Speaking Notes for
Mr. Howard Sapers
Correctional Investigator of Canada
and
Dr. Ivan Zinger
Executive Director and General Counsel
Office of the Correctional Investigator
Appearance before the Standing Committee on
Public Safety and National Security
June 2, 2009
9:00-11:00
Mr. Sapers: Thank you for the invitation to appear before
this Committee and discuss two important issues facing federal Corrections, namely
the care and custody of offenders with mental health disorders and access to programs
to prepare offenders for timely and safe reintegration into the community.
Before I address these two issues, I would like my Executive Director and General
Counsel, Dr. Ivan Zinger, to provide you with a brief overview of the role and mandate
of my Office.
Following this overview, I will outline my concerns regarding the delivery of mental
health services to federal offenders. I will then ask Dr. Zinger to speak
about access to correctional programs (including substance abuse programs).
Dr. Zinger: Last year, the Office of the Correctional Investigator
celebrated its 35th anniversary. The Office was established in
1973 to strengthen the accountability and oversight of the federal correctional
system. The Office was given a legislative mandate on November 1, 1992 with
the enactment of the Corrections and Conditional Release Act.
The Office investigates and resolves individual federal offender complaints.
As well, it has a responsibility to review and make recommendations on the Correctional
Service of Canada's policies and procedures associated with individual complaints.
In this way, systemic areas of concern can be identified and appropriately addressed.
The Office has twenty-four staff, and receives between five and seven thousand offender
inquiries and complaints annually. Last year, our investigative staff spent
approximately three hundred days in federal penitentiaries conducting interviews
with more than two thousand offenders. In addition, our staff met with many
other individuals during their penitentiary visits, including Wardens, correctional
staff, inmate committees, native brotherhoods and sisterhoods, and health care professionals.
Overall, the most common inmate complaints are related to health care, followed
by institutional transfers, administrative segregation, and case preparation for
conditional release. It should be noted that specific offender complaints related
to mental health services are relatively infrequent. However, mental health
issues are often a key factor in many complaints received by this Office.
For example, offenders may complain about being placed in administrative segregation
or transferred into a higher security penitentiary, or having been subject to an
unjustified use of force. After investigating, we discover that the placement
in administrative segregation or the transfer to a higher security institution or
the use of force were the result of a disruptive behaviour due to a pre-existing
mental health condition.
Mr. Sapers: As you can see, my mandate expresses important
elements of the criminal justice system. The Office reflects Canadian values
of respect for the law, for human rights, and the public’s expectation that
correctional staff and senior managers are accountable for the administration of
law and policy on the public’s behalf. Good Corrections, after all,
equals public safety.
Let me now turn to the issue of mental health in federal Corrections. First,
the Correctional Service of Canada is legislatively mandated to provide health care
to offenders through the Corrections and Conditional Release Act (CCRA) as federal
offenders are excluded from the Canada Health Act and are not covered by
Health Canada or provincial health systems. The Correctional Service therefore
must provide health care services (including mental health services) directly to
federal offenders, including those residing in Community Correctional Centres.
The CCRA
states that the health care services provided must conform with "professionally
accepted standards."
In the last decade, Canada experienced a significant increase of offenders with
mental illness entering federal penitentiaries. The Correctional Service is
now in the position of having to manage offenders that require a high degree of
professional mental health service and care. The ability of the Correctional
Service to effectively and humanely manage this increasing and challenging population
is being tested to its limits.
Mental health problems are up to three times more common among inmates in correctional
institutions than among the general Canadian population. More than 1 out of
10 male inmates and 1 out of 5 female inmates have been identified at admission
as having significant mental health problems, an increase of 71 percent and 61 percent,
respectively, since 1997. A recent snapshot of federally incarcerated offenders
in Ontario indicated that 39% of the Ontario offender population were diagnosed
with a mental health problem – a staggering challenge for any correctional
authority.
The Correctional Service has been aware of its challenge in this area for a long
time. In fact, in July 2004, it approved a Mental Health Strategy that identified
serious gaps in services and promoted the adoption of a continuum of care from initial
intake through the safe release of offenders into the community. At the time,
my Office concurred with the Correctional Service’s identification of gaps
in mental health services and endorsed its strategy.
