:
Thank you, and good morning, Mr. Chair and committee members.
I'm pleased to be here today, and I would like to thank you for the opportunity to speak to you on this very important issue for the Correctional Service of Canada. Over the last decade, due to a number of factors, we've seen a significant change in the offender population profile, and this reality has posed serious challenges for the Correctional Service. One of the key changes is an increase in the number of offenders with mental health problems and substance abuse problems who arrive at our institutions. To give you an example, the percentage of male offenders identified at intake as having a mental health issue has increased by 71% since 1997, while the number of women offenders with mental health issues has increased by 61% over the same period.
As a service, we must find ways to address these challenges in providing mental health services, and we must continue to strive to improve both the standard of care as well as the correctional results for federal offenders with mental health conditions. It's crucial that we continue to enhance this capacity, because addressing the needs of offenders with mental health issues not only reduces their vulnerability but helps to reduce the risk they pose to others, thereby contributing to public safety results for all Canadians.
Over the last five years, we have enhanced our efforts and continued to work diligently to identify gaps in our mental health services and implement new programs, policies, services, and initiatives to address these issues. In support of these initiatives, we've received a total of $29.1 million over five years to strengthen the continuum of specialized mental health support from institutions to the community, within the context of the community mental health initiative. In addition, in 2007 CSC was funded $21.5 million over two years to support key elements of its institutional mental health strategy. In budget 2008, the Correctional Service of Canada received permanent funding of $16.6 million annually for institutional mental health services, commencing in the fiscal year 2009-10.
These funds have gone a long way toward establishing a continuum of mental health services to meet the needs of federal offenders, from intake to warrant expiry. For example, CSC is implementing a computerized system to screen and assess all new offenders at the time of intake. As well, all institutions are putting in place a multidisciplinary team of mental health professionals to provide basic mental health services and supports.
I'm pleased to inform you that the critical aspects of the comprehensive mental health strategy are also currently being implemented, including building capacity in federal institutions and supporting offenders to return safely to communities. It is a strategy designed to improve the continuum of mental health care and interventions provided to offenders from the time of admission to the end of the offender's sentence in the community. For example, interdisciplinary mental health teams provide offenders with access to coordinated and comprehensive mental health care within their institutions. Clinical social workers provide clinical discharge planning to support offenders with mental health disorders being released from an institution to the community.
CSC's treatment centres are also an important component of the continuum of care, as they assist in addressing the intensive, acute needs of offenders with mental health disorders. Treatment centres have well-defined admission and discharge criteria, and referrals for admission are made by mental health professionals in regular institutions for various types of mental health conditions.
However, there are some complexities with convincing an offender to agree to participate in treatment. Since the centres are designated as hospitals, they must operate in accordance with the provincial acts governing health care, including the Mental Health Act. Provincial law requires that a patient must either be placed in a hospital voluntarily or, if the patient is assessed by a physician as not being competent to give consent, on an involuntary basis under certification. This certification must be renewed regularly.
An offender's stay in a treatment centre varies considerably and depends on the offender's needs. Discharge from a treatment centre could be for any of the following reasons: the clinical team assesses that a discharge is appropriate, i.e., their treatment plan is complete; the offender decides to leave or refuses to accept the treatment and cannot be held within the provisions of the provincial mental health act; or the offender has a mandated release date regardless of the above, a statutory release, or a warrant's expiry release. It should be noted, then, that in some instances it can be difficult to move an offender to a treatment centre or to keep them there to get the help and support he or she needs, if they are unwilling.
To continue to support and treat the growing number of offenders with mental health problems, the service is taking strides to boost its human resource capacity. Last year, CSC established a recruitment and retention strategy for health care professionals, including psychologists and other mental health professionals, to recruit and retain qualified candidates. Implementation of the strategy is now under way and focuses on communicating and advertising CSC health positions, doing targeted recruiting, and promoting a healthy workplace that promotes professional development.
