Good morning, everyone.
My name is Marc-Arthur Hyppolite. I am the Senior Deputy Commissioner for Correctional Service of Canada. I studied criminology, sociology, and psychology at the University of Ottawa. I also went to the Collège de Maisonneuve in Montreal. I am here to represent the Correctional Service of Canada. I have 25 years of experience in corrections and a few short periods of time in other government departments.
I'm pleased to be here and I would like to thank you for the opportunity to speak to you today.
As you know, Mr. Chair, Canada's aboriginal people are grounded in a very rich and diverse culture. Unfortunately, this history has led to a disproportionate number of aboriginal people in Canadian penitentiaries. CSC's actions, as described in the strategic plan for aboriginal corrections and supported by the recent accountability framework, reflect an understanding of that history, the current social reality, and the importance of cultural traditions when formulating meaningful correctional policy for the aboriginal people in our care.
As the Commissioner informed you in June, we have seen a significant change in the offender population profile over the past decade. Increases in the number of offenders with mental health problems and substance abuse problems are important factors in this offender profile.
Where this differs between the aboriginal and non-aboriginal population is that aboriginal offenders tend to be younger, be at higher risk, and have more health problems—specifically fetal alcohol spectrum disorder and mental health issues.
Additionally, we have found that aboriginal offenders have a significantly higher rate of drug and alcohol problems than non-aboriginal offenders.
Our approach to aboriginal corrections is based on the continuum of care that encompasses each stage of an offender's sentence, from admission to release into the community. The continuum of care, which was created in consultation with aboriginal stakeholders and partners, developed new opportunities to address aboriginal offenders' needs, as reflected in the 2006 to 2011 strategy plan for aboriginal corrections. This was developed to enhance CSC's capacity to deliver effective intervention to first nations, Métis, and Inuit offenders and to integrate this continuum into Correctional Service of Canada.
CSC recognized that aboriginal culture is holistic in nature and elders are integrating and assisting in the intervention plans for aboriginal offenders to ensure they are reflected in their healing plan. Through our experience working with aboriginal offenders, it is clear that programs that include culturally appropriate elements of correctional interventions are more effective with an aboriginal population that has higher risks and needs than other segments of our population.
As you know, effective correctional programming is an essential element in reducing reoffending and preparing the offender for their safe return to the community. As such, they include the integration of effective correctional program principles with traditional aboriginal healing and spiritual approaches.
Research has shown that programs that include culturally appropriate elements in correctional interventions are more effective with aboriginal populations that have higher risks and needs than other segments of our population.
With this in mind, we provide programs specifically designed to meet the unique needs of aboriginal offenders, we work in partnership with aboriginal communities, and we rely on the guidance provided to us by the aboriginal advisory committees that we regularly engage to help implement our plans for action.
One example is the aboriginal offender substance abuse program, which is offered at both the high and moderate intensity levels. The program is for male aboriginal offenders and is designed to reduce the risk of relapsing into substance abuse and reoffending. The program is based on a holistic approach to ensure the impact of addictions is examined across physical, mental, emotional, and spiritual dimensions in a safe and supportive environment. It is also culturally responsive to the needs of first nation, Inuit, and Métis offenders.
Looking forward, CSC has invested nearly $33 million in aboriginal corrections over 2009-2010 to support the following: the expansion of aboriginal intervention and healing programs in our institutions and of healing lodges in communities; the contracting of more elders in our institutions and in the community; an increase in apartment units and houses to offer more intensive healing support; and the creation of more aboriginal employment and job placement opportunities.
I am confident that our dedicated research and our effective program development have put us on the track to respond to the offender profile and to address the unique needs of aboriginal offenders. Within this body of work, measures to address mental health and substance abuse are important priorities.
Thank you for this opportunity to speak and I welcome any questions you may have.
Then, if you want the Deputy Commissioner for Women to make a presentation, that will be possible.
Thank you, and good morning, Mr. Chair and committee members.
Just as a little bit about my background, I have been with the Correctional Service of Canada for 25 years. I started out as a correctional officer at Kingston Penitentiary, so I've worked my way up through various positions within the institution on the security side of the house. On the case management side of the house, I've been at national headquarters for the last eleven years, and I've recently come into this position in the last year. That's a little bit about my background.
