Public Safety Committee on June 11th, 2009

[The Chair, Conservative, Garry Breitkreuz]

Order. I'd like to bring this meeting to order. This is the Standing Committee on Public Safety and National Security, meeting number 27. We are being televised today as we study federal corrections, mental and health addiction.

We'd like to welcome our witnesses this morning from the Correctional Service of Canada, Mr. Don Head, the commissioner--welcome, sir--Ms. Leslie MacLean, the assistant commissioner in charge of health services, and from the Correctional Service of Canada Review Panel, Mr. Rob Sampson, the chair.

We'd like to welcome you to our committee. The usual practice is to allow you some time for an opening statement. Without any further ado, if you're prepared to do that, we'll go ahead.

Who's going to go first? Mr. Head? Okay, go ahead, sir.

[Don Head, Commissioner, Correctional Service Canada]

Thank you, and good morning, Mr. Chair and committee members.

I'm pleased to be here today, and I would like to thank you for the opportunity to speak to you on this very important issue for the Correctional Service of Canada. Over the last decade, due to a number of factors, we've seen a significant change in the offender population profile, and this reality has posed serious challenges for the Correctional Service. One of the key changes is an increase in the number of offenders with mental health problems and substance abuse problems who arrive at our institutions. To give you an example, the percentage of male offenders identified at intake as having a mental health issue has increased by 71% since 1997, while the number of women offenders with mental health issues has increased by 61% over the same period.

As a service, we must find ways to address these challenges in providing mental health services, and we must continue to strive to improve both the standard of care as well as the correctional results for federal offenders with mental health conditions. It's crucial that we continue to enhance this capacity, because addressing the needs of offenders with mental health issues not only reduces their vulnerability but helps to reduce the risk they pose to others, thereby contributing to public safety results for all Canadians.

Over the last five years, we have enhanced our efforts and continued to work diligently to identify gaps in our mental health services and implement new programs, policies, services, and initiatives to address these issues. In support of these initiatives, we've received a total of $29.1 million over five years to strengthen the continuum of specialized mental health support from institutions to the community, within the context of the community mental health initiative. In addition, in 2007 CSC was funded $21.5 million over two years to support key elements of its institutional mental health strategy. In budget 2008, the Correctional Service of Canada received permanent funding of $16.6 million annually for institutional mental health services, commencing in the fiscal year 2009-10.

These funds have gone a long way toward establishing a continuum of mental health services to meet the needs of federal offenders, from intake to warrant expiry. For example, CSC is implementing a computerized system to screen and assess all new offenders at the time of intake. As well, all institutions are putting in place a multidisciplinary team of mental health professionals to provide basic mental health services and supports.

I'm pleased to inform you that the critical aspects of the comprehensive mental health strategy are also currently being implemented, including building capacity in federal institutions and supporting offenders to return safely to communities. It is a strategy designed to improve the continuum of mental health care and interventions provided to offenders from the time of admission to the end of the offender's sentence in the community. For example, interdisciplinary mental health teams provide offenders with access to coordinated and comprehensive mental health care within their institutions. Clinical social workers provide clinical discharge planning to support offenders with mental health disorders being released from an institution to the community.

CSC's treatment centres are also an important component of the continuum of care, as they assist in addressing the intensive, acute needs of offenders with mental health disorders. Treatment centres have well-defined admission and discharge criteria, and referrals for admission are made by mental health professionals in regular institutions for various types of mental health conditions.

However, there are some complexities with convincing an offender to agree to participate in treatment. Since the centres are designated as hospitals, they must operate in accordance with the provincial acts governing health care, including the Mental Health Act. Provincial law requires that a patient must either be placed in a hospital voluntarily or, if the patient is assessed by a physician as not being competent to give consent, on an involuntary basis under certification. This certification must be renewed regularly.

