Prison health. Prison wealth. Prison food.

What does it take for a federal agency in the public service with a simple and clearly stated Mission to do what it claims to be doing?

Money, food, and health have been questioned before….once, twice, more?  For as long as Correctional Service of Canada doesn’t do what it knows it should, the probes continue.

CSC Health Services is mandated by the Corrections and Conditional Release Act (CCRA) to provide “every inmate with essential health care and reasonable access to non-essential mental health care that will contribute to the inmate’s rehabilitation and successful reintegration in the community”.

From the CSC website:  “The delivery of care is provided by health care professionals who are registered or licensed in Canada including physicians, nurses, pharmacists, psychiatrists, psychologists, occupational therapists, social workers, dentists, and other relevant specialists.”

There’s no question our federal prison agency spends many millions on health care services each year.  So why would it be the leading source of inmate complaints?

The needs of inmate populations outstrip the means the system has to respond for one, and service delays even in emergencies can make for poorer outcomes.  Symptoms deserving attention can balloon into chronic or serious conditions if response lags, and filling out a request for care is not a substitute for triage.  Mental/emotional disorders are a notable challenge for inmate/patients given the limited treatment resources, not discounting the curse of the stigma attached to psychological conditions. 

Perhaps the CCRA’s use of the words “essential” and “reasonable” in its health care mandate are too subjective.  Despite what CSC health care does deliver, there is still too much that inhibits “rehabilitation” and “successful reintegration.”

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Money.  Inmate money.  Prison money.  We’ve been here before, more than once, and nothing has changed.  It’s odd how intelligent people, people with the smarts and connections to make it into the circle of Correctional Service of Canada management just don’t seem to get it.  Or, maybe they do…….

So, a committee in the federal service in 1980 sets up a “pay scale” for federal inmates based on the minimum wage at the time, reduced by allowances for room and board and other expenses.  It is intended to cover the costs of toiletries and food items from the canteen, it’s to help with telephone calls to family, it’s to encourage inmates to contribute to the support of loved ones at home.  It can also give prisoners some life experience at handling money, enhancing the rehabilitation process.

But then, the wheels fell off.  Not only has there been no increase over the years to account for inflationary pressures, but there are also additional reductions plus the elimination of financial incentives.  An inmate today is buying a bag of chips or a tube of toothpaste at 2021 prices using 1980 dollars.  And, there are fewer of those 1980 dollars in his account to boot.

What does that do?  It contributes to an underground economy that can be brutal and brutalizing.  The black market is always a part of prison culture, and the financial circumstances inmates sometimes find themselves are a temptation.  There are always opportunistic profiteers ready to pounce on the weak and the subordinate.  So now it is those loved ones who are putting money into that shadow economy.  How does that help anyone reach their correctional plan goals?   

It doesn’t and maybe that’s what management does get. 

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“No, you don’t feed us!” 

So said a federal inmate in an exchange with a member of a prison disciplinary panel when asked why he participated in the institution’s black market.  Topping the short list in his answer was the food he could purchase from the canteen or the underground economy.

“But, we feed you,” said the officer in response.  No, the inmate insisted, what federal inmates have is a 2600 calorie daily diet which is recommended for a low activity male, aged 30 to 50.  Any man who wants to work out, play sports or apply for a physical labour job, will go hungry.

One example from the National Menu for a supper offers chicken stew, steamed potato, tossed salad with French dressing, banana, hot beverage, dairy beverage, whole wheat bread, margarine, white granulated sugar, black pepper.  This looks appetizing if it weren’t for the cook-chill process at central locations where the food is then shipped to prisons.  There can be substitutes if a menu item isn’t locally available and subjectivity can impact a meal.  We noted some time ago that a salad at Millhaven was a handful of lettuce with a package of dressing, while a few miles down the road at Collins Bay, that same salad is what we expect it to be.  Why the difference? 

All the same, that panel member suggested that inmates can supplement their diet with food purchased from the canteen.

Look back at the previous money section.  CSC staffers are at a loss to be able to make logical arguments to support policy, but then there often are no intelligent arguments to be made.

Who speaks for Correctional Service of Canada?  Who answers for Correctional Service of Canada?

Prison life…shrouded realities…

…BEHIND THE WALLS.

Here’s two:-

Confidentiality is the right of an individual to have personal, identifiable medical information kept private. Patient confidentiality means that personal and medical information given to a health care or insurance provider will not be disclosed to others unless the individual has given specific permission for such release.

Prison health care workers are subject to this obligation of course, but congregate living environments present unusual challenges.  How much privacy can be expected when an inmate patient needs to be segregated or made available for frequent treatment or placed in an infirmary?  Who has access to mental/emotional health assessments?  How are disclosure decisions made and whose input matters?  These are and should be dilemmas calling for assessments that include the best interests of the inmate. 

Of note however, is one unacceptable and intolerable practice that management seems unwilling to address.  When an inmate submits a form for health care attention it includes the reason for the application.  Unfortunately, this form is or can be subject to scrutiny by non-health care staff.  The major concern though arises when inmates are escorted to medical appointments by guards who may then refuse to give the inmate and health care worker privacy for “security reasons.”  This can lead to a sensitive medical complaint becoming fodder for gossip among guards who overhear privileged conversations.  When spread throughout an institution, an inmate in treatment for a very personal condition will be the butt of jokes and ridicule.

This must stop.  It only serves to further damage trust in society.

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We don’t hear about sexual assaults in Canadian prisons.  For anyone who pays no attention to our prison industry, the subject doesn’t register.  Odd though, that in the American penal systems sexual violence and harassment is a common darker facet of life behind the walls.  Are we then to believe that incarcerated Canadians are ladies and gentlemen when it comes to matters of intimacy, that sex is not used as a weapon?

Correctional Investigator Ivan Zinger’s latest published Annual Report (2019-2020) devotes over 35 pages to a chapter he has titled, “A Culture of Silence:  National Investigation into Sexual Coercion and Violence in Federal Corrections.”  He notes that sexual coercion and violence in the community is one of the most under-reported of crimes and estimates suggest that perhaps only 5% of sexual assaults come to the attention of police.

“Prisons are largely closed to public view…..sexual violence in custodial settings….is even more susceptible to under-reporting…..incarcerated individuals face a myriad of disincentives for reporting experiences of sexual violence.  Many are afraid to report, fearing retaliation, retribution, or re-victimization by the perpetrators, be it other inmates or staff.  Furthermore, they face the risk of not being believed, being ridiculed, or even punished for reporting coerced sex.”

Sexual coercion and violence (SCV) have a public profile in the United States.  It’s not hidden away.  Canada does not have an equivalent to the U.S. Prison Rape Elimination Act, and we do not have any mandatory public reporting requirements.  Further, Correctional Service of Canada does not have a distinct Commissioner’s Directive instructing staff on how to respond to a reported or suspected sexual assault.  What information on the subject is referenced in CSC documentation makes Health Services primarily responsible for handling SCV incidents.

Could CSC Commissioner Kelly be persuaded to video a reading of their Mission Statement for posting on the agency’s web site?

If you don’t know what’s going on, you have a perfect excuse to do nothing.
Toronto Star reader, September, 2013