I'm very pleased to be here today, and I'd like to thank you for the opportunity to speak to you about issues surrounding women offenders. This is an area that is of key importance to the Correctional Service of Canada and one that is of great personal importance to me as deputy commissioner for women.
By way of background, I'd like to start with a few general comments about the women offender population in Canada. At any given time there are just under 1,200 women under federal sentence in Canada, with about 44% serving their time in one of our facilities and the remainder serving sentences in the community. In terms of the general demographic makeup of female offenders, they tend to experience poverty, are young, uneducated, and lacking in employment skills. Compared to the average Canadian, women offenders have a higher incidence of substance abuse and mental health problems and are more likely to have a history of physical and/or sexual abuse. In short, women offenders have unique factors influencing their criminal behaviour, and so they require an approach that is unique to their specific needs. This approach is commonly termed “women centred” in that it reflects the social realities of women and responds to the individual needs of women in our care.
As the senior deputy commissioner just reinforced, CSC has seen a significant change in the overall offender profile over the last decade. This applies equally to the women offender population. What we have seen in the last decade or so is an increase in women entering our care who exhibit mental health needs or who present complex behavioural concerns. We are also seeing women serving much shorter sentences. Taking into account these and many other factors, we are certainly facing greater challenges for our organization in terms of how we effectively manage women offenders and help them forge a path away from crime and towards more positive life choices.
One of the ways we are building on our capacity to address the needs of women offenders with mental health concerns is by identifying their requirements from the first day of admission. To this end, CSC is improving its screening and assessment process at admission with the implementation of the computerized mental health intake screening system. If we can better identify mental health issues from the beginning, we are in a better position to proactively address them.
For women who are identified as having higher needs or severe mental health concerns, we currently have three options. The first is two intensive psychiatric treatment units, one at Philippe-Pinel and the other at the regional psychiatric centre in the prairies, for those women who require treatment in a psychiatric facility.
The second option is that CSC has implemented the structured living environment, which provides a separate living space and programming area within the institution for women classified as minimum or medium security. It is a therapeutic environment that is staffed 24 hours a day with an interdisciplinary team that can provide specialized correctional, rehabilitative, and mental health treatment.
Finally, for women requiring similar intensive intervention but who are classified as maximum security, CSC constructed security units at each of the five regional women's institutions. These units feature heightened security measures coupled with an interdisciplinary approach similar to the structured living environments that provides intensive staff intervention, programming, and treatment to these higher-risk women.
In addition, important interventions for women with mental health needs are dialectical behaviour therapy, or DBT, and psycho-social rehabilitation. DBT is a comprehensive mental health treatment for women with serious emotional issues and behavioural problems. DBT addresses these issues by targeting skill development in the areas of emotions, relationships, cognitions, and stress. Psycho-social rehabilitation addresses the needs of women who are cognitively low functioning. It helps them regain control over their lives by assisting them with living skills and formulating goals and plans to prepare them for independent living.
In addition, as a majority of women offenders are survivors of abuse and trauma, intervention to address these issues is also offered. Group and individual counselling is available to all women offenders to help address the significant impact these and other experiences have had on their lives.
As I mentioned previously, in addition to mental health concerns, statistics show that up to 80% of incarcerated women have a substance abuse problem. It is vital that we work with women to identify these issues and proactively address their addictive behaviours. CSC has developed a suite of programs specific to women offenders. I'd like to highlight two programs that are dedicated to helping women offenders address addictive and violent behaviours.
The women offender substance abuse program is designed to address the substance abuse needs of all women offenders. The program offers women offenders several levels of intervention from the time they enter the institution until the time of their warrant expiry. This includes maintenance programs in the community.
The second example is the Spirit of a Warrior program, which was developed by the Native Counselling Services of Alberta to address the needs of aboriginal women offenders, specifically targeting violence, substance abuse, and gang association, with the overall objective to reduce reoffending.
In closing, I believe the programs we offer women and the interventions we make to in order to empower them to make better choices are appropriate and effective. While CSC has come a long way in addressing the needs of women offenders, we still have work to do. The nature of our business is such that we must continually evolve and adapt to meet new challenges. I believe we're on the right path, and I look forward to discussing some of this with you today.
Thank you, Mr. Chair.