Compounding mental health challenges is the fact that four out of five offenders now arrive at a federal institution with a substance abuse problem, with one out of two having committed their crime under the influence of drugs, alcohol, or other intoxicants. Unfortunately, an offender's substance abuse problem will likely continue once they have entered an institution. A major contributor to the institutional violence is drug trafficking, both in street drugs and prescription drugs. This creates a challenge to ensure our institutions are safe and secure for both staff and offenders. It also has a significant impact on an offender's willingness and capacity to successfully participate in and complete substance abuse programs.
Preventing drugs from entering our federal institutions is an ongoing issue, and it is the diligent work of CSC staff that helps us tackle this challenge. Consequently, CSC continues to develop plans and implement measures to reduce violence and illicit drugs in our institutions through the anti-drug strategy. This strategy focuses on the three key elements of prevention, treatment and intervention, and interdiction. One of the goals is to emphasize a more strategic use of existing interdiction tools. It also aims at an awareness program to inform visitors, contractors, and staff about the repercussions of smuggling drugs into penitentiaries, increased monitoring of those offenders and other individuals potentially involved in the drug trade, increased discipline measures, and a broadening of offenders' awareness of substance abuse programs.
In addition, CSC staff members use a number of tools to prevent drugs from getting into our institutions, such as x-ray machines, ion scanners, a 1-800 tip line, drug detector dogs, as well as a public information campaign. We will also be piloting a new integrated correctional program model in designated men's institutions and community sites in January 2010 for a period of one year. The integrated correctional program model will be based on the most effective aspects of our existing correctional programs and will maximize the service's contributions to public safety by helping to ensure that offenders get the right programs at the right intensity level at the right time.
Creating an integrated approach to meet those needs is the most cost-effective way of delivering services, particularly as offenders transition to the community. These are important measures that contribute to making institutions safe, secure, and drug free, measures that are critical to creating an environment where offenders can concentrate on becoming law-abiding citizens.
In May 2008, CSC hosted an international symposium on advancing solutions to offender mental health issues. This symposium was organized to allow CSC to consult with other correctional jurisdictions on their best practices. In December 2008, CSC hosted a symposium on managing the interconnectivity of gangs and drugs in federal penitentiaries. The symposium proved very successful in allowing Canadian correctional employees and their international counterparts to exchange best practices and ideas to approach gang and drug issues.
As you may be aware, on April 20, 2007, the government appointed an independent review panel to assess the operational priorities, strategies, and business plans of CSC, with the ultimate goal of enhancing public safety. In December 2007, the panel released its report containing 109 recommendations that focus on five key areas: offender accountability, the elimination of drugs in institutions, offender employment and employability, the physical infrastructure, and the elimination of statutory release in favour of earned parole.
In February 2008, CSC established a transformation team to lead the service's response to the report presented by the review panel. CSC's transformation agenda was then supported in budget 2008, with $122 million committed over the next two years. This funding allows CSC to implement the first critical stage of transformation.
Above and beyond our efforts to address mental health and substance abuse issues, we have focused on areas such as population management; safety and security; assessment and correctional interventions; employment and education; women, aboriginal, and ethnocultural offenders; transition to community; victims; human resource management; and our physical infrastructure. I believe we are well on our way to improving the federal correctional system and thus enhancing our ability to meet our mandate of contributing to public safety.
In closing, I wish to thank you for this opportunity to speak on CSC's efforts to address the needs of offenders suffering from mental health and addictions problems and to outline some of the strategies and initiatives we have taken.
Thank you, Mr. Chair.
:
Yes, I do, Mr. Chair. I don't have any written comments. I'm going to do this as I'm accustomed to doing, on the fly. But I'm going to refer the chair and the committee to the report we issued in October 2007. I suppose most of my comments are buried in the report, and one or two of the 109 recommendations are in one or two pages of that report.
The report is on the CSC website; it's a publicly released document. There are a number of sections in the report that deal with mental health in particular. I think there are some 10 or 11 recommendations that deal with mental health, recommendations 47 to 58, if members want to take note of those particular ones.
I just want to say a couple of things, and then I think it is probably beneficial to open it up for questions, Mr. Chair, or whatever your process is.
