A MOUNTAIN TOO HIGH?

A look at the Correctional Service of Canada’s (CSC) website is a place to start: “…one of our priorities is ensuring that individuals incarcerated in Canada’s federal institutions have access to quality, safe, patient-centred care.”

This is mandated under sections 85, 86, and 87 of the Corrections and Conditional Release Act.  Basically, it says that the Service will give every inmate essential health care, and reasonable access to non-essential health care.  This includes medical, dental, and mental health care delivered by registered professionals or persons acting under their direction.

While there’s no specifics with medical and dental care other than it “shall conform to professionally accepted standards,” it does define mental health care as, “the care of a disorder of thought, mood, perception, orientation or memory that significantly impairs judgement, behaviour, the capacity to recognize reality or the ability to meet the ordinary demands of life.”

And the Act further stipulates that the Service “shall take into consideration an offender’s state of health and health care needs” in all decisions affecting the offender’s placement, transfer, SIU confinement, disciplinary matters, and preparation for release.

This is CSC’s health care protocol on paper.  It doesn’t always jump off the page into practice.  It often doesn’t jump off the page into practice.  “Health non-care” is a common chorus heard among inmates for what CSC labels as health care.

)()(

Health care in our federal prisons invites constant scrutiny and deserves an exclusive forum which is why, in the absence of dedicated surveillance, this space circles back to the subject frequently.  For this first of the next few postings, a reference from the Office of the Correctional Investigator’s 2018-2019 Annual Report underscores one of CSC’s health care failings.

Correctional Service of Canada facilities across the country include five regional treatment centres for offenders with serious mental health conditions.  Correctional Investigator Dr. Ivan Zinger’s report for that fiscal year focused in one chapter on the difference between protocol and practice for the use of force in the system in general but found “most troubling” the use of force in these RTC’s or psychiatric hospitals.  He exampled an incident at Millhaven RTC in the Bath Institution on the same grounds illustrating a reality in mental health care units.

We reprint it here:

Range video evidence shows an inmate, diagnosed with a serious mental health disorder with significant impairments, engaged in a therapeutic interview with a Behavioural Technologist (BT) in the recreation room.  During the interview, he asks an officer standing nearby at the control post if he could go to the yard for recreation after the interview.  The officer declines, explaining that due to ongoing maintenance work the inmate would have to wait until later.

The inmate becomes agitated, directing a verbal protest towards an officer standing just outside the barrier of the recreation room.  The officer’s response further escalates the situation.  While the BT attempts to de-escalate through verbal coaching, without warning or consultation, officers decide to discontinue the interview due to alleged “staff safety concerns.”  The BT’s report would later state that at no point did s/he feel the inmate had put anyone’s safety at risk, and that the inmate was “appropriate and polite” in all interactions.

An officer opens the barrier and orders the BT “get out of here.”  The BT attempted to leave the area; however, a group of four other officers had already gathered at the exit.  The inmate lunges toward the officers attempting to strike one of them.  The officers charge, tackling him to the floor.  The inmate is held down by the weight of the four officers while lying prone.  A nearby health practitioner reports later that an officer was kneeling across the inmate’s neck and that his face was purple.  The inmate is seen gasping.  One of the officers is reported to have said, “want me to jizz on you face?”  The others are seen laughing on video.

The inmate is handcuffed while on the ground and then lifted and slammed against a steel door, his head pressed against it while being held from the back of his neck.  He is searched while restrained in this position.  He is then escorted, without incident, to an observation cell.

Still handcuffed, he is forced onto the cell bed in a prone position with his face planted firmly onto the metal surface until his handcuffs are removed.  The last officer to exit the cell is seen pinning the inmate’s head to the bed and applying a “pain compliance” technique (forceful twisting and stretching of the arm and wrist) to maintain control as he exits the cell.

This is how CSC mental health care treatment can look in a prison hospital setting, and it’s closer to standard operating practice than it is an isolated incident.

There’s more coming……