Public Safety Committee on March 23rd, 2010

[The Chair, Conservative, Garry Breitkreuz]

I'd like to call this meeting to order.

This is the Standing Committee on Public Safety and National Security, meeting number five. We are dealing with a study on federal corrections. Mental health and addiction is our focus.

We welcome three representatives today from the Correctional Service of Canada.

Ms. Vallée, would you like to go ahead and introduce yourself and your colleagues?

[Maria Mourani, Bloc, Ahuntsic, QC]

Mr. Chairman, I asked for someone from the Martineau Community Correctional Centre to testify today and I would like to know whether anyone from that centre is among the persons here present. Mr. Préfontaine could perhaps inform us on that matter.

[The Chair, Conservative, Garry Breitkreuz]

We did send out invitations to all the people you suggested. The clerk will give you the answer to the response we got from them.

[The Clerk of the Committee, Mr. Roger Préfontaine]

Mrs. Mourani, I informed your office as developments occurred. The other witnesses that you had suggested for today, Thérèse-Casgrain House as well as Anne Crocker and Céline Mercier, declined the invitation for various reasons.

[Maria Mourani, Bloc, Ahuntsic, QC]

I am aware of that. That's fine.

[The Clerk]

Your request concerning the Martineau Community Correctional Centre and your list of questions were forwarded to the Correctional Service of Canada, and it decided that it would be represented today by Ms. Vallée, Ms. Gaudet and Ms. Perreault to discuss the issues you raised.

[Maria Mourani, Bloc, Ahuntsic, QC]

Does that mean that people from the Martineau Community Correctional Centre were not allowed to be here today?

[The Clerk]

Perhaps Ms. Vallée could answer that.

[Johanne Vallée, Deputy Commissioner, Quebec Region, Correctional Service Canada]

In fact, as the topic of mental health goes beyond the context of Martineau Community Correctional Centre, we called on Ms. Andrée Gaudet, who is associate director of the Montreal-Metropolitan District and who, among other things, is responsible for Martineau CCC. We made sure, based on the information we had, that we would be able to answer all your questions concerning Martineau CCC. Furthermore, Ms. Perreault, who is regional coordinator and a psychologist, can also discuss the mental health caseload at Martineau CCC.

[Maria Mourani, Bloc, Ahuntsic, QC]

All right. Thank you.

[The Chair, Conservative, Garry Breitkreuz]

I hope that answers your concerns. Thank you very much.

Madame Vallée, we will allow you an opening statement of approximately ten minutes. Then we'll go ahead with the rest of our meeting. Thank you.

[Johanne Vallée]

You requested a brief presentation.

I'm a criminologist. I joined CSC almost three years ago. Before that I was associate deputy minister for the public safety department in charge of correctional services of Quebec. I have also worked for almost twenty years in the community and in Quebec.

Ladies and gentlemen, thank you for your invitation to have me appear before the Standing Committee on Public Safety and National Security.

Your work on mental health and addiction has recently brought you to visit quite a few institutions across Canada, particularly in the Quebec Region. You visited the Regional Mental Health Centre, within Archambault Institution, and the Special Handling Unit, within the Regional Reception Centre. All of these visits have certainly given you a good idea about our work and achievements in the areas of addiction and mental health interventions with incarcerated offenders. However, inmate custody is only one component of the Correctional Service’s mission, and we are pleased to be able to speak with you today about the tools available to the Correctional Service in the community to ensure effective and safe reintegration of the parolees under its supervision.

The Correctional Service places a great deal of importance on the continuum of care of offenders, from incarceration until the end of parole and even beyond. The availability and accessibility of community resources are important factors in assessing and managing an offender’s risk, and the Correctional Service therefore considers them to be directly linked to public safety.

Initially, three other community workers were also to take part in today’s session to present the addiction and mental health services they provide to offenders in the community. Although they were unable to accept your invitation, we are pleased to see you are interested in community services, given the importance of the partnership with these agencies that enables us to fully carry out our mandate in the community.

We have many community partners; together this creates a real safety net around parolees and former inmates based on each one’s estimated degree of risk. While the police do certainly contribute to this safety net, community organizations, groups of volunteers and all the community support provided are also indispensable to true public safety. This network of resources, their operations and effectiveness are unfortunately not well known; this is why I will focus mainly on these aspects during my brief presentation. We will then be available to answer any questions from your members, and that is why Ms. Perreault, psychologist and manager of the Institutional Mental Health Initiative, and Andrée Gaudet, associate director and parole supervisor for the entire Montreal and South Shore area, will be able to supplement the presentation and answer your questions.