I would encourage the committee not to look at mental health as a stand-alone issue within corrections. It's really one of a number of issues within corrections. What the panel found when we did our review of corrections was that all these pieces of the puzzle are very much connected. To tackle the mental health issues within corrections and not deal with infrastructure doesn't work. To deal with infrastructure but then not deal with the issues around mental health, or drug addiction, or programming doesn't work. The solutions around corrections and federal corrections really need to be holistic, if you will.
Just looking at mental health in particular, the panel commented on this, and I don't know how this committee looks at it, but what the commissioner just explained is that with the multi-millions they spend on mental health and health programs within corrections, effectively what Correctional Service Canada is creating is its own health system. Federal prisoners are outside of the federal Health Act, and because of that, even though these institutions may be in Ontario, Saskatchewan, or B.C., where there is a health system, the federal corrections system creates its own. The potential for duplication and reinventing the wheel is large. I think the potential for “not the best” spending of federal taxpayers' money is extremely high when you're building another health system within the federal corrections system, right in the backyard of the Ontario health system.
One of our recommendations on the mental health side alone is that there be some improvement in the coordination between the delivery of services for federal penitentiary incarcerated inmates and those that are done outside. Those inmates will be released back into the community and then they will be part of the provincial/federal health system. You need to have the integration. I know the commissioner is struggling to do it, but it is very difficult to do when in fact the act says federally incarcerated individuals are outside of the Health Act.
An interesting comment in our report was that we should look at mental health as a penitentiary within a hospital as opposed to a hospital within a penitentiary. You need to think a bit about that phrase. I would encourage the committee to do that as they tour these facilities.
I'm going to champion a particular project that was started in Ontario, not because it was started by me when I was the Minister of Corrections in Ontario, but because it was started by a government in Ontario, and that's the Brockville situation. If you have the opportunity, I would encourage you to tour the Brockville mental health facility, where they have indeed created a penitentiary within a hospital. You will walk into that place and it will be secure, there will be guards there, but the inmates are treated more like hospital patients, and I think, frankly, they respond differently than they do in some of the federal institutions that the panel toured.
That system is a little bit more integrated with the provincial health care system as well. It's actually run by the Ottawa Hospital.
Infrastructure is a recommendation in our report. The panel actually recommended the creation of complexes, not because they become these massive big prisons, as some people have twisted our recommendation into, but because they give the opportunity for the commissioner to put a hospital within a penitentiary, if you get my sense, and have the flexibility to move inmates around from one institution within the other, from one facility to the other, within the same confines--within the same fence, if you will.
Tremendous operational efficiencies, tremendous service delivery efficiencies could be achieved, and I would argue--and the panel actually alluded to this--that cost savings as well can be achieved by better managing a much smaller group.Commissioner, is it 50-some-odd institutions that you have?
A final comment around mental health. This was alluded to in the report but not specifically spoken to in the report.
On the mental health side, the panel's view is that the primary objective for corrections should be to stabilize the individual and treat as necessary. The individual will either transition down into the general population of a prison population or out of the prison on release, and they may or may not have the same level of services they became accustomed to within the institution. As a result, you need to get them transitioned and stabilized to a point at which they can actually live as law-abiding citizens outside the gates, relying upon the services that are available within the particular community they go to. To get them accustomed to a high level of service within an institution and then release them to a low level of service outside the institution is, frankly, setting them up for failure.
I think some of the recidivism statistics around mental health issues that you will have heard already from the commissioner or the correctional investigator would indicate that that's what's happening. These individuals are leaving, they're accustomed to a more individualized level of service inside the institution, and they're on their own. That is why the primary objective should be to stabilize, so they can actually survive as law-abiding citizens within their community.
In fact, I think if you ask the fellow who runs the Brockville institution what his primary objective is, that's what it is. His challenge is a little bit more difficult because of the shortness of stay within provincial institutions. It is much shorter than in federal institutions. He has to focus on stabilization because they're not around long enough to have any effective impact from treatment.
Mr. Chairman, those are my comments. I appreciate your taking a look at this very important subject and I await your further questions.
