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Mentally ill inmates being left untreated, ombudsman says
OTTAWA -- The federal prison system is leaving mentally ill inmates untreated, violating their rights and endangering public safety because it has not put money into dealing with a huge increase in their numbers, according to the prison ombudsman.
In his annual report released yesterday, Correctional Investigator Howard Sapers said the number of inmates with "significant, identified mental health needs" has doubled over the past decade, but treatment services have declined. "The level of mental health services is now seriously deficient."
The report concludes that Correctional Service Canada has developed a plan to deal with the problem, but does not have money to put most of the changes into place.
"The Service has developed an action plan filled with desirable commitments and timelines, but we anticipate little or no progress as the Service has admitted that it does not have a matching funding plan . . . ," the report states.
Judges and coroners have criticized Ottawa in rulings and inquest reports for failing to provide proper treatment, and for ignoring court-ordered treatment for convicts.
Mr. Sapers said CSC must recognize it has a serious problem that must become a priority. It must train staff to deal with mentally ill inmates, hire more professional staff, and double the 600 to 700 acute treatment beds available.
In all, about 12 per cent of federal inmates are seriously mentally ill, Mr. Sapers said, while the system is able to deal with only half of them.
Leaving mentally ill patients untreated violates their legal and moral right to health care, he said: "It's also a real public-safety imperative and it's also a very cost-effective way of approaching the problem."
Although CSC has a four-part plan to deal with the problem, it has funded only one of the parts: for offenders who are on parole.
Alex Swann, a spokesman for Public Safety Minister Anne McLellan, said money allocated for that in the last budget, $30-million over five years, or about $6-million a year, is a "good start." But he offered no indication of when the government would put money into dealing with the larger problem.
"We recognized that mental health had to have dedicated funding, so we have started down that road with that first [portion]."
The rising number of mentally ill inmates has coincided with provinces deinstitutionalizing mental-health, Mr. Sapers said.
Penny Marrett, chief executive officer of the Canadian Mental Health Association, said in a statement that Mr. Sapers's report underscored a Senate committee's finding that prisons "have become warehouses for the mentally ill due to funding cuts and closures in community psychiatric facilities.
"This is an inhumane and unsafe way to address offenders with mental illnesses, especially when they are often serving time for low-level, non-violent crimes that are the result of little to no availability of treatment or support in the community.
"Often, acute mental illness, especially untreated mental illness and efforts to "self-medicate" through drug or alcohol abuse, can be factors that led to the inmate's criminal offence, Mr. Sapers noted.
Two-thirds of federal inmates are released within three years, so it is important for the prison system to identify mental illness quickly and treat them, he said.
"Unfortunately the typical response is that the illness is either not disclosed or not recognized at intake. Their medication regime, if they were on one, is interrupted. There may be a huge, long lineup for access to a clinician, a psychiatrist or psychologist. . . .
"Many of these individuals don't go into these specialized programs. . . . They may then act out in such a way that they're considered to be a security risk." Then their security classification may be increased, decreasing access to programs.Source: Globe and Mail
Number of prisoners with mental illness on upswing: report
The number of prisoners with mental illness is on the rise while their health services are deteriorating.
Saper urged Correctional Services to invest in treatment programs and provide "supportive transitioning" back to communities.
He said proper treatment is needed to ensure mentally ill people don't re-offend.
The correctional investigator also recommended training programs for parole staff to teach them how to better deal with offenders with mental-health problems.
"Our prisons have become warehouses for the mentally ill due to funding cuts and closures in the community psychiatric facilities," Penny Marrett, head of the Canadian Mental Health Association, said in reaction to the report.
"This is an inhumane and unsafe way to address offenders with mental illness."
Marrett points out that many inmates are in prisons for low-level, non-violent offences, and aren't getting treated because of a shortage of clinical staff and inadequate facilities.
"They are victimized and exploited," says Len Wall of the Schizophrenia Society of Canada. "Prison rules punish mentally ill offenders for symptoms of their illness – such as being noisy or refusing orders."
Correctional Services says $29.5 million has been set aside over a five-year period to fund the community health section of the recommendations. Training for parole offices and staff in community correctional centres will be part of that package.
Advocates for mentally ill people say that isn't enough.
They want more "mental-health courts" which divert offenders to treatment programs rather than prison. They also want rules to prevent placing such prisoners in isolated confinement.Source: cbc.ca
Clinic full, people with mental problems jailed
People are sitting in jail in Toronto - not convicted of a crime - awaiting psychiatric assessment. In the past two months, the Centre for Addiction and Mental Health, which does the assessments, has been turning people away because it's full.
That means they must wait in jail or be sent out of town to be assessed. At last count, 14 were in jail awaiting assessment, some for as long as two weeks.
Howard Barbaree, a psychologist at the centre, says there are 28 beds for assessment patients, not enough to meet a flood of referrals.
Nadia Liva is a criminal defence lawyer who represents people with mental illness. She says she has seen too many cases where people who may not be fit to stand trial and may have committed fairly minor offenses are languishing in jail.
"That just seems wrong and an infringement of their rights. . If they need an assessment in order to determine what is best for them and for them to understand what is wrong with them, why can't they get that immediately? It's a health issue, not a crime issue," she says.
Steve Lurie of the Canadian Mental Health Association agrees, and says the problem is worse Toronto.
At the centre, Barbaree says help is on the way. Last January, the province announced it will spent about $10 million to help people who have mental disorders and have come in contact with law, by providing housing and treatment.
That includes money for safe beds, which give police a chance to take a person somewhere for care without necessarily laying a charge, he says.
He says it will be about a year before the new services are fully available, too late for those already in jail.
Link to Correctional Investigator Annual Report
Related Audio Interview:
Correctional Investigator Report Criticizes the State of Mental Health Inside: Interview with Kim Pate, Canadian Association of Elizabeth Fry Societies
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