An offender's stay in a treatment centre varies considerably and depends on the offender's needs. Discharge from a treatment centre could be for any of the following reasons: the clinical team assesses that a discharge is appropriate, i.e., their treatment plan is complete; the offender decides to leave or refuses to accept the treatment and cannot be held within the provisions of the provincial mental health act; or the offender has a mandated release date regardless of the above, a statutory release, or a warrant's expiry release. It should be noted, then, that in some instances it can be difficult to move an offender to a treatment centre or to keep them there to get the help and support he or she needs, if they are unwilling.

To continue to support and treat the growing number of offenders with mental health problems, the service is taking strides to boost its human resource capacity. Last year, CSC established a recruitment and retention strategy for health care professionals, including psychologists and other mental health professionals, to recruit and retain qualified candidates. Implementation of the strategy is now under way and focuses on communicating and advertising CSC health positions, doing targeted recruiting, and promoting a healthy workplace that promotes professional development.

Compounding mental health challenges is the fact that four out of five offenders now arrive at a federal institution with a substance abuse problem, with one out of two having committed their crime under the influence of drugs, alcohol, or other intoxicants. Unfortunately, an offender's substance abuse problem will likely continue once they have entered an institution. A major contributor to the institutional violence is drug trafficking, both in street drugs and prescription drugs. This creates a challenge to ensure our institutions are safe and secure for both staff and offenders. It also has a significant impact on an offender's willingness and capacity to successfully participate in and complete substance abuse programs.

Preventing drugs from entering our federal institutions is an ongoing issue, and it is the diligent work of CSC staff that helps us tackle this challenge. Consequently, CSC continues to develop plans and implement measures to reduce violence and illicit drugs in our institutions through the anti-drug strategy. This strategy focuses on the three key elements of prevention, treatment and intervention, and interdiction. One of the goals is to emphasize a more strategic use of existing interdiction tools. It also aims at an awareness program to inform visitors, contractors, and staff about the repercussions of smuggling drugs into penitentiaries, increased monitoring of those offenders and other individuals potentially involved in the drug trade, increased discipline measures, and a broadening of offenders' awareness of substance abuse programs.

In addition, CSC staff members use a number of tools to prevent drugs from getting into our institutions, such as x-ray machines, ion scanners, a 1-800 tip line, drug detector dogs, as well as a public information campaign. We will also be piloting a new integrated correctional program model in designated men's institutions and community sites in January 2010 for a period of one year. The integrated correctional program model will be based on the most effective aspects of our existing correctional programs and will maximize the service's contributions to public safety by helping to ensure that offenders get the right programs at the right intensity level at the right time.

Creating an integrated approach to meet those needs is the most cost-effective way of delivering services, particularly as offenders transition to the community. These are important measures that contribute to making institutions safe, secure, and drug free, measures that are critical to creating an environment where offenders can concentrate on becoming law-abiding citizens.

In May 2008, CSC hosted an international symposium on advancing solutions to offender mental health issues. This symposium was organized to allow CSC to consult with other correctional jurisdictions on their best practices. In December 2008, CSC hosted a symposium on managing the interconnectivity of gangs and drugs in federal penitentiaries. The symposium proved very successful in allowing Canadian correctional employees and their international counterparts to exchange best practices and ideas to approach gang and drug issues.

As you may be aware, on April 20, 2007, the government appointed an independent review panel to assess the operational priorities, strategies, and business plans of CSC, with the ultimate goal of enhancing public safety. In December 2007, the panel released its report containing 109 recommendations that focus on five key areas: offender accountability, the elimination of drugs in institutions, offender employment and employability, the physical infrastructure, and the elimination of statutory release in favour of earned parole.

In February 2008, CSC established a transformation team to lead the service's response to the report presented by the review panel. CSC's transformation agenda was then supported in budget 2008, with $122 million committed over the next two years. This funding allows CSC to implement the first critical stage of transformation.

Above and beyond our efforts to address mental health and substance abuse issues, we have focused on areas such as population management; safety and security; assessment and correctional interventions; employment and education; women, aboriginal, and ethnocultural offenders; transition to community; victims; human resource management; and our physical infrastructure. I believe we are well on our way to improving the federal correctional system and thus enhancing our ability to meet our mandate of contributing to public safety.