My name is Peter Ford. I am a physician recently retired from the department of medicine at Queen's.
For the past quarter of a century I have been looking after patients with HIV and associated diseases. Also for about a quarter of a century I have been looking after federal prisoners with HIV, which I do by going into the prisons on a regular basis.
At any one time I have 35 to 50 patients in the eastern Ontario area with HIV. Ninety-five percent of these have hepatitis C, which is, in this particular context, a marker of intravenous drug use.
Because of this high prevalence of hepatitis C in the HIV population, we did some studies back in the nineties--the first one was in 1994--to see what the prevalence of HIV and hepatitis C was in the institutions generally. We looked at a medium security institution in the Kingston area and did an anonymous study, which showed us that 28% of the inmates had hepatitis C and 1% had HIV.
We repeated that study in 1998, by which time 33% of the inmates had hepatitis C and 2% had HIV. With the second study we did a detailed questionnaire, which could be linked to the blood samples anonymously. What we discovered was that almost everybody who had hepatitis C had a history of intravenous drug use. The people who gave a history of sharing injection equipment had the highest incidence of hepatitis C. But the most alarming thing that came out of that study was that there was a group of people who had not injected outside prison but had shared injection equipment in prison, and two-thirds of these people were positive for hepatitis C.
So what we're looking at is a problem with a communicable blood-borne disease, which is being imported into the prisons and is proliferating within the prisons. That has some very serious public health overtones, because these folks are going to get out and they're going to go on doing what got them infected in the first place. In addition, hepatitis C can be spread by sexual transmission--just under 10% is spread by sexual transmission--so the risk is going to move beyond the intravenous drug users to their sexual partners.
The long-term health costs of this are very considerable. It costs about $20,000 to treat somebody with hepatitis C. The treatment is not always successful. The treatment is not always possible because the patients don't identify themselves or because they're not suitable for treatment--and there are some reasons why people do not get treated.
The end product of hepatitis C is liver failure. Liver transplantation due to liver failure from hepatitis C is now the largest cause of liver transplantation in North America, and we're only in the early stages of this epidemic. The epidemic of hepatitis C infection has blossomed with the increase in intravenous drug use, but it takes 20 years to get to end-stage liver failure. So the big bulk of this problem is not going to arrive for quite some time yet.
Corrections is going to find itself looking after people with terminal liver failure, and this is a very expensive prospect. As a physician, I am very concerned about the amount of hepatitis C, and to some extent HIV, that is related to intravenous drug use in our institutions.
I have brought with me something that can be passed around, but if it is going to be passed around I would really asked that you don't open this container. This contains a syringe that was brought into our clinic in Kingston by a very frightened guard who had just stuck himself on it while doing a cell search. This syringe was probably the only syringe on the range from which it came. It's probably been used by at least 10 to 15 different people, several of whom would have been infected with hepatitis C and some of whom would have been infected with HIV.
You will see that this syringe, which is made from a ballpoint pen, tape, and a needle that probably came from an insulin syringe, is dirty. It's not possible to clean it. There is no way you can clean this syringe, even with the best intentions. These syringes are not only responsible for transmission of hepatitis C, HIV, and hepatitis B, but they are also responsible for a large number of rather nasty injection site abscesses that I see in the course of my work in the prison. I think this is a problem that also needs to be addressed.
Thank you, sir.
I want to thank you for inviting us here. I also want to bring regrets from my president, Lucie Joncas, who had hoped to attend, but I think it's in part a reflection of the volume of what's coming before us that she was not able to.
One of the things I'd like to start with was also one of the questions posed to the Correctional Service of Canada in the last session. One of the reasons that women are the fastest-growing prison population also relates to this increase in more federally sentenced women serving shorter sentences, and it is in fact going to get worse, I would suggest, especially with the recent passage of .
One of the reasons we're seeing this is that with the cutbacks to social services, health care, and educational services in the community, those who are most marginalized and most dependent on those services are more likely to fall through the cracks and end up being criminalized and ultimately institutionalized, as there are fewer options, fewer places to go to for services, fewer places to get the assistance they require. We're actually seeing individuals coming in and asking for sentences under the real and well-intentioned assumption or belief--by crown counsel, by defence counsel, by the individuals themselves--that they'll actually be able to access more programs and services in the federal system.
