Public Safety Committee on Dec. 8th, 2011

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

That's interesting.

You were speaking about drug use as a mental disorder. I guess that means versus a behavioural problem.

Does drug use fall into both categories? Is there a line there? What is that fine line? Is it always a mental disorder, or is it sometimes a behavioural problem?

How do you respond to that situation if it is a dichotomy? How do you deal with that?

[Dr. Jan Looman]

It's one of those things that might start out as a behavioural problem, but when it moves into addiction and starts having an overall effect on a person's life, it becomes a mental disorder. It's an acquired mental disorder, I guess is the way to put it.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

We've heard that many inmates who enter prison are already using drugs. So by the time they get to a penitentiary, have they crossed that line between it being a behavioural problem to being a mental disorder?

[Dr. Jan Looman]

Not in every case.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Not in every case. Okay.

We've heard about the excellent programs and the excellent work that you do, but are we making progress in terms of releasing people into the community who have markedly benefited from the treatment they've received in prison to the extent that their problem is, if not wholly resolved, sufficiently dealt with that they can become productive members of society, who will not reoffend and wind up back in prison?

I understand that the programs probably are very good at maintaining control over a situation, an illness, or a behaviour, but are there long-lasting effects? I guess that's the question.

[Dr. Jan Looman]

The only evidence we have to turn to in order to answer that is the recidivism rates. The research indicates that recidivism rates are reduced by, I think, about 45%.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

That's pretty good, I guess.

[Dr. Jan Looman]

It's based on participation in the programs. So the answer would be yes, to some extent, but there's still room to improve.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Has the incidence of inmates with mental illness or the proportion with mental disorders gone up in recent years?

[Dr. Jan Looman]

Yes. I don't know the more recent data, but comparing it to probably about four years ago, it had gone up from about 12% to almost 20% of the offenders who were coming in and had mental disorders.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

How do you see that? I mean, how do you view that in terms of cause? In your view, what is the cause of that?

[Dr. Jan Looman]

Part of the cause is the deinstitutionalization, as someone mentioned earlier, the shutting down of the psychiatric hospitals. I think--

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

But that's been going on for a long time.

[Dr. Jan Looman]

Yes. I think another part of the problem is that there were changes in the mental health laws in the 1990s that made it much more difficult to send people to psychiatric hospitals. I've been noticing that a lot of people who probably qualified for “not criminally responsible” are ending up in the prison system because of that.

Lawyers don't pursue that avenue, or the offenders don't pursue that avenue for themselves because it's more difficult, and they can probably get out of prison quicker than they can out of the psychiatric hospitals.

[The Chair, Conservative, Kevin Sorenson]

Thank you very much, Dr. Looman.

Mr. Chicoine, you have the floor. You have five minutes.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

Thank you, Mr. Chair.

I also want to thank Mr. Looman for having shared his experiences in the prison environment with us.

I'd like to continue in the same vein as Mr. Scarpaleggia. There has been an increase in the number of people with mental illnesses who have been imprisoned. Currently, between 12% and 20% of people who go to prison have mental diseases.

What happens when these people arrive in the penitentiary? Are they identified quickly as having mental illnesses or does it take a certain amount of time before that happens?

[Dr. Jan Looman]

As part of the initiative to address mental illness, CSC has introduced a computerized mental health assessment that everyone goes through on intake. In Ontario, they come into Millhaven Institution and everyone goes through a screening process for mental health problems. If they're identified in that process, then there's a further assessment, a more in-depth assessment, to identify their mental illnesses and to sort of flag them for follow-up in the institutions.

It's happening within the first 90 days, let's say, after admission--in Ontario. I'm not sure.... The same process is in place in other regions. I'm not sure how quickly they are able to do it in other regions. I know that in Ontario it's within the first 90 days.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

So it takes at least 90 days before they are identified as having mental illnesses. While they are waiting for treatment, do these people experience particular difficulties since they are in contact with people who do not have mental health issues?

[Dr. Jan Looman]

First of all, it's not “at least 90 days”; it's within 90 days. So it could be 40 days or it could be the first week.

Again, I can only speak for Ontario, but at Millhaven Institution, they have a mental health unit. If there's someone who, on intake, is having difficulties and that's noticed right away, then that person can be taken out of the general population and put on the mental health unit while he's going through the intake assessment process. The officers on the intake unit are watching for those sorts of things. There are mental health staff who work on the intake unit and are available to intervene with offenders when it's needed.

The guidelines say it's within 90 days, but some people are identified immediately on intake. They say “This is a guy with mental health problems and we need to address it”. There's a psychiatrist who goes to the assessment unit and is able to prescribe medication. If they need immediate intervention, they're identified and sent to us at the treatment centre.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

I presume that there has been an increase in the prison population in the past few years. Can the overpopulation in the prisons affect the treatment of prisoners with mental illnesses?

[Dr. Jan Looman]

Yes. One of the impacts on the prison population is an increase in the disruption in the institutions. As the institutions become fuller, there's more double-bunking. As I was talking about earlier, in the mediums, there's more mix in the populations than there used to be.

At the treatment centre, we're operating at capacity. So even though we're able to admit people reasonably quickly, it's not as quickly as it used to be. We had more flexibility in the way we managed the population at the treatment centre, so we were able to address issues more quickly. Someone could immediately come in, whereas now they might have to wait a week or two because we have to shift our population around or wait for someone to be released or something like that. It's definitely had an impact on the population.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

If you had recommendations to improve this situation, would they be to send offenders to psychiatric hospitals that are better suited to address their issues? I'd like you to talk about a return to deinstitutionalization. Would it be possible to go back to a situation where we would have fewer inmates with psychiatric problems?

[Dr. Jan Looman]

If I could control the world and make happen whatever I wanted to happen, then I would say the way we deal with mentally disordered offenders would be completely different from the way it is now. But unfortunately I'm not that powerful.

As I said earlier, I think we need infrastructure changes. The treatment centre in Ontario, and probably in the Atlantic region and in Quebec, should be replaced with modern buildings and bigger buildings. I think the one in the prairie region has a capacity of over 200, and they're dealing with a smaller prison population in the prairie region than we are in Ontario and we have a capacity of 148. I think new buildings would be the reasonable solution.

[The Chair, Conservative, Kevin Sorenson]

Thank you, Mr. Chicoine.

We'll now move back to Ms. Hoeppner, please, for five minutes.

[Candice Bergen, Conservative, Portage—Lisgar, MB]

Thank you, Mr. Chair.

Thank you, Dr. Looman, for being here today.

You made a comment a couple of moments ago. You said that in the past ten years CSC has made more moves towards addressing mental health issues, and I know our government has made some pretty substantial investments, I think $89 million, including community mental health and institutional.