I'm here today as a co-author of A Flawed Compass: A Human Rights Analysis of the Roadmap to Strengthening Public Safety. A Flawed Compass is the work of Michael Jackson, professor of law at the University of British Columbia, and me alone.
Having retired over two years ago from the John Howard Society of Canada, I am not a representative of, nor do I speak for, the John Howard Society of Canada. Craig Jones has that responsibility.
Leading up to the adoption of the CCRA in 1992, the office of the Solicitor General produced nine important papers that explored issues facing Canadian prison law, particularly in the context of the new charter. Those papers formed the substance of eight years of active public consultation. It is worth noting that the correctional law review analysis was based on a human rights perspective.
In 2007, the Minister of Public Safety created a panel to advise the minister on various important issues facing the Correctional Service. Chaired by Rob Sampson, the panel's report, along with all its recommendations, was accepted immediately by the government, without public consultation. It is now the transformative agenda for CSC, the Correctional Service of Canada.
I should begin by stating that Michael Jackson and I agree with the recommendations of the Sampson report with respect to mental health. They largely endorse the mental health strategy developed by CSC in 2004, which we also support. The important observation, however, is that mental health services are very much part of, and are influenced by, the overall correctional setting. Other correctional policies and practices can completely undermine the best plans for mental health and the noblest intentions of staff. In that respect, many of the panel's recommendations for mental health are severely compromised by other recommendations. In part, the lack of coherence has occurred because the approach of the panel completely ignored human rights.
Why are human rights essential as the foundation of correctional policy? One reason is that the purpose of human rights is to protect all citizens from abuse by the state. A prison system that is not respectful of human rights is one that necessarily tolerates abuse. We know of no evidence that abusive, arbitrary, or unfair treatment improves a prisoner's prospects for success after release. Abuse teaches that might is right, the very values that often lead to criminal acts in the first place. Effective corrections cannot occur outside a human rights framework.
The road map ignored the report the CSC commissioned in 1997 by Max Yalden, former chief commissioner of the Canadian Human Rights Commission. In doing so, it also ignored his caution. He said:
||It is particularly important to recognize the fundamental nature of Canada's commitments in light of the fact that some members of Canadian society, including some CSC employees, do not necessarily share the values underlying the Service's human rights framework. In that context, it is essential to make it clear that the principles and provisions incorporated in the CCRA derive from universal human rights standards supported by all the advanced democracies with which Canada compares itself, that the Service holds itself accountable to those standards, and that it is actively committed to making them work in federal correctional institutions.
Yet this is the response given in a CFRB interview by Minister Van Loan to questions about the criticism contained in A Flawed Compass:
||Prisoners have the full protection of the Charter of Rights. They have the Office of the Correctional Investigator to look into complaints. That's not the issue here. The issue is, how do we protect the rights of the people in the community, Canadians, to be safe from the threat of criminals?
There is no totalitarian regime in the world that does not espouse human rights, so long as they do not threaten whatever they define as public safety.
Our system invests tremendous resources in preserving the right to be free from crime through police, prosecution, courts, imprisonment, supervision, and so on, all without cost to the individual. But there is virtually no publicly supported mechanisms that help us preserve our right to be free from abuse by the state.
In real terms, the charter offers no significant protections in the face of a government that chooses to disregard human rights when it suits them. We need to know that our government understands human rights. We need to know that our leaders believe in human rights. We need to know that they appreciate that defence of our human rights is at the very core of democracy and, as such, it is their fundamental obligation to safeguard them, both in law and in practice. A road map for the future of corrections in Canada and its treatment of prisoners that cannot devote a single footnote to human rights, and a Minister of Public Safety who tells us that human rights are incompatible with public safety, is not a good start.
A human rights analysis of corrections and the treatment of the mentally ill within correctional settings leads to many fundamental questions that might guide the work of this committee. Some of those questions would include the following.
Can a system that is respectful of human rights and the decent treatment of those in its care place the severely mentally ill in segregation for long periods of time without even providing a thorough psychological assessment or treatment activity?
And could it refuse to implement the minimal safeguards of independent adjudication for those placed in administrative segregation or pretend that the charter and the correctional investigator could protect their human rights?
