Hear the Voice in the Wilderness

…..IS REHABILITATION IN CSC’S VOCABULARY? (A)

Yes, there’s a point to repetition:

“The security features inherent in federal correctional facilities are designed to keep people in as much as they are to keep people out. As a result, the management of the federally-sentenced population is largely conducted away from public scrutiny. Invisible to the general population, federally-sentenced persons are often forgotten.”
The Senate of Canada, Human Rights Committee, Interim Report, February 2019

From his cell at Millhaven Institution Brennan Guigue begins to make his argument in this third installment:

“Referencing inmate pay scales, this lower liquidity can play a direct role in the reform and rehabilitation of an offender because as canteen prices continue to rise, his/her buying power decreases. Combine that with inadequate food quantities, and more importantly, also poor quality, you have morale issues that will in turn effect what’s called ‘institutional motivation.’ It is exactly the same principle as understanding that an army will be a more effective force if it is well fed, or why there is a great importance lent to breakfast programs in schools. Well fed students produce better students.

If CSC and, by greater extent, society wish to talk about producing law-abiding productive members of society, who are reformed from their criminal ways, wouldn’t creating a better motivating environment go a long way in achieving that goal? C’mon now, you don’t really believe that things will just fix themselves, do you? (Gee, aren’t we the optimist.)

CSC’s food policies prescribe a caloric intake of around 2600 calories per day for the average male inmate. However, if you look closely at the information, the ‘average male inmate’ described is somewhere between the ages of 25 – 35 years, maybe 150 – 175 lbs. He’s also described as ‘sedentary’, he’s not doing anything! Why do people lift weights and exercise, what comes to mind when your doctor or psychologist tells you to ‘get out and do more, join a gym…it’ll be good for you?’

The reality is that the average inmate, based on what I see around me, is between the ages of around 20 – 30 years of age, and most of them want to get out of their cells, work out, maybe play some b-ball, or floor hockey once of twice a week. Then there are guys like me who are getting up in age but have been active all of their lives and wish to stay in shape. Or even just to alleviate some stress, anxiety, depression, suicidal thoughts/ideation. Name the symptom and I bet being active will help in some way.

More than a third of the guys in here aren’t average as described by the Canada Food Guide, which is what CSC dieticians use as a measure. Many are 200 lbs. or more, and not sedentary. I myself am 213 lbs., having lost a good 12 lbs. since arriving at Millhaven Institution, and although I am only 5’9” tall, I am definitely not a fat guy. My body could stand to lose another 5 – 6 lbs. or so, but I think I’m doing pretty good for a 49 year-old. Besides, being locked in a 13’7” cell for 20 hours a day makes maintaining any consistent, healthy weight difficult.

However, living off just the prison diet does not allow me to work out, or exercise nearly as much as I’d like to. I am hungry ALL the time! I play floor hockey once a week as a must as it is my favorite sport to play, but I no longer get into the weight pit, which is something I’ve done since the age of 15. I try to walk the yard at least 3 times a week, but I’d much rather run around in the gym more often, perhaps play two games of hockey and even a game of b-ball a week. I just can’t do it.

As anyone who is getting older is aware, lack of energy can be very frustrating and thus have a negative effect on one’s morale.

However, keeping inmate energy levels low makes for an effective control mechanism. Now there’s an interesting thought, eh?”

Yes, there’s more……..

Yukon gets a Gold Star!

“Yukon to place strict limits on solitary” headlined Patrick White’s Globe and Mail prominent front-page story on October 28.

Editor’s note: This was prepared for publication late last year prior to the two-month hiatus referenced at the head of the last posting. It remains relevant and current all the same.

Those limits are the thrust of Yukon’s Bill 6, an Act to Amend the Corrections Act 2009, which was in committee after passing first and second reading in the territory’s legislature when the Globe article was published. Since then it passed third reading and came into force on November 27.

Under the Act, an inmate cannot be held in segregation who is pregnant or has recently given birth, who is suicidal or chronically self-harming, has a mental disorder or intellectual disability, requires medical observation, or has a mobility impairment. All exemptions have prescribed legislated conditions.

