Public Safety Committee on Oct. 6th, 2009
A recording is available from Parliament.
On the agenda
Some hon. members
For election as second vice-chair, it has been moved by Mr. Ménard that Don Davies be elected as second vice-chair of the committee.
Are there any further motions?
There being no further motions, is it the pleasure of the committee to adopt the motion?
Some hon. members
I declare the motion carried and Don Davies duly elected second vice-chair of the committee.
Some hon. members
I would invite the chair, Mr. Breitkreuz, to take the chair.
The Chair Garry Breitkreuz
I would like to thank the committee again for their confidence in placing me in this position. I pledge to do my best, and if you ever have any concerns or anything you need to discuss with me, please contact me. I'm here to serve the committee. Again, I appreciate your support in that endeavour.
I'd like at this point to invite our analysts, Lyne Casavant and Tanya Dupuis, to please join me at the front here.
We have always enjoyed your services. You have done an excellent job, and thank you for being here.
Some hon. members
The Chair Garry Breitkreuz
We did not send out a notice that we could do a few things at this meeting, maybe just to get on with our agenda, so I have suggested that we invite Mr. Sapers, the correctional investigator, to the committee. One of the things we wanted to do was discuss future travel. We had decided something earlier this year, and because of other events beyond our control, it was put off. He could talk to us about our itinerary and our plans.
If you wish to do that, we could do it. If you wish to go in camera to do it, we can do that as well. I leave it up to the committee at this point.
First of all, would you like to do some business this morning? Do you have other commitments, or can we continue with our meeting and maybe talk about this?
Mark Holland Ajax—Pickering, ON
Mr. Chair, because we didn't have the knowledge that Mr. Sapers was going to be available to speak to it today, because you obviously weren't chair and therefore couldn't send out a notice, I think it would make sense to talk today about the trip, and perhaps, if Mr. Sapers were willing, to get his input on it.
My suggestion, however, because I think there are a lot of matters referring to our study, would be that with more notice and more opportunity to prepare, we ask, if he's willing, to have Mr. Sapers back on a different occasion to speak to do that, because committee members really haven't had the opportunity to be aware this was going to happen, and neither has the public. There was obviously no public notice given of the fact that Mr. Sapers was going to be here today, and I think there's a significant amount of public interest in both the issue and also the question surrounding the things we're going to be studying.
The Chair Garry Breitkreuz
Would the committee agree that we should limit ourselves, then, to simply discussing future travel plans?
Brent Rathgeber Edmonton—St. Albert, AB
I agree with Mr. Holland. Mr. Sapers is here and can provide us with some thoughts and input regarding our future trip. But I also agree it would be unfortunate if this were a one-time-only shot with Mr. Sapers and we were to use it without any advance notice or any prep time. He lives in Ottawa; presumably it's not too much of an inconvenience to visit us here on Parliament Hill. If he can come back, then I agree with the suggestion of Mr. Holland.
The Chair Garry Breitkreuz
Does everyone agree with that?
I'd like to invite Mr. Sapers forward, then, and we can spend some time discussing the trip. After that, I see this meeting as maybe going in camera, if you wish, to plan future business of the committee, such as travel.
Do you have a question, Mr. Holland?
Let's let Mr. Sapers assume his seat.
I would like to thank you and Nathalie Neault for coming before the committee and being on standby as needed. We appreciate it, and I appreciate the committee's being willing to discuss this on such short notice.
Do you have any opening comments, sir, that you might like to make?
Go ahead, sir.
Howard Sapers Correctional Investigator, Office of the Correctional Investigator
Thank you very much, Mr. Chairman. Congratulations on being reappointed chair of this committee.
I'll start off by saying that certainly I and my office will be available to the committee as you pursue your studies in regard to corrections, mental health, and addictions. We look forward to the opportunity not only to provide you with some direct input but also to respond to any questions or queries you have. At your pleasure, we'd be happy to come back.
This morning I'm joined by Nathalie Neault, who is one of two directors of investigations for the Office of the Correctional Investigator. Ms. Neault will speak shortly about addictions issues and will address some points regarding your proposed visits to the Correctional Service regional treatment centres, which are, in fact, designated psychiatric hospitals.
When we last appeared before this committee, in early June, we covered a number of issues with you regarding the delivery of mental health services and addiction programs for federal offenders. Institutional visits will provide an excellent opportunity for committee members to gain an operational perspective to support your study on mental health and addiction. I strongly endorse your intention to conduct site visits.