Before going into the details of the mechanisms the Correctional Service uses to provide the continuum of care in the community, I believe it would be appropriate to quickly review the organization of our mental health services. You saw at the Regional Mental Health Centre that we provide intensive specialized mental health care to inmates from institutions across the region. They are referred there when the services available in each institution are no longer adequate to meet their offenders’ mental health needs. These may be particularly acute suicidal or self-injury cases, a psychiatric emergency, or a need for psychiatric assessment or long-term specialized treatment. Each institution has services to meet their inmates’ mental health needs.

The Institutional Mental Health Initiative, which was rolled out almost two years ago, focused on mental health intake screening. We now have a computerized mental health screening system at intake and for the subsequent exhaustive assessment of mental health needs, and the delivery of primary mental health care. In this respect, the tangible impact of the Initiative in the Quebec Region has been to put in place mental health teams in all institutions, that is to say 12 teams at a number of locations in Quebec. These teams are made up of mental health professionals, psychologists and mental health nurses. It has also helped develop initial findings on the prevalence of mental health needs in our inmate population, which is 15% at intake for men and 58% at intake for women.

It has also made it possible to provide primary mental health care services to 19% of the male inmate population, or roughly 575 offenders in Quebec; to provide mental health training to our correctional staff at Joliette Institution and the Regional Mental Health Centre; to develop interdisciplinary clinical management plans in complex mental health cases, in particular repeated acts of self-injury and, of course, to follow up implementation of these plans.

Lastly, in a pilot project, through the Institutional Mental Health Initiative, we have rolled out a tracking system for mental health services provided in two institutions, Donnacona and Joliette, in order to better identify our needs for developing new mental health services.

Starting on April 1, all institutions in the Quebec region will have this system, which means that we will able to say exactly who and how many people have received mental health services, and when, something we have been unable to do until very recently.

Let us now go back to our continuum of services. Institutions facing problematic mental health cases that exceed their local capacity may refer these cases to the Regional Mental Health Centre. Now, while the Correctional Service has access to highly appropriate expertise and facilities, certain cases require even greater care and are then referred to the Institut Philippe Pinel de Montréal, which has been a partner of the Correctional Service for over 30 years. IPPM is the second level of referral for women offenders. It is a national unit that serves all regions of the Correctional Service.

Under the binding contractual agreement we have with them, IPPM has up to 12 beds available for sex offenders, specialized treatment for sex offenders who also present mental health needs, 12 other beds for women offenders, and three beds for offenders with acute mental health needs. In all cases, inmates staying at either the Regional Mental Health Centre or IPPM eventually return to their home institution. In fact, the link between the local case management team and the care team where the inmate or woman offender is referred to is never broken, in accordance with the principles of the timely sharing of information and of the continuum of care.

The special needs of offenders with mental health problems are considered during their incarceration, including as part of their preparation for returning to the community. When it comes time to make concrete reintegration plans, new professionals join the case management team. Another mental health initiative, this one in the community, plays a major role in planning the release of offenders with mental health needs. Clinical teams working with this initiative, nurses and social workers, are involved in organizing transitional mental health care several months prior the first potential release date.

Case management teams and workers from both mental health initiatives work together to identify mental health needs and support needs to ensure safe release. Essentially, their work involves identifying the best place for an offender to begin his return to society, by balancing off the intensity of his needs with the individual’s resources and environment. Once the place—the resource—is identified, they then begin the real groundwork: they discuss with the resource, contact the surrounding services, the police, community health centres and community agencies, and inform the offender, thereby preparing him for his transition into society.

Currently, the Community Mental Health Initiative is monitoring 76 parolees. Of course, a greater number of offenders are presenting mental health needs upon release. However, only a fraction of these cases require supervision under this initiative. These 76 offenders currently monitored under the Initiative present supervision needs that go beyond what the regular release procedures are able to provide. Measures taken by the Community Mental Health Initiative are similar to but more intense than what is done when releasing cases with minor or no mental health needs.