:
I have a couple of responses, one just quickly on the program piece.
I mentioned briefly in my opening comments the moves we're making around what we're calling the integrated correctional program model. What that will do for us, to address the issue you raised about access to programs, is position us to start delivering the program primers to offenders during the time of admission. Rather than waiting anywhere from eight to nine to ten months before offenders start participating in programs, they'll be starting to participate in the program primers right at the time of admission. For us, this is a significant change in our programming strategy that will go a long way to address the issue you were briefly mentioning.
On the issue of infectious contagious diseases, currently we have about 250 offenders who have tested positive for HIV, and about 4,100 offenders who have tested positive for hepatitis C. These numbers have been going up gradually. They are not huge increases. We can provide the committee with a table of the actual numbers.
We know these numbers only as a result of inmates' consenting to be tested. There is no mandatory testing of offenders coming into the system. If there were a huge increase of individuals who come into the system with infectious diseases rather than getting them through something that's happening in the institution, we really don't have a good gauge for it, unless the offenders agree to be tested. We only know the statistics based on those who have volunteered to be tested.
As to our approach to clamping down, we honestly believe that unless we create a safe environment for offenders to come forward and participate in programs, we're not going to have them come out of their cells. A lot of pressure occurs in some of our institutions, primarily at maximum security institutions and some of our higher-level medium security institutions, where the pressure is placed on offenders to be more involved in the drug subculture and therefore choose not to participate in programs. On any given day, about 20% of offenders choose not to participate in any programs.
:
They are several. They are very much aligned with our overall transformation agenda.
The first priority is about ensuring we have safe and secure institutions across the country. If we do not have safe and secure environments in which the staff can work and in which offenders can choose to participate in the programs that are being offered to them, then we're not going to be effective.
The second priority is around making sure we have the most modern assessment capacity to assess the needs of offenders, so that we in turn can develop the most effective correctional plans that will allow us, again, to address the needs of the offenders. Then, based on that, it's making sure we have the most effective—empirically based effective—programs for offenders to address their needs, both while they serve their time in the institutions and while they transition into the community under our supervision.
As well, I'm trying to make sure that we have a good, strong human resource capacity, so we are recruiting the best men and women from across the country to work in our organization; that we provide them the best learning and development opportunities; and that we have a good, strong retention strategy for keeping people within the organization. Collectively, it is trying to make sure we have a good, strong continuum for delivering correctional services.
At the same time, one of my priorities is to make sure we're well connected to what I would call the front end of the system and the back end of the system. I believe very strongly that there is a lot more work we could be doing in terms of our relationships with the communities, with the criminal justice system, and with the social service agencies that address some of the issues we face and deal with on an ongoing basis.
Unfortunately, as the member may know, Correctional Services Canada becomes the point in the continuum where the expectation is that we address all the social problems that have been unaddressed for a period of time. So I am trying to make sure we are much better connected at both the front end and the back end, so that people coming into the system have many of the issues, which we have to face now, addressed ahead of time, and at the same time, once they move beyond our responsibility—beyond warrant expiry—that they have access to the types of services and supports they need in order to stay out in the community and function as law-abiding citizens.
In my opinion, you have shown that you have a great deal of competence in your field. I have always said that managing delinquency means managing failure. Here I speak of personal failure, failure of the education system, the family, society and, more and more, the failure of mental health services. It would be interesting to examine the priorities of the Correctional Investigator. His priorities would no doubt be completely different from yours, but I do not want to say anything further on that issue.
I know that the main problem, the one that is underlying all the others, is drugs. That comes as no surprise to me. In 1966, 90% of the time, alcohol was given as the reason for committing a crime. That damn alcohol! That was it. Slowly, drugs started playing a more predominant role. Obviously, drug use is not often used as an excuse, but we all know that this is the main reason. That is why I do not think that minimum sentences will do much to reduce crime if we do not attack the root of the problem.
You know, Matsqui was a failure. This prison was established in order to reintegrate drug users. I note that your service had some agreements with external organizations in order to deal with the most hardcore drug users, such as Portage in Quebec. I do not know if there are any models, such as Daytop in New York.