Bill 6 declares an inmate cannot be held in segregation for more than 15 days to an annual 60-day limit. And, an inmate who is released from segregation after 15 days cannot be placed in segregation again until a period of five days has expired since the end of the last 15-day segregation period. Those limits can be exceeded only with the consent of an independent arbitrator, who could not be a government employee.

The legislation is the first in Canada to comply with the United Nations General Assembly’s 2015 adoption of what are now called the Mandela Rules, which asks all jurisdictions to limit solitary confinement to 15 days. As such, this bill doesn’t address questions around segregation placements for less than 15 days, except that 60-day annual maximums apply.

Yukon Director of Corrections Andrea Monteiro wanted to be pro-active in dealing with the issue and make the territory a leader in segregation reform. Yukon has only one territorial prison, the Whitehorse Correctional Centre with a problematic recent history with solitary confinement, but the government is advantaged in its reform efforts over other jurisdictions like Ontario which has 25 provincial jails.

Canada’s prison industry is watching the impact of this legislation. The Courts have been very clear with its position on segregation practices and any federal or provincial government that ignores recent decisions will face and is contending with further litigation. “The hard 15-day cap has been met with stiff resistance from current and former prison staff, who say it jeopardizes the safety of employees and inmates,” said Patrick White in the Globe and Mail.

Former federal warden Glen Brown, now a criminology instructor at Simon Fraser University, described Yukon Bill 6 as “terse and perfunctory” in attempting to comply with the Mandela Rules, claiming the complexity and seriousness of circumstances can’t be effectively managed under its provisions.

On the other hand, Howard Sapers, a former federal correctional investigator who advised Yukon on this bill, says that its “far-reaching approach” is to be admired. “My experience in the federal sphere, sadly, is that the government was quite content to be re-active, to not get ahead of these things. It’s nice to see a jurisdiction that wants to be pro-active,” he said.

Aging in prison…..

…..not hard to explain.

Editor’s note: A broken leg and rehabilitation challenges led to six weeks in hospital, with follow-up therapies at home. At last, we are at work again.

Earlier this month, Correctional Investigator Ivan Zinger released “Aging and Dying in Prison: An Investigation into the Experiences of Older Individuals in Federal Custody.” From the introduction, “In so far as older individuals in federal custody are concerned, this joint investigation by the Office of the Correctional Investigator and the Canadian Human Rights Commission finds a general failure on the part of the Correctional Service of Canada to meet the fundamental purposes of the Corrections and Conditional Release Act:  safe and humane custody and assisting in the rehabilitation and reintegration of offenders into the community.”

On CBC Radio One’s “The Sunday Edition” this morning, host Michael Enright took up the question of why there is so much difficulty in releasing older and chronically ill inmates to the community. After all, as Mr. Zinger also wrote in his report, “Prisons were never intended to be nursing homes, hospices, or long-term care facilities.” Mr. Enright couldn’t answer the question, but we offered one explanation in a letter today.

Michael Enright,
The Sunday Edition, c/o CBC Radio One,
Toronto, ON M5W 1E6

Re: Aging prison inmates

Dear Mr. Enright:

A portion of today’s Sunday Edition focused on Ivan Zinger’s “Aging & Dying in Prison” report released this month, and the challenges aging prisoners have in securing compassionate release.

Take it from this long, long, long-time prison activist and prisoners’ advocate that Canada does not have a correctional system. It has a prison industry.

From that perspective, the status quo is easily explained.

Yours truly,

Charles H. Klassen

It’s good to be back!

Beware the Voice in the Wilderness……

……WE’RE SHOOTING OURSELVES IN THE FOOT BEHIND THE WALLS.

Always worth repeating:

“The security features inherent in federal correctional facilities are designed to keep people in as much as they are to keep people out. As a result, the management of the federally-sentenced population is largely conducted away from public scrutiny. Invisible to the general population, federally-sentenced persons are often forgotten.”
The Senate of Canada, Human Rights Committee, Interim Report, February 2019

In this second installment of Brennan Guigue’s testimony from Millhaven Institution, he lays some groundwork for this debate assessing the efficacy of prison practices: –

“To continue, this is about food quality, inmate pay scales, inflation as it relates to the rise in canteen prices and inmate buying power, and how all of these things can tie into the mental and moral state of inmates in general. How things which can affect all of us as human beings don’t just stop because some of us are locked up. Fundamentally on a certain level we are all affected by the same things, and to deny this is simply pure-purposeful ignorance.