In closing, I wish to thank you for this opportunity to speak on CSC's efforts to address the needs of offenders suffering from mental health and addictions problems and to outline some of the strategies and initiatives we have taken.

Thank you, Mr. Chair.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much, sir.

Mr. Sampson, do you have an opening statement as well?

[Rob Sampson, Chair, Correctional Service Canada Review Panel]

Yes, I do, Mr. Chair. I don't have any written comments. I'm going to do this as I'm accustomed to doing, on the fly. But I'm going to refer the chair and the committee to the report we issued in October 2007. I suppose most of my comments are buried in the report, and one or two of the 109 recommendations are in one or two pages of that report.

The report is on the CSC website; it's a publicly released document. There are a number of sections in the report that deal with mental health in particular. I think there are some 10 or 11 recommendations that deal with mental health, recommendations 47 to 58, if members want to take note of those particular ones.

I just want to say a couple of things, and then I think it is probably beneficial to open it up for questions, Mr. Chair, or whatever your process is.

I would encourage the committee not to look at mental health as a stand-alone issue within corrections. It's really one of a number of issues within corrections. What the panel found when we did our review of corrections was that all these pieces of the puzzle are very much connected. To tackle the mental health issues within corrections and not deal with infrastructure doesn't work. To deal with infrastructure but then not deal with the issues around mental health, or drug addiction, or programming doesn't work. The solutions around corrections and federal corrections really need to be holistic, if you will.

Just looking at mental health in particular, the panel commented on this, and I don't know how this committee looks at it, but what the commissioner just explained is that with the multi-millions they spend on mental health and health programs within corrections, effectively what Correctional Service Canada is creating is its own health system. Federal prisoners are outside of the federal Health Act, and because of that, even though these institutions may be in Ontario, Saskatchewan, or B.C., where there is a health system, the federal corrections system creates its own. The potential for duplication and reinventing the wheel is large. I think the potential for “not the best” spending of federal taxpayers' money is extremely high when you're building another health system within the federal corrections system, right in the backyard of the Ontario health system.

One of our recommendations on the mental health side alone is that there be some improvement in the coordination between the delivery of services for federal penitentiary incarcerated inmates and those that are done outside. Those inmates will be released back into the community and then they will be part of the provincial/federal health system. You need to have the integration. I know the commissioner is struggling to do it, but it is very difficult to do when in fact the act says federally incarcerated individuals are outside of the Health Act.

An interesting comment in our report was that we should look at mental health as a penitentiary within a hospital as opposed to a hospital within a penitentiary. You need to think a bit about that phrase. I would encourage the committee to do that as they tour these facilities.

I'm going to champion a particular project that was started in Ontario, not because it was started by me when I was the Minister of Corrections in Ontario, but because it was started by a government in Ontario, and that's the Brockville situation. If you have the opportunity, I would encourage you to tour the Brockville mental health facility, where they have indeed created a penitentiary within a hospital. You will walk into that place and it will be secure, there will be guards there, but the inmates are treated more like hospital patients, and I think, frankly, they respond differently than they do in some of the federal institutions that the panel toured.

That system is a little bit more integrated with the provincial health care system as well. It's actually run by the Ottawa Hospital.

Infrastructure is a recommendation in our report. The panel actually recommended the creation of complexes, not because they become these massive big prisons, as some people have twisted our recommendation into, but because they give the opportunity for the commissioner to put a hospital within a penitentiary, if you get my sense, and have the flexibility to move inmates around from one institution within the other, from one facility to the other, within the same confines--within the same fence, if you will.

Tremendous operational efficiencies, tremendous service delivery efficiencies could be achieved, and I would argue--and the panel actually alluded to this--that cost savings as well can be achieved by better managing a much smaller group.Commissioner, is it 50-some-odd institutions that you have?

A final comment around mental health. This was alluded to in the report but not specifically spoken to in the report.

On the mental health side, the panel's view is that the primary objective for corrections should be to stabilize the individual and treat as necessary. The individual will either transition down into the general population of a prison population or out of the prison on release, and they may or may not have the same level of services they became accustomed to within the institution. As a result, you need to get them transitioned and stabilized to a point at which they can actually live as law-abiding citizens outside the gates, relying upon the services that are available within the particular community they go to. To get them accustomed to a high level of service within an institution and then release them to a low level of service outside the institution is, frankly, setting them up for failure.