Would we tolerate a system where we pretend that the mentally ill have ready access to effective grievance and redress systems, particularly where their literacy and mental condition often make such grievances impossible to prepare?
Could a system that is respectful of human rights accept that while the Sampson panel is pending its recommendations to remove some of the residual rights for those in segregation, a 19-year-old mentally ill girl in segregation strangles herself to death in front of guards, who have instructions not to intervene unless she stops breathing?
Can we accept a correctional system that acknowledges that most of their population has serious mental health and/or addiction issues, and yet spends only 2% of revenue on programs?
Given that addictions in prisons consume most of the population and commonly co-exist with mental illness, can we accept that none of the Sampson panel recommendations relating to drugs addressed prevention, harm reduction, or treatment, while 13 recommendations would toughen enforcement, often by further restricting visits? Would we accept recommendations that see family and community support only as security problems, without any acknowledgement that both the prisoner and the family are entitled to visit and are dependent on those visits to maintain their crucial relationships?
Would a human rights approach allow for more correctional officers than nursing staff on psychiatric ranges? In contrast are the many community forensic facilities where there are no correctional staff on the ranges at all. Could we accept correctional treatment facilities that have a fraction of the treatment staff-to-patient ratios that community forensic facilities have? Could we accept huge waiting lists for programs while the Sampson panel asserts that we need to deprive people of their rights in order to motivate them to take these programs?
Could we endorse recommendations to abolish statutory release, the only gradual release option that is sometimes available to the mentally ill and the otherwise disadvantaged, while knowing that thousands would be released to the community without support, supervision, resource, or follow-up treatment? Could we tolerate a system that keeps seriously ill or disadvantaged people in prison as long as possible, all the while telling them and the public that they can earn parole?
Would we accept broad-ranging, indeed dramatic, changes to corrections without evidence of effectiveness, and in the face of contrary evidence posted on the ministry's own website?
Would we tolerate the removal from the CCRA of the long-held principle of least restrictive measure for the use of criminal sanctions in administration of prisons?
Would we accept vague promises for improvements to our prisons, when sentencing and gradual release policies will inevitably strangle the capacity of the system to deliver on them through huge population increases, inadequate space, and shortage of adequately trained staff?
Would we accept the recommendations that CSC build super-prisons, a complex of prisons within prisons, containing all levels of security and special populations, without justifying carefully how it is possible to actually deliver diverse environments and programs in such a monolithic structure?
If we were concerned about the decent and effective treatment of people in our institutions, would we turn over the planning for the future of federal corrections to a panel of non-experts chaired by an obviously politically partisan chair, with an all-embracing mandate, minimal resources, an impossible 50-day timeframe, and no provision for public consultation on their recommendations? Would we do that with defence, health, or policing?
Would we accept a correctional transformation agenda that is based on a report that never mentions human rights or acknowledges the necessity for human rights to be at the foundation of effective corrections?
We believe strongly that the important work of this committee will fail if it does not reflect in its principles, decisions, and recommendations an unequivocal endorsement of human rights as the foundation for effective corrections and for the treatment of the mentally ill in prisons.
Thank you for your attention.
Thank you, Mr. Chair, and thank you, committee members.
I address my remarks today to two audiences: first to you, the members of this special committee; and second, to the historical record.
Let me say that I appreciate the opportunity to bring before this committee the views of the John Howard Society of Canada. You will know that we are a non-profit charitable society governed by volunteers committed to effective, just, and humane responses to the causes and consequences of crime.
Our 65 front-line offices deliver evidence-based programs and services intended to ensure the safe and effective reintegration of prisoners at the end of their sentences. We also deliver numerous services to young persons to divert them from the criminal justice machinery.
We subscribe to the view that crime is a community issue and that an intelligent response ought to involve the community. So thank you, committee members, on behalf of our front line, our volunteers, and our boards of directors for the chance to bring our message to you.
My second audience is the future. I suffer no illusions that I will be able to alter the course of the government’s crime agenda, whose legislative components contradict evidence, logic, effectiveness, history, and humanity. The government has repeatedly signalled that its crime agenda will not be influenced by evidence of what does and does not actually reduce crime and create safer communities. So if we can’t persuade on the evidence of effectiveness, justice, or humanity, we will speak to future historians, criminologists, and parliamentarians to show them that we were dissenting voices when the government’s crime agenda was being deliberated.