In 2016-2017 the Correctional Investigator produced his annual report. Now, we all know that the position carries no real weight to effect change within the system, but this report is the only thing out there which actually corroborates the hypocrisy my father speaks about in many of his writings on the subject. Just to note. Very little if anything has changed within the Correctional Service of Canada to date. In fact, conditions affecting the mental wellness of inmates continues to deteriorate.

As anyone who bothered to read the report knows, some of the key issues targeted for improvement were healthcare services, food and diet, inmate pay/employment (the gap between pay and inflation). In fact, we like to call the Healthcare Department the health ‘don’t care’ department.

Here’s the thing; the report stated that ‘although inmates have not had a pay scale increase in 30 years, CSC’s own numbers indicate costs have risen about 700% in the same period.’ If you don’t believe that, just ask the guard’s union. It’s one of their major pay arguments presented during contract negotiations.

The Harper government decided that if would be a good idea politically to target crime and criminals, that to be ‘tough on crime’ would certainly win many votes. In doing so, this country’s prisons became more concerned with crime and punishment, and less worried about reform and rehabilitation. There is now a system in place where not only have we not had a pay raise, but takes 30% of what little we earn for ‘room and board’. It breaks down to 22% for food and accommodation, and 8% for the inmate telephone service maintenance.

Sure, from a taxpayer’s point of view, that sounds like a great idea; why not have those damn criminals pay for their own incarceration. That is not where the problems arise. Add that 30% to 10% saving account, and 1-2% inmate welfare fund. Savings and IWF come off before anything else, then the other 30% comes off the rest, for a total almost 50% of an inmate’s full pay. An inmate’s full pay on average is about $5.85 daily at Level C. An inmate can increase his pay level every 16 weeks with good behaviour, good attendance, good performance, and so on. One needs ‘excellent’ ratings for these categories in order to get an upgrade to Level B or Level A, but he cannot receive more than $62.90 for 10 days work, and that’s only provided he actually gets a full 10 days in.

He may miss days for any number of reasons which may be caused by an institutional lock-down. Regardless of whether of not he is at fault, an inmate’s pay will still be cut in half for that day. Except for a couple of specific institutional jobs, a pay increase is almost impossible to achieve as it is very unlikely an inmate will every gain such a high ‘excellent’ rating on all seven or eight categories reviewed. It’s nothing personal; it is just a matter of principal to always have ‘the offender’ reaching for that carrot, so to speak.

In the past a Level C paying job used to earn an inmate about $47-$49 a week – gross. Now that same job earns the inmate, on average, about $28-$30 a week, provided he gets in all his 10 days. Factor into that institutional lockdowns, staff shortages, inmate escorts, etc. and the result in inmate earnings will be cut considerably.

This may seem tedious and boring, and I apologize for that; however, I ask that you bear with me as you will need this background information to understand my point. All of the things I speak of, and will speak of, have a cumulative effect on the attitudes, emotions and overall outlook of inmates living in, and getting out of these institutions.”

……continued.

Bill Blair in charge……

……OR IS HE?

The Honourable William Sterling “Bill” Blair spent almost forty years with Toronto’s police service, the last ten as Chief. After retiring, he was elected to Parliament in 2015, appointed as a parliamentary secretary to the Minister of Justice, and then the head of a task force to develop a plan for the legalization of cannabis. Last year, he was named Minister of Border Security and Organized Crime Reduction, and in November of this year, Minister of Public Safety & Emergency Preparedness. He’s now in charge of our federal prisons.

Bill Blair will need help, and a December 5th letter offered some advice.

Dear Minister Blair:

A few years ago, as Toronto’s Chief of Police, you made one of many visits to the CBC Radio Metro Morning studio. I was on my first cup of tea that particular morning, going through a newspaper, and with half an ear tuned to your conversation with program host Matt Galloway.

The subject was police response to city crime, its causes and potential fixes. At one point you said, and I think I’ve nailed this with reasonable accuracy, “We need to do more with these people when we have them in custody to help them turn their lives around.” That made me sit up and take notice…not something I expected to hear from law enforcement.