I think some of the recidivism statistics around mental health issues that you will have heard already from the commissioner or the correctional investigator would indicate that that's what's happening. These individuals are leaving, they're accustomed to a more individualized level of service inside the institution, and they're on their own. That is why the primary objective should be to stabilize, so they can actually survive as law-abiding citizens within their community.

In fact, I think if you ask the fellow who runs the Brockville institution what his primary objective is, that's what it is. His challenge is a little bit more difficult because of the shortness of stay within provincial institutions. It is much shorter than in federal institutions. He has to focus on stabilization because they're not around long enough to have any effective impact from treatment.

Mr. Chairman, those are my comments. I appreciate your taking a look at this very important subject and I await your further questions.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much.

We'll move to comments and questions, beginning with the Liberal Party. Mr. Holland, seven minutes, please.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Thank you, Mr. Chair, and thank you to the witnesses.

I'll start with one of the areas Mr. Sampson really spent a lot of time on that is deeply concerning to me because it deals with two issues. One, you mention the fact that four out of five inmates who come into correctional facilities have substance abuse problems. Clearly, those are problems that don't simply go away through trying to deny drugs coming into the facility. That's laudable, but I'll come back to that point.

The problem I have is that the correctional investigator indicated that in many cases there are individuals serving their sentences and in that entire period of time they never have access to any program. And programming is key to reducing recidivism, yet it seems right now that we're not even meeting the statutory obligation to provide programs to these inmates to make sure they're getting the skills and help they need to be able to reintegrate into society.

I'm wondering if you could respond to those comments by the correctional investigator and give your perspective on where we are on the delivery of programs right now.

[Don Head]

Thank you very much, Mr. Chair. That's an excellent question.

Under the legislation, we have an obligation to provide a range of programs for offenders. The legislation very much puts the onus on us to make available a variety of programs, not only correctional programs but social-based programs, ethnocultural-based programs, a whole array of programs. I would say that we've been relatively successful in doing that.

Now, there are several challenges that we face in that regard. First, we cannot force an inmate to participate in any programs. Our obligation is to make them available, but we can't force an offender to participate.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Let me pause you there, just for a clarification.

The correctional investigator indicated that there were individuals who did not have access to programs, even should they want it. Do you disagree that this situation exists?

[Don Head]

I think we have some issues in some of the more unique or specific types of programs, some very unique problems—particularly, for example, on the mental health side. We have a huge array of programs available and in some cases we have more capacity than we have demand.

I'll use substance abuse as an example. Of the 509 program officers we have across the country, 400 are trained to deliver a substance abuse program, which gives us the capacity to deal with about 10,000 offenders a year going through programs on substance abuse alone. For the last several years we've been averaging between 5,000 and 5,500 people going through substance abuse programs. We've been putting a lot of our time and energy into that area.

We have some challenges in some of the other unique areas, such as sex offender programming, and some of the more unique sex offender types of programs.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Maybe you can get back to me on this, because it's probably not something you can answer immediately now, but what I think the committee is really going to need to know is how we fix this. If you have individuals who are entering our facilities with issues on which they clearly need help if they are to be redressed, and if we're not dealing with them in the correctional facility, they're going to be reintegrated, and the likelihood of their repeating an offence is exceptionally high. I think we need to know what Correctional Services Canada would need to make sure that everybody who needs programming gets it. That's an area of deep concern for me.

I'll talk just for a second about substance abuse. We heard from the correctional investigator that over the last five years a very large amount of money and effort has been put into keeping drugs out of prisons. The result of testing has shown that in the overall prison population, drug use has gone down by 1%. Could you tell me how much STDs have grown in that same five years—hepatitis, AIDS, and HIV? What kind of growth have we seen?