Our federal prison system is likely the best in the world. We say that without necessarily having a great deal of pride in that right now, because it is not very good at this stage. In fact, there are many deficits, and I'd like to speak to some of those. Some of them have already been spoken to. You have copies, I'm sure, of the recent report of the correctional investigator that was tabled by the last week. I'm also aware that you're familiar with the reports into the death of Ashley Smith and other Office of the Correctional Investigator reports.
I was just at the RPC in Saskatchewan yesterday, the regional psychiatric centre, about which you heard. It's always interesting to me to hear the descriptions of these institutions from the perspective of those who have a responsibility to uphold the work that they do as part of the Correctional Service of Canada, and to uphold the policy. I would suggest to you, though, that the reality belies the representations that you heard, not because there aren't well-intentioned people--there are very many good people working within the corrections system--but increasingly because they are unable to actually talk about what's really happening in the system.
When I was in the regional psychiatric centre, I saw women in what was described to you as intensive psychiatric care. Intensive psychiatric care is essentially segregation, with chemical restraints in addition to the mechanical restraints and the uses of force that you've heard about and seen chronicled in various reports. I was looking into the treatment that was used with people like Ashley Smith. You'll pardon me, but I'm using that example because there have been so many publicly discussed descriptions of her treatment that it probably will generate some images that you're able to link this to.
The only difference I saw in the treatment of the women compared to the last time I was there was that women are now less likely to be in security gowns unless they're actively suicidal. If they're self-harming, they may instead be in institutional sweats. When you're visiting that institution, that's what you'll likely see, if indeed you meet with the women there--and some of them are interested in meeting with you; you need to know that.
Also, although we are repeatedly advised that the prisoners there are treated as patients, when I was at the courthouse where the corrections supervisor who has been charged with assaulting Ashley Smith is facing those charges and is now on trial as I speak, successive staff talked about the fact that even for nursing staff and mental health staff within a psychiatric hospital that is also duly designated as a penitentiary, the priority issue is security, not the treatment needs of the individuals who are there.
Even though that is not the law and is not the policy, it is the perception of the staff who were testifying, who presumably were also prepared for that testimony. To them, in fact, the priority issue is security. When you look at issues of mental health as you're going around the institutions, I would suggest that you ask questions of all of those programs you heard about. They are very good programs, and some of them are excellent programs, but ask how often they are offered and how many people have been through those programs recently. Are they operating currently? How many people in the last year have been through those programs? What is the duration of those programs? How long have they been fully staffed?
A benefit of this committee is in fact that there has been an increase in resources going into those areas over the past few months. It's a credit to all of you that you're doing this work, because in fact there are individuals who are benefiting.
There are individual women who have been released, and I'll talk a bit about some of those cases in a minute. They were also alluded to by the previous speaker.
I also want to say that I disagree, however, with the notion that we need to improve the mental health strategies within the prisons, for the very reason I just spoke about. I think it will be very difficult to improve mental health services in the prisons. The women's prisons have the best mental health resources in the country, and yet in the special living environments—or they may be called something else now—the mental health units that were just described to you are essentially for those who have intellectual disabilities or less severe mental health issues.
The women with the most significant mental health issues, as I sit here today, are still the women who are in segregation units, are still the women who are self-harming and are experiencing the response to their self-harm as punitive responses, whether or not that's the intention of staff. I agree that in fact for many staff it is not their intention; however, that's how it's experienced by the individual women. And if they try to speak out or grieve those situations using the mechanisms available, they are often encouraged to remove the grievances or not follow through on them. You just need to look at the reports into Ashley Smith's death to have an excellent chronicling of how this occurs and how those responses are systematically not an effective way to deal with either individual issues or systemic issues.
I also want to ensure that you are aware that, as we try to raise some of these issues, we have some very real difficulty in being able to gain access. We are in discussions right now. We have been denied access to segregation units. Concerning the very areas we have documented over the years with the correctional investigator and others, or have asked the correctional investigator to examine after we have identified issues in set areas, whether it be concerning the Prison for Women in 1994, or Ashley Smith recently, or other women now who are in those areas, one of the responses has been that we may not be allowed access any more.
