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HOUSE OF COMMONS CANADA MENTAL HEALTH AND DRUG AND ALCOHOL ADDICTION IN THE FEDERAL CORRECTIONAL SYSTEM Report of the Standing Committee on Public Safety and National Security Kevin Sorenson, MP Chair DECEMBER 2010 40th PARLIAMENT, 3rd SESSION The Speaker of the House hereby grants permission to reproduce this document, in whole or in part for use in schools and for other purposes such as private study, research, criticism, review or newspaper summary. Any commercial or other use or reproduction of this publication requires the express prior written authorization of the Speaker of the House of Commons. If this document contains excerpts or the full text of briefs presented to the Committee, permission to reproduce these briefs, in whole or in part, must be obtained from their authors. Also available on the Parliamentary Internet Parlementaire: http://www.parl.gc.ca Available from Communication Canada — Publishing, Ottawa, Canada K1A 0S9 MENTAL HEALTH AND DRUG AND ALCOHOL ADDICTION IN THE FEDERAL CORRECTIONAL SYSTEM Report of the Standing Committee on Public Safety and National Security Kevin Sorenson, MP Chair DECEMBER 2010 40th PARLIAMENT, 3rd SESSION STANDING COMMITTEE ON PUBLIC SAFETY AND NATIONAL SECURITY CHAIR Kevin Sorenson VICE-CHAIRS Mark Holland Don Davies MEMBERS Roger Gaudet Ben Lobb Andrew Kania Dave Mackenzie Phil McColeman Maria Mourani Rick Norlock Brent Rathgeber Alexandra Mendes OTHER MEMBERS OF PARLIAMENT WHO PARTICIPATED Nicolas Dufour Louis Plamondon Robert Vincent LaVar Payne David Christopherson Laurie Hawn André Bellavance Kevin Sorenson Bonnie Crombie Glen Douglas Pearson Meili Faille Carole Freeman Gary Ralph Schellenberger Hon. Navdeep Bains Gerard Kennedy Scott Sims Serge Ménard Robert Oliphant Siobhan Coady Carol Lavallée Hon. Joseph Volpe Paule Brunelle iii Todd Russell Peter Braid Luc Desnoyers Garry Breitkreuz Shelly Glover Borys Wrzesnewskyj Sukh Dhaliwal Randy Hoback CLERK OF THE COMMITTEE Roger Préfontaine LIBRARY OF PARLIAMENT Parliamentary Information and Research Service Lyne Casavant, Tanya Dupuis iv THE STANDING COMMITTEE ON PUBLIC SAFETY AND NATIONAL SECURITY has the honour to present its FOURTH REPORT Pursuant to its mandate under Standing Order 108(2), the Committee has studied Federal Corrections: Mental Health and Addiction and has agreed to report the following: v TABLE OF CONTENTS MENTAL HEALTH AND DRUG AND ALCOHOL ADDICTION IN THE FEDERAL CORRECTIONAL SYSTEM ............................................................................................ 1 CHAPTER 1: INTRODUCTION ....................................................................................... 1 1.1 THE COMMITTEE’S MANDATE AND PROCEDURE ..................................... 2 1.2 STRUCTURE OF THE REPORT .................................................................... 4 CHAPTER 2: SHARED RESPONSIBILITY FOR CORRECTIONS AND HEALTH CARE .............................................................................................................................. 5 2.1 CORRECTIONS .............................................................................................. 5 2.2 HEALTH CARE ............................................................................................... 6 CHAPTER 3: THE CORRECTIONAL SERVICE OF CANADA’S CAPACITY TO ADDRESS THE MENTAL HEALTH AND ADDICTION NEEDS OF OFFENDERS ......... 9 3.1 CORRECTIONAL SERVICE CANADA’S RESPONSIBILITIES AND EXISTING INFRASTRUCTURE FOR ACCOMMODATING FEDERAL INMATES ........................................................................................................ 9 3.2 CORRECTIONAL SERVICE CANADA’S BUDGET ...................................... 11 3.3 CORRECTIONAL SERVICE CANADA’S STAFF .......................................... 11 CHAPTER 4: OVERVIEW OF THE INCIDENCE OF MENTAL DISORDERS AND ADDICTIONS WITHIN THE FEDERAL INMATE POPULATION .................................. 13 4.1. THE IMPACT OF MENTAL DISORDERS AND ADDICTIONS WITHIN THE FEDERAL INMATE POPULATION ....................................................... 