The Strategy indicated that significant investments were required in four major
areas:
- comprehensive clinical intake assessment;
- specific requirements for enhancing the current five Regional Treatment Centres
(i.e., psychiatric hospitals ran by the Correctional Service);
- intermediate mental health care units within existing institutions to provide on-going
treatment and assessment during the period of incarceration; and,
- community mental health to support offenders on conditional release.
In December 2005, the Correctional Service secured funds to strengthen the community
component of this strategy. This Office welcomed the news of these new investments—approximately
$6 million per year for five years—in community mental health. We also were
pleased when the Government of Canada included in its March 2007 Budget new temporary
investments—approximately $21 million over two years—to address the
lack of a comprehensive mental health intake assessment process and to improve primary
mental health care in CSC
institutions. The March 2008 Budget provided ongoing funding for these initiatives—approximately
$16 million per year.
Despite these important investments (totaling over $60M to date), I continue to
be disappointed by the very slow pace of change and by the lack of real, demonstrable
improvements in the level of mental health services and support provided to offenders
with mental disorders.
There is no doubt that the Correctional Service has had some successes in the last
two years, such as the implementation of a new mental health training package for
front-line staff, the development of a mental health screening system at intake
and the implementation of an enhanced discharge planning community initiative.
However, the overall situation of offenders suffering from mental health disorders
has, in my view, not significantly changed since my Office first reported about
the troubling situation back in 2004.
The problem faced by the Correctional Service is largely one of capacity to respond
to an increasing number of offenders with significant mental health issues.
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 psychologists’ day within
CSC is spent conducting mandatory risk assessments to facilitate security
or conditional release requirements rather than treating or interacting with offenders
in need of their clinical services. Those offenders with acute needs, or requiring
specialized intervention, may be sent to one of the five Regional Treatment Centres;
however only if they meet the admissions criteria that they possess a serious and
acute psychiatric illness. Typically, however, the offender is monitored at
the RTC 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 prisons
do not generally meet the admission criteria that would allow them to benefit from
services provided in the Regional Treatment Centres. They stay in the general
institutions, and their illnesses are often portrayed as "behavioural" problems,
not mental health issues per se. This is especially true for offenders
suffering from brain injuries and those with
FASD.
I am particularly concerned by the persistent and pervasive use of segregation to
manage and isolate offenders with mental disorders in federal penitentiaries.
As I noted in my testimony before the Senate Standing Committee on Social Affairs,
Science and Technology, in 2005 offenders who are locked up in segregation for up
to 23 hours a day in maximum security institutions are often intellectually challenged
or present behavioural problems, have learning disabilities and/or symptoms of attention
deficit hyperactivity disorder, or have fetal alcohol spectrum disorder. The
mentally ill often suffer from illogical thinking, delusions, paranoia and severe
mood swings. In the correctional environment, mentally ill offenders do not
always comprehend, conform or adjust properly to the rules of institutional life.
Irrational and compulsive behaviours associated with their individual affliction
can result in verbal or physical confrontations with staff or other inmates, which
often leads to institutional charges and long periods in administrative or disciplinary
segregation. Mental illness can lead to a vicious cycle in correctional settings.
Simply placing an offender in ever more restrictive conditions of confinement and
isolation is not an effective correctional or mental health intervention.
Prolonged periods of deprivation of human contact cannot but adversely affect mental
health and is counterproductive to rehabilitation. Far from treating personality
disorders and mental illness, the conditions of deprivation in most segregation
and dissociation cells too often serves to exacerbate the symptoms and "acting-out"
behaviours such placements are supposed to be managing. After conducting an
investigation, my Office often discovers that these placements are the result of
disruptive behaviour from a prevailing mental health condition. It is a classic
"catch-22" scenario: when the intervention fails, the response is to do more of
the same.
The practice of confining mentally disordered offenders to prolonged isolation and
deprivation must end. It is not safe, nor is it humane.
A case in point is the death of Ms. Ashley Smith. Ms. Smith died on October
19, 2007, at the age of 19 at Grand Valley Institution for Women (GVI).
She died in segregation, having never been the subject of a comprehensive psychological
assessment during her 11.5 months in federal custody. In my report of June
20, 2008, amongst my 16 recommendations, I recommended that the Correctional Service:
- immediately review all cases of long-term segregation where mental health issues
were a contributing factor to the segregation placement.