Lee Chapelle of Canadian Prison Consulting estimates that 80% of prison inmates in our federal system are salvageable. I’ve been an activist around prison issues since the 1960s, but it’s been a principal interest for the last 30 years. I know that hundreds of federal inmates, maybe more, want help. They want programming help, they want help with their emotional well-being and mental health, they want help reintegrating.

They’re not getting it.

You oversee the ‘big house’ now. You can “help them turn their lives around.” Don’t let Correctional Service of Canada snow you with reams of budget statistics, policy directives and institutional reports. It’s just paper. Don’t let anyone at CSC tell you all’s well. It’s not.

Yours truly…..

Yes, Minister, you have work to do…..

A Voice in the Wilderness……

……FROM BEHIND THE WALLS.

Worth repeating:

“The security features inherent to federal correctional facilities are designed to keep people in as much as they are to keep people out. As a result, the management of the federally-sentenced population is largely conducted away from public scrutiny. Invisible to the general population, federally-sentenced persons are often forgotten.”
The Senate of Canada, Human Rights Committee, Interim Report, February 2019

Brennan Guigue composed a testimony earlier this year from confinement in Millhaven Institution near Kingston in a letter addressed to no one….but intended for all. There is much to say about the cloistered reality of life under a penal system that is often cited as correctional in name only, and from a prison that is little more than a barren warehouse, desolate of hope.

In this first excerpt, inmate Brennan Guigue begins:-

“I am not sure to whom I should address this letter, nor am I certain that anyone will take up our cause.” He than references the proprietor of turnoverarocktoday.com as saying, “everyone loves to pick on inmates….to be tough-on-crime,” and describes the site as “a place he has created as a means of getting his opinions ‘out there’. He writes a lot about the hypocrisy of our democracy, as well as the incorrectness of Canada’s Correctional System (federal & provincial). How, through person experience, he has come to see that though the various media pages produced by these entities ‘talk’ a good game about justice, reform, and rehabilitation, the reality of what is really happening ‘behind the walls’ is truly a contradiction.

I guess that this letter is simply about venting some of the frustrations I live with as there seems not to be many other options available to me. Contrary to popular (mis)conception, prison is not all weight-pits, and video games. There are very real issues affecting the state of inmates in this country, issues which impede the desire of a society which claims to want better, healthier, contributing citizens to be reintegrated back into communities. How can this be true when the reality of the situation is so dismal? Did you know that inmates at Millhaven Maximum Penitentiary spend on average 20-22 hours a day locked up in their cells? Did you also know that there are absolutely no social development programs currently offered at the institution? So basically, inmates are expected to just vegetate in their cages until the powers that be see fit to allow them to move on. Tell me how much spiritual, emotional, or moral growth does one expect to happen under these conditions? As much as many of those in ‘society’ would like to lock us all away, that simply is not going to happen. Most of us will be getting out into your communities……like it or not. Now, I am not saying anything that hasn’t already been said many times over. Nor do I believe that what I will say is likely to have any real effect on what people think or say on the issue of ‘prison reform,’ but I’m gonna say it anyway.

The issue I want to speak about at the moment does not seem like such a big deal on the surface, but like most things with CSC, it is poorly thought out. However, policy makers don’t really care to think it out; it doesn’t have to make sense. After all, who’s gonna notice, who’s gonna care should anyone notice?”

……will be continued.

THE POLICE – What’s new in Montreal?

…..picking up from the October 23 posting.

Police in Montreal seem somehow different than in Toronto. Are Montreal cops less retrained, more aggressive, militaristic and cocky, as if there is an ultra-alpha police culture at work in the force? At the same time, self-ennoblement allows a level of benevolence missing elsewhere. Or do we in Toronto miss subtle cultural influences that are only perceptual?

)()(

In the early 1960s, the writer befriended a family transplanted to Toronto from Montreal when the husband’s employer promoted him to a position in their Bay Street head office. The couple, originally from the Maritimes, moved to Montreal for a job opportunity and raised a family there. Driving in downtown Toronto one day and passing a police traffic stop, this man recalled a Montreal habit he abandoned after arriving in Toronto. Montreal drivers, he said, were wise to tuck a five-dollar bill into their wallets with their license. That sometimes avoided a summons if the police pulled them over.