We have been denied access; it is unclear right now what the official position is. The last letter I have from the Commissioner of Corrections said that we were not permitted to go into segregation units. Since that time, in discussions with the commissioner we've been advised that it will be at the warden's discretion. I've been allowed into one of the units and not allowed into another.
So I encourage you also to ask those questions—of who is monitoring what's happening—and as you're examining this issue, to really focus on the recommendations made by Louise Arbour, by the Human Rights Commission, by the Office of the Correctional Investigator, and by Corrections Canada's own task force on the use of segregation, which recommended limits to the use of segregation and changes to the classification. Even though there's a new classification scheme, it is still predominantly the needs of women—and of men, I would suggest—that are translated into risk factors that allow them to be classified as requiring higher security, allow them to be kept in segregation.
And I can't stress sufficiently the need for external oversight of corrections. Even though the Privacy Commissioner has ruled that we should have access to the records of Ashley Smith, we still don't have them, so I can't tell you some of the things that I'm pretty certain existed and happened, based on what she told me and what other prisoners told me and what staff have told me.
I also want to reiterate something that I have said to a number of you in other committees and other contexts, which is that we are increasingly being asked by the Correctional Service of Canada itself—not officially, but by corrections staff—to take on these issues in courts and with human rights complaints in various other venues, because people are feeling impotent within. People feel that they can't speak out about the very real issues of the limits being placed upon them.
There are examples of very positive things that have happened. I was going to give you a list of 15 women whose cases.... I won't do that, because I see the chair shaking his head.
I will tell you about the one alluded to by Ms. Van Allen, the deputy commissioner for women. She talked about the very good progress that has happened with a woman who was released recently after being in segregation. Let me tell you, that was one of the examples of people coming to us asking us to push at every level we could to have this woman out. I'm very pleased that Corrections Canada and the National Parole Board saw fit to release this woman. I'm very pleased to tell you that I've now seen her three times in the community. She's doing very well; she's in her own place; she's working; she's blossoming. People from Corrections whom I introduced her to last week, when I was at a conference and invited her to come and have lunch with us, did not recognize her, three months after she was out of that segregation cell. That should tell you something about the difference in her mental health, just being free. I use “free” loosely, because she's under supervision; but being in the community, having some support, having a place to live, having something to do, and having community support around her.
Let me also tell you—I have yet to have this confirmed, although I've requested the information—that it cost, I'm told, $2 million to keep that woman in the conditions she was in in prison, just for overtime, and there is something on the order of $10,000 per year being spent on that kind of support in the community.
I would strongly urge that when you're looking at these issues you examine ways in which the resources can be developed in the community, not within the prison, so that individuals can go into the community for those services. From day one of a sentence, for health reasons people can go into the community and access services.
I understand that we need to move to questions now. I look forward to those questions.
It would be my opinion, yes, that they could. The law currently, as it exists, the Corrections and Conditional Release Act, would allow that.
In fact, Corrections routinely sends individuals to psychiatric institutions in jurisdictions. The obvious one people know about and was discussed is the Phillippe Pinel Institute, which has a separate unit. In addition, though, in this region, St. Thomas has been used. Other hospitals have been used. Portions of Kingston General have been used. It depends on the institution, but most of the provinces and territories--not all the territories--have locked forensic units.
Although those sometimes aren't the greatest places, because of the limited resources, in my experience, the reality is that every single prisoner, to a person, who has gone from a prison segregation cell to a forensic unit, even if it's a locked forensic unit, even if it's the most secure forensic unit, even if it has essentially the same conditions of segregation, within 24 hours has shown improvement. Partly it's because of the more appropriate medication treatment or whatever. As well, they are treated, fundamentally, as individuals with a mental health issue whose behaviour is symptomatic of that mental health issue, not of bad behaviour, which is how they tend to be seen in prisons, not surprisingly. That's what prisons are.
As I mentioned, at the regional psychiatric centre most of the staff believe that security takes precedence over mental health, even though it's the business of this facility.
Another issue you should ask about, especially in the psychiatric centres you go to, is how many times committal proceedings are commenced. In my experience, the mental health legislation is often used to commence committal proceedings and to then do forced injections. It is then abandoned before the mechanisms for oversight kick in at a provincial mental health point.
My post-graduate work right now is in forensic mental health because of these issues. So if there's anything we can assist with, I'd be happy to. I know that we're limited in time.
