The wrong fix -- how our correctional system fails mentally ill inmates

The wrong fix

Alan Nicolson hung himself in his prison cell at Manitoba’s Stony Mountain Institution back in 2003. A first-time inmate, Nicolson, 34, was facing four years of incarceration after holding up a convenience store. Suffering from anxiety, depression and drug addiction, he was being held in a special segregated unit called the “mental health range.” But two years later, an inquest into his death found the solitary cell where Nicolson spent his last hours to be a “mental health range” in name only. “There is no programming. There is no treatment,” the report reads. “The mental health staff has no special responsibilities to those housed in this ward.”

The mental health range has since been shut down, but Nicolson’s death still bothers correctional investigator Howard Sapers. It’s a prime example, he says, of how Canada fails inmates—especially the mentally ill. Sapers cites the case of Ashley Smith as well, a New Brunswick teen who killed herself in a prison in Kitchener, Ont., in 2007. Smith, who’d acted out and threatened suicide, was held in isolation up to 23 hours a day before she was found dead in her cell. (An inquiry into her death is planned, although a date hasn’t yet been set.)

In Canada’s prisons, more inmates are being held in solitary confinement than ever before. They’re staying there longer, too. At any given time, Sapers says, about 900 offenders are locked in segregation (Canada has 13,000 federally incarcerated offenders). His annual report talks of various forms of segregation—called transition units, special needs units and other names—that are popping up across the country. They operate much like solitary confinement cells, minus some built-in safeguards, such as the requirement for a report on why an offender is being transferred there, for one, or what he must do to get out. Increasingly, says Sapers, “we’re seeing mentally ill offenders held in units that aren’t called segregation, but sure look like it.”

Our federal prisons now hold the largest psychiatric populations in the country, and over the past five years, their numbers have doubled: at admission, 11 per cent have a significant diagnosis like schizophrenia, and more than 20 per cent are taking prescription medication for a psychiatric condition. Almost one-third of female inmates have previously been hospitalized for psychiatric reasons. Just as we’re de-institutionalizing the mentally ill, shutting down mental health beds across the country in favour of community-based care, we’re re-institutionalizing them—as prisoners. Public Safety Minister Peter Van Loan has said we’re “criminalizing the mentally ill.”

Once behind bars, the acutely disabled might land in one of five regional treatment centres, which provide psychiatric treatment to inmates. But with just over 600 mental health beds across the country, the RTCs are overwhelmed, says Sapers; they’ve become “revolving doors of referrals, admissions, and discharges.” And mental health services in prisons are stretched to breaking point, says Wayne Bennett, the union representative for the Professional Institute of the Public Service of Canada. Of the 340 correctional psychology positions that exist, 15 per cent are vacant. “We’re all working flat-out, doing the stuff that’s mandatory,” like risk assessments, the former correctional psychologist says. “What doesn’t get done is ongoing regular treatment and therapy.”

The rules of life behind bars can be difficult to grasp; yet acting out might spark confrontations with other inmates, or prison staff. Too often, mentally ill offenders end up in segregation as a disciplinary tactic, or for their own safety, Sapers says. The Correctional Service of Canada doesn’t keep track of how many mentally ill offenders are in solitary, but research suggests they’re more likely to end up there: some studies show that up to one-third of prisoners in segregation are mentally ill.

Canadian officials are aware of the challenges posed by mentally ill offenders, but “I do believe it is getting better,” says Van Loan, who points to newly funded programs, like a mental health training initiative for front-line staff. The government has provided new money for institutional mental health services, he says, including $16.6 million in permanent annual funding, which kicked in last year. But critics contend it isn’t enough. “That $16 million might be enough to operate one more RTC equivalent,” Sapers says, let alone repair massive holes in the system.

In their response to his report, the Correctional Service agreed to begin a study of long-term solitary confinement. But as for those pseudo-segregation units, the process “already had procedural safeguards” to ensure an inmate’s rights aren’t violated, it said.

The treatment of our inmates is ultimately a public safety question, notes Craig Jones of the John Howard Society of Canada, which offers supports to those who come into conflict with the law. “Everybody gets out,” he says. “The question is, what condition will they be in, once they do?”

I believe that those with mental health issues and disorders or learning and behavioural problems, should not be in prisons as they do not understand the consequences of their actions and therefore, cannot be held blameworthy. Their brains don't function the same as everybody elses'. They should be held in treatment facilities or in the community and be provided with treatment or medication as prisons and their negative environment, influences and lack of resources or proper programming for them, often worsens their condition. That is not in society's best interests as most inmates are released someday and we need to care about them.