A little context is in order. Prisons are dumping grounds for Canada’s mentally ill. It was not supposed to be this way when, in the 1970s and 1980s, the provinces closed their mental hospitals and transferred care to the communities. As is now understood, the resources for community-based care never appeared, and as increasing numbers of people went off their meds or fell through the cracks created by cutbacks to provincial social services, a larger number of them have been criminalized and ended up in federal custody. The federal prison system is the only component of the state apparatus that cannot say “Sorry, we’re full”, so today we face a crisis of mental illness and substance abuse in our federal prisons.
Simultaneously, governments have been pursuing a utopian experiment in social engineering called “drug prohibition”. This policy transforms a public health issue—that is, drug abuse and addiction—into a criminal justice matter and has the effect of filling prisons with people who need medical attention, psychiatric care, and substance abuse treatment.
The government has recommitted to this madness with the national anti-drug strategy. Ignoring the experience and evidence from the United States, the national anti-drug strategy adds, for the first time, mandatory sentences for drug crimes. The historical experience of the United States illustrates that “getting tough” on drug offenders simply stuffs prisons and jails with low-level users, many of whom show clear evidence of mental illness that, in most cases, preceded the onset of their substance abuse problems.
Drug prohibition has had other consequences too. It has produced a hardened cohort of violent young men schooled in ruthless gang violence over drug profits, and this is what has given rise to CSC’s changing offender population.
These young men are not necessarily mentally ill—though many of them do suffer the effects of prolonged drug abuse—but they create legitimate management problems for Correctional Service Canada. And prisons have become, in the words of one aboriginal gang member, “gladiator schools” for young men as they cycle in and out of the criminal justice system.
So our federal prisons have become gladiator schools where we train young men in the art of extreme violence or warehouse mentally ill people. All of this was foreseeable by anyone who cared to examine the historical experience of alcohol prohibition, but since we refuse to learn from history we are condemned to repeat it.
That brings us to the present. I call on the federal government to engage the Mental Health Commission of Canada in the development of a national strategy that would achieve collaboration and coordination among federal-provincial-territorial criminal justice, correctional, and mental health systems to, one, promote the seamless and cost-effective delivery of services to offenders with identifiable mental disorders; and two, to initiate innovative community-based service delivery models for these offenders and focus resources in particular on those mentally disordered offenders with co-occurring substance abuse problems who are living in disadvantaged social circumstances, a population that poses the greatest challenges for effective service delivery and social reintegration.
A national strategy to address mental health in the correctional system must grapple with the reality that the great majority of persons in the correctional system suffer from concurrent disorders. They have a mental health condition as well as a substance abuse disorder, which means that both conditions have to be treated simultaneously.
If the government achieves its objectives, estimates are that the current population will grow by as many as 3,000 new beds for men, and as many as 300 for women. These are conservative estimates, because so far no one has made public the anticipated costs and consequences of the crime agenda. But we can make some general projections based on the American experience.
Number one, crowding increases tension among inmates. Among the first noticeable effects of crowding is elevated blood pressure, both systolic and diastolic. Elevated blood pressure is a gateway to metabolic syndromes, including diabetes and heart disease. So the first obvious effect will be to create the conditions for chronic health conditions downstream.
The second immediate effect is that crowding elevates the incidence of viral and bacterial transmission between inmates, so crowded prisons are sicker prisons. Crowded prisons are also less habitable environments, because malodorous air pollutants heighten negative psychological effects and cause behavioural disturbances and depressive symptoms.
Currently, the federal system is running at about 10% double bunking. No one, to my knowledge, has assessed the population health burden of the crime bills once they come into force, but it would be prudent to assume that our prisons, which are already incubators of HIV and hepatitis C, will begin to breed numerous other infectious diseases as they fill up.
To my knowledge, no one has assessed the consequences of this elevated level of infectious conditions for labour requirements across the federal system. People have to work in these places too.