Thank you, Mr. Chairman.
The first thing I want to do on behalf of all Canadians is thank you, Ms. Pate, and the Elizabeth Fry Society for providing such an essential and profoundly important service to women across this country.
I also want to thank Dr. Ford for all the work you have done in our prisons for the last 25 years. I can tell you must have started quite young.
There is so much to ask on the subject of mental health, and we only have seven minutes. I'll just get to some specific things.
I want to come back to the issue of segregation. I think all members of this committee would probably agree that we're dealing with mental health problems in our prisons by tossing people into segregation. The other thing I hope everybody agrees with at this point is that segregation is probably the worst place you can put someone who is having an acute problem with mental health.
Mr. Sapers puts it best. He says that prolonged periods of deprivation of human contact adversely affect mental health and are counterproductive to rehabilitation.
I do know there are models around the world that are using methods other than segregation. One of them is used at an institution in Britain called Styal Prison, where I understand they have a ten-bed unit. When someone self-harms or goes into some sort of behaviour indicating acute mental illness, the person is sent to that unit and one specific staff member is assigned to that person. Essentially that person is put within a health care setting within the institution.
Do you think that is something we should emulate in this country?
Corrections would indicate that most of them have been, and I would say that in part, many of them have been. There's a deputy commissioner for women, but with none of the other recommendations that went with that position. It depends on which recommendation you're talking about.
What's important for you to know is that the 1990 report of the task force on federally sentenced women, against which each of those has been measured--it was a Conservative government that implemented that task force--promoted actually very much a decarceral model. In fact, it promoted minimum security settings across the country for women. I would suggest that was a very wise recommendation. It was derailed because of the mix of women into men's, so the minute there was an escape, women running away and being caught within ten blocks, there was a decision to put massive security around. The perception was that somehow they were going to pose a risk, which never came to pass in those cases, or in others. Nevertheless, because there have been some high-profile incidents of men escaping, that was used to justify this.
I think what Louise Arbour said was the recommendations that were made in 1990 talked about women's corrections being a flagship for corrections as a whole, being the place where you can actually make some really progressive changes that don't increase risk to public safety at all, and that hasn't been followed. I would urge you to very much look at those and examine the possibility, because with this population you could be doing that. In fact, it's a great missed opportunity to not do that.
The heads of corrections all across the country, federal, provincial, and territorial, in the mid-nineties had a strong push for a decarceration strategy, which never got implemented as well. That was supported, as I understand it, by all parties.
You're much more attentive than my law students, I can tell you.
I can obviously not comment on the merits of the proposal but simply inform on the background. When officials looked at the amendment, one of the things we did was to consult with the drafters at the Department of Justice. So all I can advise the committee, as Mr. MacKenzie has done, is that the response we got from the legislative section was that only English and French words can appear in the statute. I appreciate that this is odd, because my colleague Mr. Hoover looked in the index to the Criminal Code, and of course the words mens rea appear there. However, he advises me they do not appear in the section in the code itself.
Of course those of us who have been to law school spend enormous amounts of time learning Latin phrases in the law and use them quite regularly, but that is a bit different from their role in drafting a statute.
The other thing I did was to go back to Black's Law Dictionary, 8th edition, as this is the standard dictionary. Modus operandi is in there, along with many other Latin legal phrases. It's defined in Black's as “A method of operating or a manner of procedure; esp. a pattern of criminal behaviour so distinctive that investigators attribute it to the work of the same person”.
I sought also instruction in the French and found a very useful volume entitled Les locutions latines et le droit positif québécois, which also contains modus operandi and defines it as
a "Way of working, operating, doing, method of acting."
The last point I would make is that this phrase does not appear in the Ontario sex offender registry statute or regulations, and the challenge in identifying elements in section 8, of course, is to be precise enough that all field officers are able to input accurate relevant information. There is some concern among officials that the phrase, although well understood in a popular context, may not be sufficiently precise to allow police officers to identify what needs to be in there. And of course in section 8 they're receiving the order from the court, so they are to a large extent going to be reliant on the court information. So things like a name or fingerprint or the precise offence are very easy to put in a header to a field and to enter. There is some concern that anything like MO or the English or French words that define it would lack that kind of precision.
That's simply a comment on the technical aspects, not obviously on the merits of the proposal.