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.