Later, in the mid-1970s, while visiting a Toronto friend living in Montreal, the writer was driven on a tour of the old city. Slowly cruising downhill on a quiet Sunday morning, the distracted friend didn’t notice a red light and braked as the car skidded into the intersection. He had no choice but to coast through the intersection; luckily there was no opposing traffic, but a police cruiser was parked at the opposite curb in full view of the infraction. We continued cautiously and slowly, the cruiser did not move, and finally the friend said quietly, “You must remember that in Montreal, red lights are only a suggestion.”

)()(

“The Montreal police force engages in systemic racial profiling that targets Arab, black and Indigenous people, a report by independent academics and commissioned by the city has found.”

So began the account by Montreal reporter Les Perreaux published in Toronto’s Globe and Mail on October 8, referring to a comprehensive study released the day before.

Described as the most exhaustive study of police racial profiling in Canada, sociologists Victor Armory and Mariam Hassaoui along with criminologist Massimiliano Mulone assembled data from tens of thousands of incident reports from 2014 to 2017. They found police stops increased 143 per cent during those years, even though the level of crime in the city remained constant. Indigenous people and Arabs accounted for most of the increase. Overall, black people are four times more likely to be stopped than whites, indigenous people 4.61 times more likely, and an Arab person twice the rate for a white person.

Black and Indigenous advocacy groups have been calling for action on racial profiling for years, and a Quebec inquiry on Indigenous people released at the beginning of October supported the claim of “systemic discrimination” against that community. As the Perreaux article continued, “Other advocates were startled by the scope of the problem, which has not improved after a series of incidents, reports and police promises over a decade.” Instead, the Montreal police force has denied a problem exists.

With the release of this report, Montreal’s police chief and the city’s mayor have committed to take “concrete” and “vigorous” action on its recommendations, and to make solutions a priority. In the meantime, various community groups have called for an end to street checks….an end to carding.

Quoted in the Globe, Nakuset, the director of the Montreal Native Women’s Shelter said, “We’ll see what they do this time.”

Reprise: Note there are ‘good cops’ in all police services who work in the best interests of the people they serve and respect their badges of office and what they represent. Unfortunately, that formidable police blue wall silences these men and women, shackling them to a corrupt code that challenges good order and threatens community safety.

THE POLICE – What’s New?

When the train goes off the tracks, and nary an engineer’s in sight….what to do, what to do.

“Farewell & Good Luck” from April 1 last year closed the file on policing. There’s plenty of scrutiny and coverage of police governance, while the prison industry is one example of a crisis calling for urgent attention from wherever resources can be found. But, there’s been four police postings since that goodbye, prompted by an apparent unwillingness of police management to either comply with the wishes of the people, or to bring their officers to heal when progressive policies are adopted.

So, we ask the question:

Why is it that men and women who voluntarily sign up with a law-enforcement agency, train to put themselves at risk, make a commitment and swear an oath to uphold and enforce the law of the land, will then turn around and violate the basic human rights of the people of the community to whom they are accountable?

First from Toronto…..”The Office of the Independent Police Review Director might have reported in March that Toronto police strip search those arrested forty times more often than other large police forces in Ontario, but that didn’t lead the Police Services Board to make any changes. As well, the Ontario Human Rights Commission’s report on racism in policing (A Collective Impact) found that black men make up 4.l% of Toronto’s population, yet were complainants in a quarter of SIU cases alleging sexual assault by TPS officers.”
Toronto Police Accountability Bulletin No. 116, September 26, 2019

OIPRD data shows that 40% of people arrested in Toronto are strip searched, 40 times higher than other large forces, although police staff claim it’s more like 35%….still 35 times higher. While a 2001 Supreme Court of Canada proposal recommended a reduction in the use of strip searches, and given there’s no evidence that the large number of strip searches are necessary, a recommendation that would still permit the search of 2% of those arrested (still double the norm in Ontario) was rejected by the police.

“Toronto will continue to humiliate and degrade 40 per cent of those it arrests,” says the TPAC bulletin cited above.

Then to Nova Scotia……Kirk Johnson, a 1990s Olympic boxer has been working to ban ‘street checks’…CARDING….since he was pulled over in 1998 by a white Halifax police officer and had his Ford Mustang impounded….because he was black. Nova Scotia’s Human Rights Commission agreed five years later with a decision exposing racial bias in the Halifax-area police, and mandating change.