Number two, tension increases stress levels among inmates and staff. As tension increases, staff feel less safe and limit their personal contact with inmates. They adopt a more cautious posture and keep a greater distance from inmates on the ranges. This contributes to increased tension, because it creates a self-escalating cycle as staff and inmates perceive elevated anxiety in each other’s non-verbal behaviour. Disputes that might have been resolved with conversation take on a combative quality, and staff—in order to protect themselves—wear heavier apparel, such as stab-resistant vests.
Behaviour symptomatic of mental illness is sometimes treated in prison as a disciplinary rather than medical problem. This cycle rapidly degrades the quality of work for staff and guards, which is an outcome that this committee should examine closely, because among other problems, it will eventually drive good correctional officers out of the profession. As CSC will admit, they already have problems attracting and retaining staff. Rapid growth in the rate of incarceration can only exacerbate this problem.
Number three, as stress levels rise, we can expect to see more incidents of self-harm and suicide attempts. As Alison Liebling has written, prisoner suicide is not exclusively or predominantly a psychiatric problem. There are multiple psychological pathways to suicide in prison, one of which is the social isolation that accompanies the management of a rapidly growing population. Furthermore, there are at least three identifiably different kinds of prison suicides in the literature: life-sentence prisoners, the psychiatrically ill, and the poor copers. These latter are generally younger and non-violent, which is exactly the population that will be caught up in this new binge.
Liebling claims that women far outnumber men in terms of incidence of self-injury per head of population, up to as many as 1.5 incidents per week per woman, and that 20 or 30 incidents of cutting during one sentence is not unusual among women prisoners.
Fourth, elevated stress correlates with population management problems. As populations become harder to manage and control, staff turn to segregation and other forms of offender control. Invariably, these fall disproportionately on those least able to cope with the pace of change and who act out of desperation and frustration. Again symptoms of mental disorder manifest as behavioural misconduct, which are disruptive to the good order of the institution, and mentally ill persons find themselves singled out for special, usually harsher treatment, but also for the hostile attention of other inmates.
So crowding turns into elevated stress, which turns into heightened tension, which manifests as violence.
I'm going to conclude now.
If the government is committed to growing Canada’s rate of incarceration, it will impose great costs on the correctional system in the short term--costs that will be felt in the safe management of the population, in staff and inmate stress levels, and in the overall incidence of violence. The service will have to fill many vacancies in its therapeutic complement—social workers, psychologists, and substance abuse specialists—if it wants to prevent the worst effects of overcrowding upon inmates with concurrent disorders. As the correctional investigator told you, “...many institutions are currently not staffed, funded or equipped to deal adequately with the needs of mentally disordered offenders…. Interdisciplinary mental health teams are supposed to be on-site, but in many facilities these teams exist in name only.”
The last point is that we could be heading into a very difficult time for the service. It is urgent that the government grow the service’s capacity to address these issues with the same alacrity as it seeks to grow the rate of incarceration.
Thank you for your time and attention to this urgent matter.
Thank you very much, Chair.
I appreciate the opportunity to speak. I'm obviously filling in for Mr. Davies, who's required in the House to speak.
Thank you for your presentation. I was here for most of it. I read your report. As a former Ontario corrections minister, I'm certainly familiar at the provincial level. At that time the provincial system in Ontario was as big as the federal. I don't know if that's still the case, but I suspect that.... At least so far it's like that. Who knows what will happen now.
But also, prior to that, being on Hamilton city council as an alderman back in the 1980s, I headed up a task force looking at mental health services in the community for those who pretty much were on the street. What we found—and I was referring to what you mentioned on page 2, the revolving door—was that there would be an incident of some sort. The police would be called. They would take them to the hospital. That would hold for a while. They may get out, or they may not. Eventually, they end up in jail for a short period of time. Then they're back out on the street. Then the police, then the hospital, then the jail, and there's just a revolving door. I haven't seen anything since then, either in my time as the minister or since, that suggests that's getting any better.
We know the shame of it, certainly in Ontario. I don't know about the rest of the country, but in Ontario, when the decision was made to deinstitutionalize the psychiatric hospitals in the late 1960s and 1970s, as the back wards were opened up and people were allowed out on the street, that money that was saved was supposed to be reinvested into the services that would be required in the community, since these people were now being removed from those back wards—and they were back wards: locked, dark, forgotten-about places in our society. And that money was just soaked up by the government of the day and taken into general revenue. So what was a problem in the prisons and in the hospitals became a problem on our streets and in what we in Hamilton call second-level lodging homes, which provided services for them. Anyway, all of that is to give a context for the Ontario experience.
