KNOWNS AND UNKNOWNS.
Donald Rumsfeld answered a question in 2002 with, “…..there are known knowns; these are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.”
Psychoanalytic philosopher Slavoj Zizek added a fourth category, the unknown knowns, that which one intentionally refuses to acknowledge that one knows.

Correctional Service of Canada’s Anne Kelly sends “Messages from the Commissioner” to employees, stakeholders, volunteers, and almost weekly to “offenders and their families.”  Often, offenders are offended.  Her November 14^th message lauding Nurse Practitioners Week drew a negative health care assessment from us on behalf of annoyed inmates.  Our November 30 letter to her was referenced in the December 3^rd posting, “OPCAT! OPCAT! OPCAT!”

Commissioner Kelly wrote back on February 5^th this year to defend the work of “the health services teams,” as would be expected, and then she writes that, “CSC abides by the Corrections and Conditional Release Act and provides health services through health professionals that are consistent with professionally accepted standards.  Commissioner’s Directive 800: Health Services outlines that inmates should be provided with efficient and effective health services.  CSC’s health care professionals provide services which respect professional code of ethics, provide patient-centred care, patient advocacy, and promotes decision-making that is based on the appropriate medical, dental, and mental health care criteria.”

Does Ms. Kelly know what she wrote is at least 50% wishful thinking?  And we do know we are only one among thousands who do know that.

As a leading failed example, the criminality of a large number of incarcerated men and women is rooted in addictions, often as a result of PTSD from childhood trauma, along with other mental health disorders.  Correctional Service of Canada published “Guidance on Opioid Use Disorder (OAT) Program: August 16, 2021”, as a 24-page blueprint for the effective practice of an Opioid Agonist Treatment (OAT) for OUD, which is considered a chronic medical condition.

Yes, inmates on OAT are maintained on suboxone or methadone, but that in itself only supports the status quo.  It does nothing to address the cause/causes of addictions, a necessity to facilitate a safer reintegration into the community and reduce the rates of recidivism.  That is the role of the prescribed Treatment Teams, made up of nurses, doctors, mental health providers, and all involved in the inmate patient’s care.  The Guide is a worthy and extensive venture to restore broken lives for the betterment of us all; it’s available on-line.

“There is no such thing,” said one inmate.  Inmate after inmate has never seen a “team.”

Does Commissioner Kelly know that?

March 11, 2024

Anne Kelly, Commissioner,
Correctional Service of Canada,
Ottawa, ON  K1A 0P9

Dear Commissioner Kelly:

“You can be assured that all members of the health services teams continue to work together to provide the best care to all patients.”  This is the close to your February 5, 2024, letter.  Generally, I agree.  CSC spends millions each year on prison health care and many inmates do benefit. 

The operative word here is “patients,” unfortunately.   Many inmates are not patients due to limited CSC resources or are subject to policy irregularities where needs are ignored, or treatment is cursory, incomplete, or suspended.  CSC institutions, regional offices and the national headquarters continuously contend with health care grievances, and the Office of the Correctional Investigator brings health care deficiencies to your attention annually.

I’ll cite one serious negligence.  Reference Correctional Service of Canada “Guidance on Opioid Use Disorder (OAT) Program: August 16, 2021,” which reads in part on page 3, “Effective OAT (Opioid Agonist Treatment) incorporates physical and mental health care and harm reduction delivered in an integrated fashion (not provided sequentially).  For example, care includes counselling, substance use monitoring, provision of comprehensive primary care, harm reduction, and assessment of emotional and mental health, and offering of psychosocial treatment interventions and supports.”

You know that the criminality of many offenders in your charge is rooted in drug addictions and mental health issues.  The options on page 3 are repeated at other points in the guide and yet, where are they for the men and women who line up each morning for their suboxone or methadone doses?  Ask those men and women.  Ask Dr. Zinger.

CSC’s toe-the-line response is to insist inmates get the health care they need.  Ma’am, this is simply not true.  Too bad for us.

 

Commissioner Kelly, what do you really know?

Next posting is April 7.