13 4.2 THE VULNERABILITY OF INMATES WITH MENTAL HEALTH AND ADDICTION PROBLEMS .............................................................................. 16 4.3 THE CHALLENGE CORRECTIONAL SERVICE CANADA FACES IN MANAGING SUCH A POPULATION ............................................................ 16 CHAPTER 5: COMMITTEE OBSERVATIONS AND RECOMMENDATIONS ............... 19 5.1. INVEST UPSTREAM TO ENSURE THAT PEOPLE WITH MENTAL DISORDERS AND ADDICTION PROBLEMS DO NOT END UP IN PRISON DUE TO A LACK OF COMMUNITY RESOURCES ........................ 19 vii 5.1.1. The Need for Investment in a Mental Health and Addiction System and an Appropriate National Strategy in Collaboration with the Provinces and the Territories .......................................................................................... 19 5.1.2. The Need for Greater Investment in Diversion Initiatives ......................... 21 5.1.2.1 Drug Treatment and Mental Health Courts .................................. 23 5.2 RECOGNITION OF THE ADVANTAGES OF PARTNERSHIPS IN THE DELIVERY OF MENTAL HEALTH AND ADDICTION SERVICES WITHIN THE CORRECTIONAL SYSTEM .................................................... 25 5.2.1. Healthcare Service Delivery Models in Norway, England and Wales ....... 25 5.2.1.1 The Norwegian Approach ............................................................ 25 5.2.1.2 England and Wales ..................................................................... 26 5.2.1.3 Benefits of Transferring Responsibility for Healthcare Services within the Correctional System to Provincial Health Authorities ................. 27 5.2.2 Strengthening the Capacity of Correctional Service Canada to Meet the Needs of Federal Inmates by Developing Partnerships as an Interim Measure ......................................................................................................... 29 5.2.2.1 The Need to Develop Agreements with Provincial and Territorial Health Authorities under which Inmates with Serious Mental Health Disorders would be Treated in Psychiatric Hospitals, rather than in Conventional Correctional Institutions .................................................... 29 5.2.2.2 The Need to Develop Agreements with Provincial and Territorial Authorities and Community Organizations to Correct Shortcomings in Continuity of Care ............................................................ 30 5.3 THE NEED TO BETTER RESPOND TO THE SITUATION OF ABORIGINAL OFFENDERS ......................................................................... 31 5.3.1 Correctional Service Canada’s Commitment to Aboriginal Offenders ....... 33 5.3.2 The Need to Improve Correctional Service Canada’s Capacity to Work Effectively with Aboriginal Offenders .............................................................. 34 5.3.3 Correctional Service Canada’s Obligation to Work with Aboriginal Communities (ss. 81 and 84, CCRA) .............................................................. 36 5.4 THE NEED TO IMPROVE CORRECTIONAL SERVICE CANADA’S CAPACITY TO MEET OFFENDERS’ HEALTHCARE NEEDS ..................... 37 viii 5.5 IMPLEMENTATION OF THE CORRECTIONAL SERVICE OF CANADA’S MENTAL HEALTH STRATEGY ................................................. 38 5.6 AN APPROACH TO DEAL WITH DRUGS IN PRISON THAT PUTS TOO MUCH EMPHASIS ON CONTROL, AS OPPOSED TO TREATMENT OF ADDICTIONS ................................................................... 41 5.7 THE PHYSICAL INADEQUACY OF SOME INSTITUTIONS ........................ 44 5.7.1 Penitentiaries that are Decrepit, Crowded, Noisy and Devoid of Natural Light ................................................................................................... 44 5.7.2 The Need for New Specialized Mental Health Units .................................. 46 5.8 CREATING AN ENVIRONMENT CONDUCIVE TO REHABILITATION ........ 47 5.9 GAPS IN THE TRAINING OF CORRECTIONAL STAFF .............................. 51 5.10 INAPPROPRIATE USE OF ADMINISTRATIVE SEGREGATION ................. 53 5.10.1 Statutory Framework ............................................................................... 53 5.10.2 Administrative Segregation