Canada’s corrections watchdog remains dismayed by the federal government’s inaction in dealing with offenders with serious mental health issues

 

Offender self-harm a growing concern

Ivan Zinger, Executive Director and General Counsel, Office of the Correctional Investigator, recently spoke out about the continuing lack of reform by Correctional Services Canada in properly addressing offender self-harm in federal penitentiaries.

Zinger echoed Correctional Investigator Howard Saper’s plea for reform at The Congress on Law and Mental Health in Amsterdam in July where he presented a paper about self-injury in Canadian federal correctional institutions.

Self-injurious behaviour includes the use of razors or other sharp objects for “cutting”, head-banging, self-strangulation and the ingestion or insertion of sharp objects into the body.

Mandate of the Correctional Investigator

The Office of the Correctional Investigator acts as an Ombudsman for federally sentenced offenders.  It represents, therefore, the interests of offenders who are serving a sentence of two years or more.

One of the Investigator’s mandates is to determine whether the Correctional Service of Canada is acting “fairly, reasonably and in compliance with law and policy” when dealing with offenders.  Importantly, the Correctional Investigator makes ongoing recommendations to ensure accountability in Canada’s federal penitentiaries.

In the fiscal year 2011-2012, the Correctional Investigator responded to 5.600 offender complaints and reviewed more than 140 deaths and incidents of serious bodily harm by inmates in the federal penitentiary system.

Self-harm among inmates in Canada

In his Annual Report to Parliament in October 2012, the Correctional Investigator notes that the inmate population across Canada has increased 3.7 per cent since March 2011.

The number of inmates participating in serious self-harm has tripled in the last five years.

Sapers is alarmed by the rapidly increasing rate of self-injury incidents in prisons in general and the the increasing number per offender in particular.

The number of self-harm incidents, compared to the number of inmates involved, rose from 261 per 160 inmates in 2003-2004 to a staggering 901 per 264 inmates in 2012-2013. 

Sixteen per cent of female offenders in medical or psychiatric cells were found to self-injure frequently, compared to seven per cent of male inmates.

Self-harm among women inmates rose from 43 in 2003-2004 to 323 in 2012-2013.

Position  of the Correctional Service of Canada

In Commissioner’s Directive 843 regarding the management of inmate self-injurious and suicidal behaviour, issued on July 21, 2011, the Commissioner of the Correctional Service of Canada states that the policy objective of the Service, when faced with issues of self-harm, is to “ensure the safety of inmates who are self-injurious or suicidal using the least restrictive measures for the purpose of preserving life and preventing serious bodily injury, while maintaining the dignity of the inmate in a sale and secure environment.

The Directive also calls for the immediate transfer of mentally ill inmates to regional treatment centres or appropriate health care facilities if required mental health assessments cannot be facilitated in the regular prison environment.

The Directive also encourages and supports “an interdisciplinary approach so that the inmate can resume regular activities as soon as possible”.

Saper, however, does not believe this directive is being followed consistently in federal penitentiaries across Canada

Recommendations of the Correctional Investigator

Sapers notes that a disproportionate number of self-harm incidents occur when inmates are kept in segregation, forensic psychiatric centres and maximum security institutions where the use of force and physical restraint is often employed to manage self-injurious offenders.

Sapers recommends in his latest annual report that there be an absolute prohibition on the practice of placing mentally ill offenders and those at risk of suicide or serious self-injury in long term segregation.

Sapers stresses that self-injury cases need to be managed as mental health issues and not primarily as security incidents.  He pleads for Correctional Services Canada to expand the use of alternative mental health delivery options, recognizing that a federal institution is not the appropriate place for treating complex cases of self-injury. 

Canada’s first forensic padded cell

Sapers is especially alarmed by the fact that the first padded cell in a forensic facility in Canada was constructed at the Saskatoon Regional Psychiatric Centre in March of 2011.   

The cell was specially built by Correctional Services Canada to accommodate one particular female who engages in chronic self-injury by head-banging.  

In addition to its barren rubberized walls, the space has a primitive grate in its floor, in place of a normal prison toilet.

Corrections Canada maintains the cell was built “for therapeutic reasons” to provide management with the least restrictive environment to address self-injury, and that it was created on the advice of an unnamed internationally-recognized forensic psychiatrist.

To date, the cell has not been occupied and Sapers hopes this fact means that Correctional Services Canada has determined it to be “inappropriate.”   

In Recommendation 16 of his report, Sapers calls for an absolute prohibition of padded cells in all Correctional Services of Canada treatment facilities, stating bluntly that “there is no role for a padded cell in a correctional facility”.

 

He also notes that the use of padded cells require full-time medical supervision and are controversial even in a mental health setting where the first responders are health care professionals and placement decisions are made exclusively by health care providers.

Self-harm in the spotlight

 

The issues of self-harm and the treatment of mental health in federal correctional institutions has become prominent in light of the current inquiry into the death of 19 year-old Ashley Smith while in custody at Joliette Federal Institution in 2007.

Of particular concern to the Smith inquiry is the fact that the persons in authority at the Institution who were making daily decisions affecting the mental health and physical well-being of female inmates such as Ashley Smith, had virtually no training in the areas of risk assessment and treatment of offenders with mental health problems – especially those involving serious self-injury.