Could you tell me how much money we spend to treat serious drug addicts at these external agencies?
:
Yes. In terms of the first point that you raised around segregation, you're absolutely right, the correctional investigator pointed that out in his testimony to this committee.
One of the problems we've always had in corrections is that when individuals act out, our first response is to respond to that outward behaviour. Sometimes that behaviour is violent and could result in harm to others or harm to the individuals themselves. Our response has always been to try to contain that behaviour so that we can move in the direction of stabilizing the individual and then making the best assessment or determination of what next steps to pursue.
Now, unfortunately, with individuals with mental health problems, we sometimes find ourselves in a bit of a recurring situation. The individual acts out, we take the appropriate measures, which may include placing the individual in segregation, get them stabilized, release them back into the population, and then that behaviour starts again. Unless we have the means to get these people plugged into some of the more specific programs they need to keep their behaviour stabilized, or get them access, for example, in some of the more severe cases, to our treatment centres, our psychiatric centres, we have some problems in terms of this cycle.
It is a challenge. It's a challenge every day for the women and men who work the floors of these institutions, because there is no question in my mind that they are trying to find the most humane, safe, and secure way to deal with that behaviour and be respectful to the individual. It is a challenge with some of the more severe cases.
In terms of your question around the issue of access to programs, particularly for mental health offenders, I think one of the things I would definitely plug is the need to have support, and continued support, for the initiatives and for the funding we got for our community mental health initiative and our institutional mental health initiative. We're still a far way from having the absolutely 100% right formula for everybody, but these are very critical steps in terms of our addressing the problems that we have to deal with on a day-to-day basis.
This funding has allowed us to move light years from where we were 10 years ago. We still have a long way to go, and we have as much work to do in terms of making sure there's support beyond the correctional system, so that when these people do return to the community they stay out longer and eventually, hopefully, do not come back into conflict with the law.
:
Thank you, Chair, and thank you to the panel for being here.
As Mr. Ménard mentioned, he was involved in the legal profession for a long time, and some of us on this side have the same story from a different perspective.
One of the things I think the law enforcement side would say is that over the last 30 or 35 years, mental health issues within the provinces have changed a great deal. It certainly used to be one of the tools in the tool box that police officers had, which was to properly, I think, use the mental health act across the country and to frequently divert people who had mental health issues from the criminal justice system into the mental health system.
I recognize that corrections, both at the provincial and the federal level, are now ending up with people who make it very difficult for the correctional system to deal with. What would be ordinarily offenders with a problem...more importantly, now we have mental health issues, people who have a problem who end up being dealt with in the criminal system. Perhaps—I'm not accusing anybody of anything—the tools have changed a little bit in an unfortunate way.
When you talk about the need for treatment--as all of my colleagues have, and we would agree there's a need for treatment--the difficulty, as I understand it from both what you've told us here and what we've read, is that proverbial “you can take the horse to water, but you can't make him drink”. We can have great programs—I believe we do and we perhaps need more—but there is no mechanism. I think Mr. Holland addressed this. There is no mechanism to force that treatment on someone who doesn't wish to take it.
I don't know if you're in a position now where you would have some suggestions as to how we might do that. Do you need more resources if they were available? Or is the problem a bigger one in that we need to find a way to get the people who need the help to get the help?
:
Thank you very much, Mr. Chair, for the question.
It's a combination of several things.
As I mentioned briefly earlier, about 20% of the offender population absolutely refuse outright to participate in programs. These individuals have become a significant challenge for us. They are the ones who, to be honest, will probably be coming back through the provincial doors, and ultimately our doors, for years to come. We need to find a way to have them become more motivated to participate in the programs.
There is no question that the majority of offenders who participate in the programs do want to make a life change, and they're quite committed to that. They see that their involvement in programs is the first step in doing it. It's not the one that's going to cure everything that brought them into conflict with the law, but it's a first step in the right direction.