In order to fulfill its mandate to ensure the successful transition of offenders, the Community Mental Health Initiative has forged ties with community partners whose mission is to work with, support and defend the human rights of people with mental health needs. These ties are intended to make these resources available to offenders with mental health needs. The areas targeted by these ties between the Correctional Service and specialized community mental health resources range from psychiatric supervision, adherence to pharmacological and/or psychosocial treatment and housing needs, to job skills through supervised workshops and support for day-to-day activities.

[The Chair, Conservative, Garry Breitkreuz]

May I just interrupt for a minute? Are you going to go through the entire report you have given us here?

[Johanne Vallée]

Almost. Okay?

[The Chair, Conservative, Garry Breitkreuz]

Can I just get the permission of the committee to allow you to finish? Normally we allow ten minutes.

All those in favour of letting her finish? It will probably take another seven or eight minutes.

Okay, it looks as if the committee is in favour.

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

Mr. Chair, I only saw two hands. It's not that I don't appreciate the presentation--I do--it's just that I want to make sure we have the opportunity for questions.

[The Chair, Conservative, Garry Breitkreuz]

You were the only one objecting.

[Maria Mourani, Bloc, Ahuntsic, QC]

I agree with him. We need more time to ask questions.

[The Chair, Conservative, Garry Breitkreuz]

I guess then if you could wrap it up in a few minutes.

Mr. MacKenzie.

[Dave MacKenzie, Conservative, Oxford, ON]

Mr. Chair, from this side we don't mind; whatever satisfies the other side. But we will be out of here at 5:15, I believe.

[The Chair, Conservative, Garry Breitkreuz]

Okay.

Let me take another count. How many would like to have her finish the report?

Okay, if you could wrap it up within the next several minutes.

[Johanne Vallée]

Okay.

I’ll be brief.

We've told you about the Institutional Mental Health Initiative, about the link with the community and the work being done in partnership with a number of community agencies to ensure offenders' return to society. We've also talked to you about the teams in the community, social workers, nurses and so on. We've also discussed the doctors and psychiatrists.

In Quebec, there is a special feature. And that is the Martineau Community Correctional Centre. It is an institution that belongs to the Correctional Service of Canada. It is located in Montreal north and operates in cooperation with the community. It is important that the community correctional centres ensure that their services are not provided separately from the community. We work with citizen advisory committees, which essentially consist of volunteers from the surrounding community where we operate. They enable us to get a better grasp of community needs and to adjust our services.

At the Martineau Community Correctional Centre, unless I'm mistaken, there are about 28 spaces for 60% of offenders. Of that number, 24 spaces are occupied by men and 4 by women. Some of those men have reduced mobility problems. They are in wheelchairs and need special medical care. Those 24 spaces for men are for people with mental health problems. The same is true for the women. At Martineau CCC, 60% of the male clientele comes from the Regional Mental Health Centre. We have provided follow-up, integrated our services and provided them with services through a clinical intervention plan carried out into in the community. It should also be understood that, at Martineau CCC, unlike at other CCCs, specialized staff are on-site 24 hours a day, 7 days a week, to provide services. There are nurses, whom we call clinical behavioural advisors, parole officers, psychologists and correctional officers. The clientele is met regularly so that we can monitor them, adjust medication and ensure that reintegration plans are being carefully followed.

I won't go any further. I will not address the issue of substance abuse. Based on the questions the clerk sent us, mental health appears to be what interests you most. That's a fundamental factor in Martineau CCC's success because that is the only place where we can really ensure continuity. There's no break in services for mental health cases. We are also developing ties with community agencies that continue the work beyond our mandate.

Thank you.

[The Chair, Conservative, Garry Breitkreuz]

Thank you.

You obviously have a lot that you want to communicate with us. We can read your report, but without any more hesitation we will go to the Liberal Party.

Mr. Holland, do you want to start?

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

Thank you, Mr. Chairman.

Thanks to the witnesses for their presentation.

There will definitely be an increase in the inmate population as a result of the new bills in the House of Commons. Does the department intend to increase resources for individuals with mental health problems or drug problems?

[Johanne Vallée]

For the moment, we are conducting analyses on the bills' impact on the inmate population. Correctional Service Canada regularly assesses needs for infrastructure changes or infrastructure adjustments based on offender needs. The same is true for mental health. A little earlier, I talked to you about new assessment tools that are now being used at intake. We'll have to adjust our intervention as we acquire much more specific information on the nature of offender needs.