Public Safety Committee on April 1st, 2010

[Jennifer Oades]

Exactly.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much.

Mr. Davies, please, for seven minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you for being here today.

I heard one of you say, and I was writing quickly but I think I got the essence, that sharing paraphernalia is a major source of disease transmission. I'm going to just read a brief quote from a submission we got from the senior policy analyst of the Canadian HIV/AIDS Legal Network, where it said:

Substance abuse is a contributing factor for the criminal behaviour of 70% of people admitted to federal institutions. Because of the scarcity of needles and syringes in prison, people who inject drugs in prison, including those with addictions, are more likely to share injecting equipment than those in the community, thereby increasing their risk of contracting HIV and HCV.

Programs that ensure access to sterile injecting equipment are therefore an important component of a comprehensive approach to reducing the vulnerability of incarcerated people to HIV and HCV infection.

The best available evidence strongly suggests that in countries where prison-based needle and syringe programs exist, such programs reduce risk behaviour and disease, do not increase drug consumption or injecting, do not endanger staff or prisoner safety, and have other positive outcomes for the health of people in prison including increasing referrals of users to drug addiction treatment programs.

I'm just wondering if any of you would like to comment on that. Is that accurate or not accurate?

[Kate Jackson]

That's a different question from what I thought I might get.

I think there has been research to show that providing safe and sterile equipment in some environments does reduce the infection rate. However, within CSC our harm reduction strategies include, as I mentioned before, such things as education, training, and we do provide dental dams and condoms, and we do also provide bleach. But currently we do not have a needle exchange program.

[Don Davies, NDP, Vancouver Kingsway, BC]

The last sentence of the quote--and I'm sorry, I didn't mean to hold this back, but I think it's important--said:

These findings were confirmed in prison needle exchange review of the evidence, a 2006 review by the Public Health Agency of Canada undertaken at the request of Correctional Services Canada.

Are you familiar with that report? Okay.

The reason I ask is that we're opposed to drugs in prison, but we have methadone, and methadone is an opiate. We are opposed to sex between inmates in prison, yet we have dental dams and condoms. We are opposed to having paraphernalia in prison, but we supply bleach. This committee saw a rig, a very grotesque homemade piece, that was shared by inmates, passed among the inmates.

I'm just wondering, does it not make sense to go that final step, if drug use is going to happen in prison, to ensure that at the very least we're not spreading the disease? As pointed out by my colleague, it's something that will spill into the general population and become a public health issue as well. Is that not a logical conclusion?

[Kate Jackson]

I think at this stage of the game, based on the evidence, CSC, in terms of harm reduction, does have a few initiatives in place, which I've stated, but we currently do not provide a needle exchange program or other such paraphernalia.

[Don Davies, NDP, Vancouver Kingsway, BC]

I want to shift to mental health.

We had Mr. Sapers appear before our committee last June. I'll quote what he said:

This problem is compounded by the inability of the Correctional Service to recruit and retain trained mental health professionals, and by security staff that are ill-equipped to deal with health-related disruptive behaviours. For example, the majority of a psychologist's day within the Correctional Service of Canada is spent conducting mandatory risk assessments to facilitate security for conditional release requirements rather than treating or interacting with offenders in need of their clinical help. Those offenders who have acute needs or who require specialized intervention may be sent to one of the five regional treatment centres; however, this is only if they meet the admission criterion that they possess a serious and acute psychiatric illness. Typically, however, the offender is monitored at a regional treatment centre only to be returned to the referring institution after a period of stabilization. Driven by volume, the regional treatment centres have become a revolving door of referrals, admissions, and discharges. The overwhelming majority of offenders suffering from mental illness in prison do not generally meet the admission criteria that would allow them to benefit from the services provided in the regional treatment centre. They stay in general institutions, and their illnesses are often portrayed as behavioural problems.

It's not mental health issues per se.

That seems to jibe with my own observations when I participated in the prison tour. We have a lot of people with mental illnesses. We are not doing a very good job providing intermediate mental health care and we are not actually providing a lot of counselling and therapeutic time. Is that something you see from your point of view?

[Jennifer Oades]

I'll start, and I'll let the experts finish.

The mental health file is certainly a huge challenge. Intermediate care is the bigger challenge. I think we are getting better at it. We have received funding to get better at it over the past couple of years.

Part of the problem has been the actual assessments. We now have a system in place that is done right at intake. We know as early as possible if the person has a mental health disorder or not. We can then start working at that right away, rather than waiting.

[Don Davies, NDP, Vancouver Kingsway, BC]

Do you mean for women or do you mean in general?

[Jennifer Oades]

That is generally.

For the women, you haven't been to one of our facilities where there are structured living environments, which is very much seen as a Cadillac model for an intermediate care facility. It has been recognized internationally. It was recognized by the Glube report. It was recognized by Her Majesty's prison inspector.

[Don Davies, NDP, Vancouver Kingsway, BC]

Is that in B.C.?

[Jennifer Oades]

No, there is one in every single regional facility, other than Okimaw Ohci. It's a house. It is staffed 24/7. It's been set up a little differently.

[Don Davies, NDP, Vancouver Kingsway, BC]

How many inmates in total are in those across the country?

[Jennifer Oades]

There are 40 beds in total across the country. For five institutions, there are eight beds in each one.

[Don Davies, NDP, Vancouver Kingsway, BC]

How many women are incarcerated across the country?

[Jennifer Oades]

There are 492 today.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have one last question. One thing I've heard is that practically every woman in prison has suffered a trauma. It's probably an exaggeration, but I think it makes the point. We can certainly agree that the vast majority of women in prison have had some type of severe trauma. Do you have any special programs or advice to give this committee on how we could better respond to treat female offenders who have suffered from serious trauma?

[Jennifer Oades]

You might be exaggerating as to all of them having suffered trauma, but there are certainly many more incidents of women who have suffered physical abuse, mental abuse, or sexual abuse at some point in time before becoming inmates. It is even higher when you look at the aboriginal offender population.

[Don Davies, NDP, Vancouver Kingsway, BC]

What percentage would you use?

[Jennifer Oades]

I'm not sure I have that with me. I can check, but I would say it's somewhere around 70 percent. I can find out for you, but I don't have it.

[The Chair, Conservative, Garry Breitkreuz]

Okay.

[Jennifer Oades]

We have a number of programs they can take. The new “Spirit of a Warrior” program, which was actually developed by the Native Counselling Services of Alberta, certainly has a component to address that aspect, because it is more of a holistic program. We also have counselling and trauma services available in every one of our institutions, should they wish to partake in those programs.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much. We're over time here.

Mr. McColeman, please.

[Phil McColeman, Conservative, Brant, ON]

Thank you, Chair.

Thank you to the witnesses for being here today and taking the time to share your expertise with us.

There was a reference in one presentation to the drug Suboxone, and that's the first time I've heard of it. Perhaps other committee members heard of it for the first time. I'd like to find out a little bit more about this drug. Obviously, we know about methadone, but is this something new? Is it cutting edge? And what does it do--obviously the same types of effects, outcomes, but how does it differ from methadone?

[Kate Jackson]

Without getting into a lot of technical detail, it's a slightly different chemical compound, but it works very much the same way as methadone, and it's administered differently.

We introduced it because it's starting to be introduced in community programs and in other programs outside the correctional environment. It's been shown to be an effective alternative sometimes for people who can't tolerate methadone, or if for some reason methadone doesn't work for them.

We currently only have one person on Suboxone.