We need to do something as well with the other 20%. We need to expand our capacity in some of the areas around our programming. I think we have a good start in the funding we've received to date, and we look forward to having that carried on in subsequent years so that we can advance our integrated correctional program model.
We believe we need to have some changes made to our infrastructure to facilitate the delivery of the programs, but more importantly, to reinforce this program learning on a day-to-day basis back in the living units, in the recreation areas, and in the other areas the inmates participate in during the day. Our current infrastructure actually works against us in doing this, and we need to have some changes there.
I would also suggest that there needs to be some consideration as to how we find approaches or avenues to motivate the offenders who are not motivated to participate in programs. Right now, if you have two offenders, one who chooses to make a difference in his life and participate in programs and one who chooses not to, both would enjoy the same privileges within the walls of our facilities. It's very difficult, if you choose not to.
One of the experiences I had in both the territorial and the provincial systems is that offenders knew, based on the earned remission system, that it was unlikely they were going to lose remission. They would normally earn the one-third off; therefore, they would just wait out their time. We're seeing, with a lot of the younger offenders who are coming into the federal system, that they're carrying that attitude over and are just waiting until their two-thirds mark to be released at statutory release, and they believe they're therefore going to be free and clear. Unfortunately, in the federal system, as you know, they're still under our supervision for the last third, in contrast with the situation in the provincial system.
We need to find a way to get those individuals motivated to participate in programs both in the institution and in the community in order to continue to produce the public safety results that Canadians expect from us.
:
This is just a response to the points that were raised.
There is absolutely no question that in order for us to be 100% effective, we need to be better plugged into or tied into the kinds of support services that social service agencies provide across the country.
In some cases, that's a challenge just because of our physical location, where we're located. We have institutions, for example, in Sept-Iles and Port Cartier, where the kinds of support services that would be needed if people were going to be released into that immediate community are just not available. They would be in places like Toronto, Montreal, or Vancouver, so that's a challenge. In other communities where we need to tie into those kinds of agencies, they're currently overtaxed with just the demands that are placed on them by citizens that aren't incarcerated. So there are some challenges there.
In terms of the question around recruitment and retention, particularly in the health care field, this is one of the most significant challenges that we have at the moment. We are starting to make some headway in terms of our hiring of nurses, our hiring of psychologists and social workers. But we have challenges, again partly due to our physical location, but partly due to just, as the committee members would be well aware, the demand for health care professionals across this country.
:
Thank you so much, Mr. Chair, for that two minutes. I'll do what I can in two minutes.
The Chair: I'll give you three.
Mr. Blake Richards: Thank you for being here.
The transformation agenda was touched on in your report. I think it's a great report, and I would encourage anyone on the committee who hasn't read it to read through it, because there are some great keys to the changes that need to happen in our correctional system in that report.
You mentioned the five key areas in your opening remarks. There are three that I think directly apply to the topic of our study on mental health and addictions. Primarily, the goal in dealing with mental health and addictions is to try to give the offenders the tools they need to succeed in society. So I think these three points—offender accountability, offender employment and employability, and the elimination of drugs in institutions—strongly apply to this. Particularly, when we talk about the elimination of drugs in institutions, despite the Liberals' denial of the reality of this situation, the first step in ending drug use is eliminating access to the drugs. If I get a chance, I'll go back to that.
On what Mr. MacKenzie was discussing with you, I certainly appreciate the fact that there is a recognition that we need to find a way to help them understand how to help themselves as well. We could provide all the programs, options, and treatment we can—and it's important that we do so—but we have to find a way to ensure that the offenders or inmates are taking advantage of that. I appreciate that it's being considered, you understand and recognize it, and you're dealing with that.
You mentioned that there are basically three reasons for discharge from the treatment centres you have set up for mental health. One is that the clinical team has assessed that discharge is appropriate and treatment is complete. Another one is that the offender has decided they don't want treatment anymore—they've refused it and decided they're going to pull themselves out of it, which is what we talked about that needs to change. The other one is that they've reached their release date.
Can you give me some percentages on the three different reasons for discharge from the treatment? I'd like to get an idea of the statistics.