“The Nova Scotia government will permanently ban police street checks, the province’s justice minister said Friday after a retired judge issued a formal opinion that the practice is illegal.”
Toronto Globe and Mail, Saturday. October 19, 2019

Justice Minister Mark Furey had imposed a temporary moratorium on the practice after Toronto criminologist Scot Wortley issued a report in March commissioned by the province’s human rights commission found black people were six times more likely to be street checked. However, groups representing black Nova Scotians said non-white citizens were still stopped and asked for identification in cases where no crime was under investigation.

Retired justice Michael MacDonald’s 108-page analysis concluded “carding”, stopping citizens to collect and record personal information, violates basic constitutional and common-law rights. Referencing the earlier Wortley report recording the treatment of black people by police in Halifax, the justice found a “disproportionate and negative” impact on minority communities, noting Mr. Wortley “did not identify any benefits to street checks.”

The Toronto Star reported on October 22 that Halifax Police Chief Dan Kinsella will make a formal apology for street checks near the end of November. “This is an apology for much more than street checks,” the chief said. “I think we all know that street checks are part of a larger issue. The more broad issue here is some 200 years of inequalities and injustice that have occurred and the apology will be all-encompassing.”

And now, to Montreal……What’s new with the Montreal police service will be given the honour of place in a posting dedicated solely to this one law-enforcement agency. That’s next time.

Note there are ‘good cops’ in all police services who work in the best interests of the people they serve and respect their badges of office and what they represent. Unfortunately, that formidable police blue wall silences these men and woman, shackling them to a corrupt code that challenges good order and threatens community safety.

Putting patients first!

SPOTLIGHT: PRISON HEALTH CARE – A BOTTOM LINE

“The security features inherent to federal correctional facilities are designed to keep people in as much as they are to keep people out. As a result, the management of the federally-sentenced population is largely conducted away from public scrutiny. Invisible to the general population, federally-sentenced persons are often forgotten.”
The Senate of Canada, Human Rights Committee, Interim Report, February 2019

)()(

These often forgotten inmates in our federal prisons are wholly dependent upon Correctional Service of Canada for the necessities of life, including health care. The Corrections and Conditional Release Act (CCRA) says that CSC is responsible for providing “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.”

Despite the millions of dollars budgeted annually for health care and the aggressive treatment targeting some conditions, like HIV and HEP-C, access and timely attention to care is a major source of inmate complaints and grievances. That is a slow and cumbersome process, but inmates can elect to file a complaint through the professional associations of doctors, dentists, and nurses. However, doing that means the incriminated doctor, dentist or nurse cannot treat the complainant during the review process.

Yes, while the voices of inmates are devalued by CSC, there are others who make studied and authoritative assessments that can’t be ignored. Or can they?

)()(

“Healthcare in CSC penitentiaries is not provided independently of corrections. Instead, healthcare providers are employees of CSC, though recently CSC has been making changes purportedly to encourage their independence. This is nevertheless a violation of the Mandela Rules, which requires that prison health services be organized in close relationship to the general public health administration and that medical providers act in full clinical independence.”
West Coast Prison Justice Society, Damage Control, June 2019

“Bill C-83 includes several positive health care obligations, and recognizes the professional and clinical independence of health care professionals, but the legislative requirements are again vague and don’t include enforceable standards. Health care providers should partner with federal and provincial Ministries of Health, without the influence or interference of prison administrators, and without any CSC staff supervision or oversight. And, add legislation to ensure confidentiality between health care providers and prisoner patients.”
Canadian Bar Association, letter to Ottawa on Bill C-83, November 19, 2018

“There are many areas of correctional health care practice that give rise to clinical role conflicts of ethical dilemmas, where clinical independence and professional autonomy may be impaired or impeded or where health care providers may feel compelled to follow correctional authority rather than health care rules.”
Office of the Correctional Investigator, Annual Report, 2017-2018

“The crux of the matter boils down to the fact that role conflicts and misunderstandings between health care and custodial staff are common and everyday occurrences. Examples abound: population movement schedules determine health care clinic hours; when or if an inmate’s medical escort takes place is dependent on staffing levels; who provides care or how it is provided in a prison setting is not a matter of patient choice.”
Ibid.