Bill C-83 was introduced in the House of Commons on October 16, 2018.  Its purpose was to amend the Corrections and Conditional Release Act and one other Act, impacting several federal prison industry practices.  Most importantly, it would end administrative segregation and disciplinary segregation, replacing them with structured intervention units (SIUs), along with establishing a process for reviewing decisions to confine an inmate in them.  After the first two readings and a study by the House Standing Committee on Public Safety and National Security which resulted in several amendments, the bill passed third reading on March 18, 2019.

The bill then went to the Senate where it received first reading on March 19, 2019.  After its second reading, it moved to a Senate committee that made 11 amendments which the Senate adopted, and the bill was approved and returned to the House on June 12.  The Commons considered the Senate amendments, rejecting most, and Bill C-83 became law on June 21, 2019.

Bill C-83 did not end the use of segregation, and the government’s own data shows that SIUs can replicate conditions of segregation and solitary confinement where the new provisions are not executed uniformly and where periods of isolation have stretched from sixteen to hundreds of days.  The Correctional Investigator found that conditions of segregation have expanded outside SIUs to units listed as medical observation and voluntary limited association ranges.  There is also a scope of options not covered by C-83, referred to as secure units, therapeutic units, maximum security, dry cells, and what the Correctional Investigator refers to as “hidden cells,” some label as “ghost cells.”

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Kim Pate was appointed to the Senate of Canada and assumed office on November 10, 2016.  She is an alumnus of the University of Victoria and Dalhousie Law School, with post graduate work in forensic mental health, is a 2011 recipient of a Governor General’s Award, a member of the Order of Canada since 2014, and was formerly the executive director of the Canadian Association of Elizabeth Fry Societies.  She is a Senator for Ontario, sits with the Independent Senators Group (ISG) and has a special interest in matters of criminal justice and our carceral system.

On December 2, 2021, Senator Pate announced the introduction of Bill S-230 “to require judicial oversight of Correctional Services of Canada decision-making, prevent and remedy conditions of cruel and unusual punishment and torture in Canadian prisons.”  The bill encompasses the amendments that the Senate made to Bill C-83 in 2019 but which the government rejected.  Bill S-230 would require a court approval to keep an individual in isolation for longer than 48 hours.  It would also give inmates with mental health disabilities access to community-based care as opposed to isolation in medical observation or other pseudonyms for segregation.  The bill asks too for additional aggressive release options for Indigenous and Black offenders. 

Bill S-230 has been in committee since November 30 of last year after passing two readings.  The committee heard from 26 witnesses in five meetings up to February 8, and is now going through a clause-by-clause consideration.  If the resulting report is accepted and the Senate passes the bill on third reading, it will be sent to the House where it will almost certainly be summarily rejected.

We commented to the committee chair on February 22:

The Honourable Senator Brent Cotter,
The Senate of Canada Building,
Ottawa, ON  K1N 8X5

Re:      Bill S-230:  An Act to amend the Corrections and Conditional Release Act

Dear Senator Cotter:

As Chair of the Senate of Canada Standing Committee on Legal and Constitutional Affairs, you’ve had six meetings to consider S-230. 

I will limit myself to just three comments.

First, I take exception to Senator Pierre-Hugues Boisvenu’s December 14, 2023, view that, “Having visited federal penitentiaries in Quebec, I can tell you that offenders in these units are treated very well, often better than in a public hospital.  That’s my observation.”

Just exactly where did he make these observations?  Did the senator know at the time of his visits that Quebec Superior Court Justice Christian Immer’s July 28 decision authorized a class action lawsuit on behalf of federal prisoners in Quebec over the use of SIUs?

Unfortunately, Senator Boisvenu retired in February and can’t be challenged.

Further, CSC Commissioner Anne Kelly testified on the same date that there are no “hidden cells” in CSC prisons.  They’re sometimes labelled as “ghost cell’s” and they certainly do exist.  I wouldn’t suggest Ms. Kelly was being untruthful, but I would argue she doesn’t know what goes on in the facilities in her charge.

Lastly, while many notable people have appeared before the Committee, an important omission are the voices of inmates, the men and women who live the SIU experience.  Testimony within the walls of prisons chosen by the Committee is a necessary component for your consideration.

Senator Pate, CSC Commissioner Kelly, and Correctional Investigator Zinger were copied.

Bill C-230 is another reminder that all is not well in paradise.  Where is OPCAT?