• 08/31/11 - - CSC seeks to stem 'revolving door' for inmates with mental disorders

    - - CSC seeks to stem 'revolving door' for inmates with mental disorders

    Douglas Quan, Postmedia News:

    The Correctional Service of Canada has quietly rolled out two pilot programs in the past year — one in British Columbia and one in Ontario — with the aim of stemming the "revolving door" of inmates with mental disorders who repeatedly get transferred between prisons and regional psychiatric facilities.

    Canada's corrections watchdog says the programs are a step in the right direction but need to be expanded nationwide.

    Currently, the correctional service gets funding from the federal government to provide primary or basic mental-health care support at all its institutions, as well as funding to provide intensive treatment for offenders with the most serious mental illnesses at one of five regional treatment centres.

    However, there is no direct funding to support inmates who fall somewhere in the middle — those who don't meet admissions criteria at regional treatment centres but who still have complex mental-health problems or who engage in risky behaviour.

    As an "interim" measure, the correctional service launched two pilot programs in November, according to details contained in a briefing note sent from corrections Commissioner Don Head to Public Safety Minister Vic Toews in January.

    At the Kingston Penitentiary in Ontario, a 30-bed Intermediate Mental Health Care Unit opened to provide a "structured therapeutic yet secure environment" for male offenders with a range of mental health needs.

    And at the Pacific Institution/Regional Treatment Centre in Abbotsford, B.C., a 10-bed Complex Needs Unit opened to specifically help treat male offenders from across the country who repeatedly self-injure.

    Both pilot programs, which cost an estimated $5 million annually to run, are scheduled to last 18 months.

    Howard Sapers, the correctional investigator of Canada, said these initiatives are important first steps in helping to bridge a serious gap in the "continuum of care" for offenders with mental disorders.

    Intermediate care units, he said, can help stabilize a person and decrease the likelihood that they will need to be sent for more intensive treatment at a regional psychiatric facility. They also can help someone who has been discharged from such a facility transition back into the general inmate population.

    One case that Sapers' office investigated recently involved a 28-year-old inmate who died in the spring of 2010 from medical complications from years of self-inflicted injuries.

    The man was transported to different treatment centres in an attempt to treat his chronic self-injury but to no avail. The correctional service wrote no fewer than eight investigation reports about his behaviour.

    At one point, according to a summary of his case, the correctional service took the "extraordinary" step of seeking the help of an ethicist about what types of interventions could be used to better manage the inmate's behaviours.

    Right now, given the lack of resources, inmates with complex mental-health disorders or risky behaviours are often placed in segregation, which can exacerbate the symptoms of mental distress, Sapers said.

    That's what appears to have happened in the high-profile case of Ashley Smith. In 2007, the 19-year-old woman was found dead in a segregation cell at Grand Valley Institution for Women in Kitchener, Ont., after tying a ligature around her neck. Over the course of 11 1/2 months in federal custody, Smith had engaged in numerous acts of self-harm involving self-strangulation or headbanging. An inquest into her death is scheduled to resume in September.

    According to the correctional investigator's annual report last year, the number of offenders who present serious mental-health problems continues to grow. At least one in four new admissions to federal corrections have some form of mental illness, the report said, with many struggling with a concurrent disorder such as substance abuse.

    "It has to catch up and keep pace," Sapers said, referring to the need to expand intermediate care and complex needs units for men and women across the country.

    Suzanne Leclerc, a spokeswoman for the correctional service, said a formal review of the pilot projects is expected to be complete by the fall of 2012.

    There are no plans to expand the number of pilot projects because there isn't any funding, she said.

    But Sapers said even if the federal government doesn't cough up more money, the correctional service could find ways to reallocate money. He also suggested that the federal agency could try partnering with provincial health agencies to provide mental-health support to some inmates.

    Julie Carmichael, a spokeswoman for the public safety minister, said the government is waiting to see how the pilot programs work out before making decisions about additional funding.

    "Once the pilot is complete, the results will be examined and the next steps will be decided," she said.


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