I didn't hear a lot about the strategy of breaking the cycle of addiction; I heard more about just keeping the drugs out of the facility. Is that very realistic as a strategy? Do you see that correlation—that the more we clamp down, the more dangerous these desperate individuals, who need help, become and the higher the rate of infection? I believe 30% of inmates are faced with hepatitis right now. These individuals are coming back into society and infecting the general population; this is becoming a huge health concern.

I'm interested in your thoughts.

[Don Head]

I have a couple of responses, one just quickly on the program piece.

I mentioned briefly in my opening comments the moves we're making around what we're calling the integrated correctional program model. What that will do for us, to address the issue you raised about access to programs, is position us to start delivering the program primers to offenders during the time of admission. Rather than waiting anywhere from eight to nine to ten months before offenders start participating in programs, they'll be starting to participate in the program primers right at the time of admission. For us, this is a significant change in our programming strategy that will go a long way to address the issue you were briefly mentioning.

On the issue of infectious contagious diseases, currently we have about 250 offenders who have tested positive for HIV, and about 4,100 offenders who have tested positive for hepatitis C. These numbers have been going up gradually. They are not huge increases. We can provide the committee with a table of the actual numbers.

We know these numbers only as a result of inmates' consenting to be tested. There is no mandatory testing of offenders coming into the system. If there were a huge increase of individuals who come into the system with infectious diseases rather than getting them through something that's happening in the institution, we really don't have a good gauge for it, unless the offenders agree to be tested. We only know the statistics based on those who have volunteered to be tested.

As to our approach to clamping down, we honestly believe that unless we create a safe environment for offenders to come forward and participate in programs, we're not going to have them come out of their cells. A lot of pressure occurs in some of our institutions, primarily at maximum security institutions and some of our higher-level medium security institutions, where the pressure is placed on offenders to be more involved in the drug subculture and therefore choose not to participate in programs. On any given day, about 20% of offenders choose not to participate in any programs.

[Mark Holland, Liberal, Ajax—Pickering, ON]

My point here is not that we should allow drugs to run through the system, but if we want to break the cycle of addiction we have to treat it differently. When we have the level of infectious disease that we have in our correctional facilities, that poses a huge health risk, not only to the other inmates but to the population in general when these individuals come out. It's an area I think we have to do a lot more on.

I have one last question.

I had an opportunity to meet with a lot of the people involved in the farm prison program. I met with former inmates and I saw that the rates of recidivism in that program had dropped dramatically. It seems to me as yet another example of where there's some great programming and some wonderful things being done. In fact, we're using it in Afghanistan as a model to show how corrections should be done, yet here we're cancelling it.

Can you explain to me why we're cancelling that program? It's providing food to the area prisons and it's providing some great programming, job skills, and self-confidence. Why are we cutting that right now?

[The Chair, Conservative, Garry Breitkreuz]

Mr. Head.

[Don Head]

We're trying to provide opportunities that address the criminogenic needs of offenders. The participation in farm programs don't necessarily do that. There is more emphasis on trying to meet production quotas than there is in meeting the criminogenic needs of the offenders. Our primary focus is to address the needs of the offenders that led them into conflict with the law.

As I mentioned earlier, we're also trying to provide employment and employability skills opportunities. That's not to say that the farm participation doesn't do that, but we're trying to find those kinds of skills that will allow offenders to access the more modern job market that they're going to face when they're released into the community.

[The Chair, Conservative, Garry Breitkreuz]

We'll move to the Bloc Québécois for seven minutes.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

Thank you for coming here. It is really unfortunate that we have so little time to meet with you. I will therefore quickly go to the nub of the issue.

How long have you been in your current position?

[Don Head]

I've been the commissioner of Correctional Service Canada since June 2008. Previous to that I was the senior deputy commissioner from 2002 until I was appointed commissioner. Previous to that I was the assistant deputy minister in Saskatchewan responsible for the provincial probation in Correctional Services. Prior to that I was the superintendent of the territorial jail in Whitehorse and then shortly ran the territorial system in the Yukon. Previous to that I had started my career as a correctional officer in Correctional Service Canada in 1978 and worked my way up through several positions.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

I see that you have spent your entire career in the field of criminal justice. We may very well get along, since I have worked in the field of criminal justice since 1966, but as a lawyer.

