Public Safety Committee on Oct. 29th, 2009

[The Chair, Conservative, Garry Breitkreuz]

We're really out of time, so just very briefly. It's 5:35.

[Andrew Kania, Liberal, Brampton West, ON]

Dr. Jones indicated approximately 80% of the prison population suffer from some form of mental illness or concurrent disorder. Do you all agree with that statistic?

[Gail Czukar]

I've heard that 80% have substance use issues and could well have some kind of underlying mental illness. I don't accept that they're always exactly the same together, but a very high percentage have substance use problems.

[The Chair, Conservative, Garry Breitkreuz]

Mr. Norlock, please, for five minutes.

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

I thank the witnesses very much for coming today.

We've learned much so far, but as with learning much, it increases the number of questions you may have.

I was very interested in the line of questioning from Mr. Kania and your response with regard to stigmatization. You're 100% correct. There is stigma to mental illness out there. You will know that the government did fund a national organization and part of that funding has gone to increased advertising on TV, where we see some relatively famous personalities talking about mental illness and that it's okay to say you suffer from some form of mental illness. I think every single one of us in this room has a relative or a close friend who has had treatment for mental illness and may very well continue to do so. I think we all relate to that.

Coming from a police background in Ontario, I was very interested in the Mental Health Act, the grounds for arrest, etc. I think you referred to training. Would the three of you not recommend that before this committee makes any recommendations we need to know what training correctional officers have in recognizing and dealing with people who have mental illness? I wonder if you're aware of what kind of training they may have, if any.

[Gail Czukar]

I'm not aware of what training they currently get, but in general it would certainly be a good idea to increase their capacity to deal with people who have problems and to manage behaviour in ways that are helpful rather than unhelpful to people.

[Dr. Frank Sirotich]

I would agree. I think it also makes sense in terms of obtaining a baseline for what training is currently on the ground, then ascertaining from there what the gaps are, and once you have the gaps, how best to address them.

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

Thank you.

You would recommend that before this committee was to make any recommendations we'd have to interview Correctional Service of Canada with a view to seeing what kind of training is available.

I guess we need to go to an organization that might make recommendations.

Do you know of any organizations that might wish to attend these committee hearings that we could subpoena as witnesses? We could provide them with a training manual, or the numbers of hours and training curriculum, and then they could come back and make some recommendations.

[James Livingston]

There are two streams here. There's training available for correctional officers, but clinical staff also provide mental health services.

Your statement not to move forward until we know the training of correctional officers is blurring the issue, with respect. You can still develop specialized mental health services for people who are legally and professionally competent to deliver those services while you train your correctional officers in how to identify the suicidal and how to identify mental illness. Your correctional officers are not necessarily going to be providing your mental services. It's going to be people who have graduate degrees, who are trained to do so.

To your other point, regarding anyone who would be interested, the report I wrote was commissioned by a centre called the International Centre for Criminal Law Reform and Criminal Justice Policy. It is an independent organization. I know they're interested in doing further work in this area. They're Vancouver-based, although they work internationally. I think they're affiliated with the UN. I could give you the contact information and I'm sure they'd be interested.

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

Thank you. Would you provide that to the clerk, please?

[James Livingston]

Yes, no problem.

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

Thank you.

Do I have any time left?

[The Chair, Conservative, Garry Breitkreuz]

You have a minute.

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

When I made reference to training, I wasn't referring to the training of Correctional Service officers to treat mental illness. What I was suggesting is to be more sensitive to stigmatization--in other words, to dissuade the tendency to stigmatize, and at the same time have the sensitivity to recognize certain indices of mental illness, or perhaps sensitivity to someone who may want to commit suicide or maybe somebody who is taking some kind of drug. In other words, you really don't expect to see drugs in prison--although we know they're there--but the best way is to intervene and see where a person is at risk or may be consuming and therefore be there to help them. That's what I was referring to.

I think we need to see what the training is and then use some comparisons when we go elsewhere to see what kind of training their people get. That's what I was looking at.