The American example is the closest we have in terms of an acceleration of the number of inmates increasing in a short period of time. The American system, as I understand it, is still predicated on private prisons. For a while, in the last decade, the biggest growth industry in the United States was building and operating prisons. If you're running prisons for a profit, it makes sense that the more prisoners there are--guess what?--more profit.
I'm curious: in that system and in that experience that they've gone through, that we're about to head into, are there any lessons at all to be learned in terms of services for drug and other substance abuse programs, the hiring of professional services? In other words, did the privatized system take care of this problem in a way that can provide us with any examples that we want to follow? Or are there some lessons there on the downside that we need to take into account?
I think the question of whether a prison can provide a good psychiatric treatment environment has to be answered with a no. First of all, psychiatry is generally referred to across the country, as Senator Kirby said, as the poor cousin. So psychiatry within corrections would be equally low. It's not a high priority. The institutions that we have for psychiatry are prisons first and treatment facilities second.
If you compare our psychiatric facilities in prisons with community psychiatric hospitals like the Philippe Pinel Institute in Montreal--which I hope you could visit--it's a completely different environment. When you go into the Pinel Institute there are no custody staff on the ranges, whereas in our federal institutions there are more custody staff than mental health workers. Staff are assigned to particular inmates and they work with them continuously, in the day, at night, in their yards, and in their recreational areas. It's a completely different model, and I hope you have a chance to see what the difference is when you're a hospital first as opposed to a prison first.
The fact is that a psychiatric institution within a large correctional system is still a small problem. The policies that are going to take precedence deal with the big issues, the budget issues, the working of the federal institutions generally, and very seldom are the mental health issues accommodated. For instance, in the current context we're talking about the abolition of statutory release. Well, statutory release abolition will have a huge disproportionate impact on anyone who's disadvantaged, and particularly the mentally ill. What we will be doing in effect is releasing more and more people into the community with serious mental illnesses and without either support or supervision. That kind of criminal justice approach for the mentally ill is simply incompatible with what we know is the best way to address mental health issues.
We do have examples of different models in this country that I think would be very instructive for you to consider. Otherwise, we end up with systems that simply recycle people, as Mr. Christopherson was mentioning.
If we don't make a change, if we can't bring together the proper treatment, if we don't have the proper reintegration support for people re-entering the community, you can be sure that being as vulnerable as they are, having the difficulty they have day by day in their lives, they will be back at the door in short order--and not necessarily for serious crimes. Interestingly, the research department has shown that actual criminal recidivism is not any higher among those with mental illness than for those who are not designated with mental illness, but it's because of the social environment.
And thank you, witnesses, for coming today.
I'd like to look at this in a positive as opposed to negative vein. If we keep telling ourselves all the negative stuff, we'll never get to the positive stuff; in other words, where we want to be.
I could go through some of the great steps we've taken over the last while, with the Mental Health Commission of Canada and some of our budgets and the amounts of money we have placed there. I could tell you the stories of dealing with some of the folks in my own riding and their comments about the closing of the institutions we referred to--they look at that as a good thing--and how we need to build community support.
I could tell you some of the good stories there, but that's not dealing with the issue today. The issue we're dealing with is as a result of government members wanting to take a look at this, because we do realize it is a problem. I'd like to not look at it from the perspective of whipping the people whose approach you don't necessarily philosophically agree with.
In particular, I'd like to ask Mr. Jones a question, because he's the current representative of the John Howard Society. Would you describe the kind of institution in which there would be what you would consider the appropriate delivery of substance abuse treatments/mental health abuse treatments? Could you describe that? You could describe it under the present context of our system, because we have to start somewhere. I'd like to hear about some of the changes that need to be made, that you believe could be made, and that would be reasonable and accepted by ordinary people on the street. In the end, they're the people every member of Parliament is responsible to.
Could you describe that? I'm not asking for nirvana, just something that's practicable, deliverable, and that has changes from the way we're doing it currently.