I would like to understand what your current priorities are, as the Commissioner of the Correctional Service of Canada?

[Don Head]

They are several. They are very much aligned with our overall transformation agenda.

The first priority is about ensuring we have safe and secure institutions across the country. If we do not have safe and secure environments in which the staff can work and in which offenders can choose to participate in the programs that are being offered to them, then we're not going to be effective.

The second priority is around making sure we have the most modern assessment capacity to assess the needs of offenders, so that we in turn can develop the most effective correctional plans that will allow us, again, to address the needs of the offenders. Then, based on that, it's making sure we have the most effective—empirically based effective—programs for offenders to address their needs, both while they serve their time in the institutions and while they transition into the community under our supervision.

As well, I'm trying to make sure that we have a good, strong human resource capacity, so we are recruiting the best men and women from across the country to work in our organization; that we provide them the best learning and development opportunities; and that we have a good, strong retention strategy for keeping people within the organization. Collectively, it is trying to make sure we have a good, strong continuum for delivering correctional services.

At the same time, one of my priorities is to make sure we're well connected to what I would call the front end of the system and the back end of the system. I believe very strongly that there is a lot more work we could be doing in terms of our relationships with the communities, with the criminal justice system, and with the social service agencies that address some of the issues we face and deal with on an ongoing basis.

Unfortunately, as the member may know, Correctional Services Canada becomes the point in the continuum where the expectation is that we address all the social problems that have been unaddressed for a period of time. So I am trying to make sure we are much better connected at both the front end and the back end, so that people coming into the system have many of the issues, which we have to face now, addressed ahead of time, and at the same time, once they move beyond our responsibility—beyond warrant expiry—that they have access to the types of services and supports they need in order to stay out in the community and function as law-abiding citizens.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

Thank you.

In my opinion, you have shown that you have a great deal of competence in your field. I have always said that managing delinquency means managing failure. Here I speak of personal failure, failure of the education system, the family, society and, more and more, the failure of mental health services. It would be interesting to examine the priorities of the Correctional Investigator. His priorities would no doubt be completely different from yours, but I do not want to say anything further on that issue.

I know that the main problem, the one that is underlying all the others, is drugs. That comes as no surprise to me. In 1966, 90% of the time, alcohol was given as the reason for committing a crime. That damn alcohol! That was it. Slowly, drugs started playing a more predominant role. Obviously, drug use is not often used as an excuse, but we all know that this is the main reason. That is why I do not think that minimum sentences will do much to reduce crime if we do not attack the root of the problem.

You know, Matsqui was a failure. This prison was established in order to reintegrate drug users. I note that your service had some agreements with external organizations in order to deal with the most hardcore drug users, such as Portage in Quebec. I do not know if there are any models, such as Daytop in New York.

Could you tell me how much money we spend to treat serious drug addicts at these external agencies?

[Don Head]

I don't have that number. We could do some research on the cases where we've sent offenders to specialized treatment programs. They're usually cases where offenders have been released on conditional release or in preparation for release to the point of warrant expiry.

As was pointed out, there's a series of treatment centres across the country. Places like Poundmaker, and Tsow-Tun Le Lum on Vancouver Island provide substance abuse treatment and support for offenders and others in the community who need that kind of help.

We can get back to the committee with the number of individuals and the costs we incur in that regard. But we try to deal with the individuals we have, both in the institution and under our supervision. Last year, for example, we put just over 5,000 offenders through substance abuse programs.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

Are you able to measure the success rate that you have obtained with such cases?

[Don Head]

I can give you the success rate for the offenders who complete the programs. For the substance abuse programs we have a successful completion rate of between 70% and 74%. For us that is relatively high. The model we use for substance abuse programming--

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

I apologize for interrupting you. But if I understand correctly, by success you mean people who have completed the program.

I would like to know whether you have an evaluation form that indicates whether or not these programs have managed to help these people—

[The Chair, Conservative, Garry Breitkreuz]

There's time for a brief response.