[Gail Czukar]

I think that's really important. It's always important to give people better tools to do their jobs, and this would be one of them, both on the stigma front--the recognition front you're talking about--and sensitivity. And there's no question that increasing all of the Correctional Service officers' capacities to recognize problems and have some elementary skills about how to deal with that would be good.

We do capacity-building work in many countries of the world, actually, with primary health-care providers and others. And it is possible to provide short courses even in therapy, and so on. So you do need people who are trained to do this, but we can also increase the capacity of people at the front line. It's very important.

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

Thank you.

[The Chair, Conservative, Garry Breitkreuz]

Okay. We've gone through our list and Mr. Oliphant has indicated he still has a supplementary question.

Does anybody else want to ask any questions after Mr. Oliphant? Would you like to, Mr. Davies? The Bloc would actually have first opportunity, but if you want.... Okay.

Mr. Oliphant, please.

[Rob Oliphant, Liberal, Don Valley West, ON]

Thank you.

Going back to where I left off, for a moment I want us to imagine that we have full capacity in terms of bricks and mortar, the government gets a heart and we have full capacity in terms of trained professionals, and we have a centre for excellence within Canada on mental health and addictions within the prison population.

I think there would still be barriers to treatment. I wonder if you have thoughts on what those barriers are. They may be legislative; they may be the nature of mental illness and addiction itself, they may be socio-cultural, or maybe something else I don't know. In that perfect world with those facilities, what are the barriers, and do you have any ideas as to how we could address them?

[Gail Czukar]

At the risk of sounding like a broken record, I would say that the primary barrier is still stigma. It's still whether people seek treatment or not, and whether people who are around them are willing to recognize it also. So you're hypothesizing that we have all of the capacity, but not necessarily receptivity.

The other thing I would say is that barriers exist around social determinants. And we face this in hospitals all the time. We may do a perfect job of treating someone and stabilizing their illness, but if they're then going back to a very bad living situation or they're going back to no employment.... And of course we know that people who have been in psychiatric institutions have a much higher rate of unemployment. I'm sure it's very high among people coming out of correctional facilities as well. If we don't take care of the social determinants--people's connections to their communities, decent housing, income, and those sorts of things--those are going to minimize the effects of treatment very quickly.

[Dr. Frank Sirotich]

Just following up on that, if there aren't the adequate resources in the community so persons being discharged.... If you have a five-star treatment facility within the prison system but there isn't a mechanism or there isn't the capacity and the appropriate resources in the community when they come out, then in terms of that transition and the person's success, some of the gains that have been made could be lost.

[James Livingston]

In the utopia you've built, I'd also like to see health literacy, as people might not know they're experiencing symptoms of mental illness. That's a separate issue from stigma. So it's a matter of having people, the inmate population, being more mental health literate about what's available for good treatment—because there are good treatments out there—and attending to symptoms and those sorts of things.

[Rob Oliphant, Liberal, Don Valley West, ON]

So it's their “normal”. In fact, they have become normalized.

I think Ms. Glover was very helpful, in that we have a disproportionate aboriginal population in our prison system. There is no morality, I don't believe, attached to that. I think it is socio-cultural and I think it has to do with many oppressions and many socio-cultural problems. It seems to me that's a barrier as well. You're the witness, I'm not, but it seems to me that Ms. Glover has pointed out some pretty important stuff.

Whether it's Poundmaker's Lodge Treatment Centre in Alberta, or other things, it seems to me that we're going to need more help from you experts on how to do this, whether you're willing to do that work in your organizations.

[James Livingston]

I would just echo that as well. We're focusing on mental health and substance use, and that's what my report does, but this is within a holistic environment where people have HIV/AIDS and other forms of diseases, dental diseases and what not. So considering mental health and addictions as part of a holistic health problem is very useful in addressing this.

The interrelationships between other health conditions and the social determinants of housing and other forms of marginalization, and attending to diversity and intersections of diversity, whether they be gender, culture, sexuality, or what not, are all very, very important.

[Rob Oliphant, Liberal, Don Valley West, ON]

Thank you.

[The Chair, Conservative, Garry Breitkreuz]

Mr. Davies, please.