don't know. I think that if and when the health care.... Right now the health care in the provincial system is run by a private health care contractor. So I don't know if there is any sense in which it is tracked at this point. But I would hope that if we have an integrated service whereby the provincial health system is actually assisting with prison health care, those are the kinds of data we'll be able to look at.
4:30 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
Anecdotally or otherwise, can you comment on how successful methadone prescription has been in dealing with heroin, morphine, and opiate addictions, in your experience?
4:30 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
When I'm working inside the prison as a prison physician, all I see over time are the failures, as do the prison staff, because we see people coming back when they're not doing well. When people don't come back to prison, you don't know if it's because they're doing well or that they've died. So it's a difficult position to be in to see whether it's successful. My own understanding from the medical point of view is that methadone is the only medical option we have for heroin treatment. So just anecdotally, seeing people come in if they're on methadone maintenance treatment, I know they are not as ill as if they're using heroin on the street.
I don't know if I'm answering.... I'm not quite sure what's underlying your question and what you really want me to get at.
4:30 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
I think you've answered it.
How am I doing for time, Mr. Chair?
4:30 p.m.
Conservative
4:30 p.m.
Conservative
The Chair Conservative Garry Breitkreuz
I was so engrossed in listening to the commentary I forgot to note the time.
4:35 p.m.
Conservative
Brent Rathgeber Conservative Edmonton—St. Albert, AB
I could have kept going and you would never have known.
4:35 p.m.
Conservative
The Chair Conservative Garry Breitkreuz
Okay. We'll come back now to the Liberal Party.
Mr. Wrzesnewskyj.
March 16th, 2010 / 4:35 p.m.
Liberal
Borys Wrzesnewskyj Liberal Etobicoke Centre, ON
Ms. Martin, we saw that approximately 10% of those incarcerated are women. I would also assume that the characteristics of the types of crimes they are incarcerated for are quite different from in the male population. Is that correct?
4:35 p.m.
Clinical Professor, Department of Family Practice and Collaborating Centre for Prison Health and Education, University of British Columbia, As an Individual
I don't think I'm the best expert on that, but that's certainly consistent with the prison health literature. There's a different profile among women versus men.
4:35 p.m.
Liberal
4:35 p.m.
Retired Warden of Alouette Correctional Centre for Women, As an Individual
As far as the provincial population is concerned, 40% of those who are sentenced are on a non-compliant type of a sentence, so they're in breach of bail, breach of probation, non-compliant with a court order of some type. A very high percentage just break the rules of the court enough times that they end up being sentenced.