“….United Nations Standard Minimum Rules for the Treatment of Prisoners (now known as the Mandela Rules)….state that clinical decisions may only be taken by the responsible health care professionals and may not be overruled or ignored by non-medical prison staff. Though a review of the Mandela Rules was purportedly conducted and completed, in response to an Office request for an update, CSC provided no documentation, report or findings to corroborate its claim that CSC health care services are compliant with the Mandela Rules. Saying or believing that the Service is compliant with domestic or international rules and standards is different from demonstrating it. As with many other activities within CSC, transparency would go a long way towards ensuring that health care standards behind bars are demonstrably met.”
Ibid.

“Federally-sentenced persons also provided the committee with disturbing personal accounts of health and dental care services, most often involving doctors or dentists hired by the CSC on contract. On the other hand, some federally-sentenced persons had a more positive view of certain mental health nurses and clinical social workers with whom they were in contact but felt that they had inadequate access to these professionals, especially outside of normal business hours. In other words, a mental health crisis should occur between 9:00 a.m. to 5:00 p.m., Monday to Friday in order for the affected individual to receive help. Overall, the committee has heard many examples of how security concerns of staff routinely trump health – especially mental health – needs of prisoners.”
The Senate of Canada, Human Rights Committee, Interim Report, February 2019

)()(

This is a sampling of what is in front of the federal government and Correctional Service of Canada. They’re from the latest of a long list of opinions, research, studies and examinations over many years that have called for change.

One bottom line sees the appointment of a Minister who chooses to manage rather than be managed.

Hey, I’m the patient!

SPOTLIGHT: WHOSE HEALTH CARE IS IT, ANYWAY?

“The sole task of health care providers in correctional settings is to provide health care with undivided loyalty to the patients, with unrestricted clinical independence, acting as the patient’s personal caregiver without becoming involved in any medical actions that are not in the interest of the patient health and well-being.”
Pont, Engglist, et al, American Journal of Public Health, April 2018

Health care in the prison systems was previously framed in “Scene One” on March 3rd of this year, and “Scene Two” on April 14 where a note pointed to a future third entry about dental care in federal institutions. Those first two postings were necessarily harsh as inmates can run into problems accessing reliable care due to “dual loyalties” among some health care workers.

Nurses, psychologists, pharmacists and social workers are employees of Correctional Service of Canada, whereas doctors and dentists are contracted. The focus here is dentistry.

A toothache is distracting, uncomfortable, and left untreated, can result in excruciating pain and a serious infection. As previously noted, inmates submit a written request for health care and then wait for attention. It’s unlikely an inmate will ask for a dentist unless there is some urgency, but a nurse is just as unlikely to consult promptly with an inmate when a request is received by the health care unit.

Sit and wait. It’s not unusual to wait weeks or even months to see the institution’s dentist, and aside from knowing there is a waiting list for treatment, an inmate doesn’t know when help will come. For the most part, a dentist’s time is managed at the discretion of the institution’s on-site health care workers who generally don’t recognize the word “emergency.”

Dental services are contracted and so too are the number of service hours, often expressed as a maximum number of hours per year. For example, the dentist who services Millhaven Institution in Bath with roughly 500 potential patients is available a maximum of 364 hours a year, and may run one to three clinics a month, depending on need which is established by institutional nurses. Joyceville Institution in Kingston has up to 637 hours a year for about 750, Collins Bay in Kingston a maximum of 644 hours per year for 760, and Warkworth Institution in Campbellford lists dental services one day a week for just over 500. And, all managed by institutional employees.

Given the ratio of hours to population, dental therapies are more curative than preventive. There are examples of people waiting so long for help they’re admitted to institutional hospitals on IVs to fight infections. There are examples of inmates taken to outside dentists for help when advocates press CSC national headquarters and regional offices for action. Too, outside referrals can be critical of the damage delays can cause.

To be fair, negative experiences with institutional dental services are not entirely universal. An inmate can feel ignored at one point but get help in reasonably short order another time. Consistency is illusive. The culprit? Refer to the first paragraph.

Part II of the spotlight on health care follows.