At the chair's initiative, I was provided a copy of the proposed itinerary that has been set out for the committee's June trip. Assuming that this June itinerary remains largely in play, I would like to offer a few comments and suggestions on the proposed schedule of visits. I'd also like to contextualize these comments by saying that I am fully appreciative of your time constraints. I find it remarkable that at this point you're committing up to a week of travel. I would encourage you to do even more. The best time I've ever spent was time spent in jail. So I think in terms of learning about the issues, I would encourage you to spend more time if you could. But I do appreciate your time constraints. And I would suggest, perhaps, that while it may not be possible to do everything in one trip, you may think about opportunities to go on other one-off site visits.
I'd like to say that the proposed itinerary does represent a good balance between the regional treatment centres and the regular penitentiaries. But keep in mind that these penitentiaries also house a large portion of offenders who have significant mental health issues. I suggest that members may want to capitalize on their visit to the Shepody Healing Centre in the Atlantic region by also touring the Dorchester Penitentiary. In visiting Dorchester, members will gain an appreciation of some of the physical limitations the Correctional Service faces in trying to provide modern, accessible, quality health services.
Members should be mindful of the fact that Canada's prison estate is showing its age. Many of the older penitentiaries in this country, some of which were built in the mid to late 19th century, simply lack the design and infrastructure capacity to meet the needs and challenges of a rapidly expanding population of mentally disordered offenders. Staff cannot do their best, nor are offenders suffering from mental illness well served when they are housed in conditions that are decrepit, crowded, noisy, and devoid of natural light. The impact of these conditions of confinement on offenders whose thinking, learning, and/or emotional responses are impaired, delayed, or damaged can have deleterious and degrading effects on their mental functioning over time.
We no longer live in a time when penitentiaries are designed to be solitary and confining places with minimum human contact. Modern correctional practice requires modern infrastructure. Places of confinement should not purposely add to the pain of incarceration, nor should their design hinder the delivery of correctional interventions.
Ideally, committee members should also visit one of the five institutions for women, and Nova Institution in Nova Scotia may be a good choice in this regard. As I said, I'm mindful of your time constraints, but given the high prevalence of women offenders with serious mental health issues, I believe that such a visit would be beneficial.
I would recommend visiting one of the secure units of a women's facility to gain a better appreciation of the dynamic tension between security and treatment perspectives. Some of the higher-need women offenders, many of whom suffer severe mental or behavioural disorders, endure conditions of confinement in secure units that are even more restrictive than those at the male offender special handling unit, which I know you'll be visiting in Quebec.
I have serious concerns about the impact of overly harsh and punitive conditions on the mental health and emotional well-being of special high-needs women offenders. If this committee has the inclination to look at or compare best practices from other countries, I might recommend a closer examination of the experience of three jurisdictions in particular.
In the United States, the State of Ohio has some experience with court-appointed monitors for mental health in its state prison system. Keep in mind that Ohio is the fifth-largest correctional system in the United States and currently houses about twice the offender population of the federal correctional system in Canada. It may interest the committee to discover why the courts became involved in the first place and how that state system has responded.
The United Kingdom's Prison Service has recently adopted their country's national health service delivery model for providing health care to offenders in England and Wales. In Australia, the New South Wales Justice Health system provides dedicated services for all persons in the criminal justice system, including corrections, pretrial detention, police custody, and those with forensic mental health needs.
In light of the fact that federal offenders are excluded from the Canada Health Act and are not covered by Health Canada or provincial health systems, these jurisdictions may offer some promising developments in terms of alternative health care governance and accountability.
In terms of the issues, concerns, and questions that committee members might be advised to take under consideration when conducting site visits and meeting with staff, I would offer the following.
In all cases, it is important to inquire about the level of front-line training in mental health issues and the sharing of information between health care professionals and correctional staff. The experience of my office suggests that front-line staff members are not always well supported or trained to manage and respond to offenders exhibiting mental health and/or addiction problems.
Offenders may exhibit their illness through disruptive behaviour, aggression, violence, self-mutilation, or refusal to follow prison rules. They may act out in ways that prison officials consider manipulative or otherwise contrary to correctional authority. In too many cases, underlying mental health behaviours are met by security-driven interventions: use of force, segregation, and self-confinement.
It is especially critical that specialized training be provided for correctional officers working in mental health and psychiatric centres.
It's equally important to inquire about the programs and health care staff complement at each of the institutions the committee visits, including vacancies and under-filled positions. Although the service is well aware of its recruitment and retention challenges, the fact remains that many institutions are currently not staffed, funded, or equipped to deal adequately with the needs of mentally disordered offenders.
As I have stated before, this issue is one of focus and priority as much as it is one of numbers. For example, CSC psychologists are primarily engaged in risk assessment as opposed to treatment and rehabilitation. Interdisciplinary mental health teams are supposed to be on site, but in many facilities these teams exist in name only.