- amend its segregation policy to require that a psychological review of the inmate's
current mental health status, with a special emphasis on the evaluation of the risk
for self-harm, be completed within 24 hours of the inmate's placement in segregation.
- immediately implement independent adjudication of segregation placements of inmates
with mental health concerns.
It is almost a year since I submitted my report to the Correctional Service, and
few concrete steps have been taken to respond to these recommendations. I
understand that Correctional Servbice will shortly publicly release its response
to my 16 recommendations flowing from my investigation into the tragic death of
Ms. Ashley Smith, and I look forward to a detailed and robust action plan that will
address my recommendations and reduce the likelyhood of future preventable deaths
in custody.
I will now ask Dr. Zinger to discuss the issue of program access and substance abuse.
Dr. Zinger:
The Correctional Service is mandated by law to provide programs and interventions
that address factors related to an offenders’ risk of re-offending.
The Corrections and Conditional Release Act (CCRA)
stipulates that the Correctional Service must provide a range of programs designed
to address the needs of offenders and contribute to their successful reintegration.
The CCRA
also includes specific provisions for the delivery of programs to women and Aboriginal
offenders.
From a series of evaluation reports we know that correctional programs work in contributing
to public safety and are a good value for money.
Offenders who complete their programs are significantly more likely to be granted
a discretionary release and are less likely to re-offend following their release.
In terms of value, internal CSC
documentation suggests that for every dollar the Service spends on correctional
programs it saves, on average, $4 in avoided incarceration costs (due to earlier
community releases or extended stays in the community).
Programs address a number of important issues that when dealt with can significantly
reduce the risk of re-offending. The Correctional Service offers numerous
very good programs, including in the areas of sex offenders, anger management, family
violence and substance abuse.
In terms of addiction issues, about four out of five offenders now arrive at a federal
institution with a serious substance abuse problem, with one out of two having committed
their crime under the influence of drugs, alcohol or other intoxicants.
The main problem with programming is access. The Correctional Service allocates
only 2% of its total annual budget to offender programming. Currently, the
Service spends $37 million annually on all its core correctional programs (including
for women and Aboriginals). The program funding envelope, which has remained
stable over the last decade, includes training, quality control, management and
administrative costs. We do not think 2% of an over $2 billion annual budget
is enough. The Correctional Service has indicated to us that it hopes in the
next fiscal year to reallocate a significant portion of the $48.1M it anticipates
receiving as part of its Strategic Review initiative to core programming.
We look forward to seeing more programs being provided to more offenders as this
reallocation rolls out.
The most recent investments dealing with drugs and addiction in penitentiaries has
been limited to interdiction initiatives. In August 2008, the Minister of
Public Safety announced a five-year $120M investment into the
CSC’s Drug Strategy. All funding went to interdiction
initiatives, including drug detector dog teams, increase in security intelligence
capacity, ION scanners and X-Ray machines. No new funding was allocated to
treatment programs for addiction or harm reduction initiatives.
Drug interdiction alone can only go so far in addressing addiction issues and the
spread of infectious diseases. Over the last five years (2004/05 to 2008/09),
the Correctional Service has spent significantly more time and money on efforts
to prevent drugs from entering its institutions. A measure of the success of these
efforts is the percentage of positive urinanalysis samples, which indicate drug
use. Institutional random urinanalysis has shown that drug use declined by one (1)
percentage point in the last five years. In the last fiscal year (2008/09),
the rate of positive samples was 10.8% (889 positives out of 7,543 urinanalysis
samples taken in CSC institutions).
Five years earlier, it was 11.8%.
For now, offenders have to contend with long waiting list for programs, cancelled
programs because of insufficient funding or lack of trained facilitators; delayed
conditional release because of the Service’s inability to provide timely programs
they require to complete their correctional plans; and longer time served before
parole consideration. The situation is becoming critical as more and more
offenders are released later in their sentences, and too often having not received
the necessary programs and treatment to increase their chance of success in the
community.
Mr. Sapers: The health and welfare of our federal inmates
is a public issue. The vast majority of inmates are one day released into
society. It is beneficial for everyone if these offenders return to society
having received adequate mental health services and rehabilitative programs.
All of us have a vested interested in treating offenders with humanity and responding
to their clinical needs to help them lead productive and law abiding lives upon
release.
Thank you.
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