It is disappointing that the service has not been able to move forward on the creation of intermediate mental health care units. The lack of this kind of option is increasingly problematic. Many offenders struggle to make the transition between the clinical services offered at the regional psychiatric facilities and their return to the regular institution. Without some form of intermediate care, segregation becomes the default option for too many.
I very much encourage members to visit and walk the segregation ranges of the facilities that you visit. You would be well advised to visit other areas of the institution that closely resemble segregation but are often designated by other names, such as “special needs”, “transition”, or “structured living” units. In many respects, these units are segregation by any other name, and they have become particularly ubiquitous population management strategies, especially at the highest security levels.
However, these are primarily measures of convenience and expediency, as they have very little to do with providing clinical treatment or rehabilitative programming. Members are encouraged to meet with long-term segregated offenders and make inquiries about their access to treatment, service, and programs.
Finally, I'm pleased to see that the committee will be visiting the special handling unit. Many members may be surprised to learn about the increasing number of offenders suffering from mental illness being held in “supermax” conditions.
The highly controlled and secure environment of the SHU is not favourable to treatment of mental illness, yet an alarming number of offenders requiring acute clinical intervention are being warehoused there. According to the service, there is an upsurge in the number of offenders with serious mental health problems who do not meet the admission criteria for the regional treatment centres. Some of these offenders cannot be medically certified, or they refuse to consent to treatment. A percentage of this group of offenders is extremely difficult to manage in regular institutions because of aggressive, disruptive, or self-injurious behaviour.
All that considered, the special handling unit is meant to be a facility of absolute last resort. It is not meant to house mentally ill offenders who seemingly cannot be managed elsewhere. It is certainly not the least restrictive option nor the most humane option for those with a diagnosed mental illness.
I'll now ask Ms. Neault to provide a few additional comments.
October 6th, 2009 / 11:20 a.m.
Nathalie Neault Director of Investigations, Office of the Correctional Investigator
As Mr. Sapers noted in his remarks, federal offenders are excluded from the Canada Health Act. By virtue of this exclusion, the Correctional Service of Canada must directly provide essential health care services to offenders in federal institutions in conformity with professionally accepted standards. However, because the Regional Treatment Centres are governed by provincial legislation, committee members are encouraged to examine the differences in the physical structure, admission criteria, professional accreditation, consent to treatment guidelines and conditions of confinement at the regional psychiatric facilities across the country.
In that respect, the Pacific region stands out in that their treatment centre has the modern, open-concept architecture that promotes staff interaction with patients and offers more resemblance to a hospital environment. While the treatment centre in the Prairie region may not be as modern, committee members may notice that its infrastructure is more conducive to treatment than, for example, the medieval-like treatment unit that houses mentally ill offenders within the walls of Kingston Penitentiary. Committee members would be furthermore encouraged to speak directly and frankly with the Correctional Service of Canada staff psychologists and psychiatrists to gain their insights regarding the tension between clinical and professional practices on the one hand and security imperatives on the other.
On the addictions front, committee members may wish to inquire about specific harm reduction measures, including programs, services, treatments and supports offered to offenders struggling with substance abuse issues. In recent years, the Correctional Service of Canada has received millions of dollars in new investments targeting drug interdiction, operational intelligence, visitor screening, and monitoring and surveillance measures. Despite the fact that upon admission to federal custody, approximately four out of five offenders have a history of substance abuse, there has not been an equivalent focus of effort or commensurate infusion of professional resources for treatment, harm reduction and prevention strategies.
Committee members may want to inquire about waiting lists for substance abuse programs and the frequency of delivery of these programs as offenders approach their conditional release points.
In terms of the committee's examination of best practices, members of the committee may want to build on their visit of the Atlantic region by touring the Central Nova Scotia Correctional Facility, which is co-located with the Capital District Health Authority's East Coast Forensic Hospital. While each of these provincial facilities is independently operated, and offenders and forensic patients are separate at all times, it is interesting to note that the provincial health authority provides all the primary health services via clinics on the corrections side as needed, and corrections staff provide security for the forensic hospital. This exchange of professional services model could provide some instructive lessons and efficiencies in managing federal facilities.
Finally, I also encourage committee members to learn more about the Regional Reception and Assessment Centres, as it would provide some insight into how the Correctional Service of Canada currently assesses the needs and mental health status of offenders upon admission to the federal system. Early assessment and diagnosis of mental health and addictions issues is critical in creating a clinically sound treatment and appropriately sequenced correctional plan for every offender.
We trust our comments and suggestions will be helpful to committee members as you embark upon your study tour.
We welcome your questions. Thank you.