DON’T KID YOURSELF!

“Federal prisons…..MAKE’EM CARE?” posted here on June 12 included a May 9 letter to the health care unit at Port-Cartier Institution, which was copied to CSC’s regional office in Quebec, the national headquarters in Ottawa, the correctional investigator, and others.

This is the May 9 covering letter also posted on June 12 that was sent to the correctional investigator with his copy of the Port-Cartier letter:-

Dr. Ivan Zinger, Correctional Investigator,
The Office of the Correctional Investigator,
Ottawa, ON  K1P 6L4

Enclosed is a copy of a May 9, 2022, letter to the Chief of Health Care Services at Port-Cartier Institution in Quebec, where my son, Brennan Guigue is incarcerated.

This is not a complaint on behalf of my son.  I’m simply sharing my annoyance after decades of advocacy and as I enter the late stages of my life that CSC seems impervious to the sound of any voice but its own.

Mark Twain is reported to have said, “When we remember that we are all mad, the mysteries disappear, and life stands explained.”  Brennan, who is adopted and half indigenous, gets tired of telling me that when I ask ‘why’ questions about what goes on with Correctional Service of Canada, I must begin by reminding myself that, “They don’t care.”  By starting with that, the mysteries disappear, and CSC stands explained.

I’ll buy that.

Thank you for the work you do.

The correctional investigator’s office was the first to respond in a May 20 letter over Derek Janhevich’s signature:-

Mr. Charles H. Klassen,
Toronto, Ontario

On behalf of Dr. Zinger, thank you for reaching out to our Office,

While you indicate that you interaction with our Office is not a formal complaint, please allow me to note that we will nonetheless trat it as an issue that warrants further examination.  As always, the matter will be raised in a discrete manner while also ensuring the importance of the issue.

The Senior Investigator assigned to Port-Cartier is set to visit the institution soon and is aware of your concerns.  We will make an effort to meet with Brendan (sic) and will most certainly raise the matters with the Warden and the Chief of Health Care Services.

I noticed that you have also included the relevant stakeholders in your letter, including the Assistant Commissioner Health Services, with whom we continue to have numerous discussions on the exact issues you raise.

The mental health needs of patients residing in federal correctional facilities continues to be a top priority for our Office,

Sincerely,

Derek Janhevich
OCI, Director of Investigations – Ontario & Quebec

What came out of that?

June 19, 2022

Derek Janhevich,
Director of Investigations – Ontario & Quebec,
The Office of the Correctional Investigator,
Ottawa, ON  K1P 6L4

Thank you for acknowledging my May 9 letters to Dr. Zinger and the health care unit at Port-Cartier Institution. 

Manjeet Sethi, Acting Assistant Commissioner-Health Services wrote on behalf of Correctional Service of Canada on May 24.  I was offended by his lack of accurate and complete information regarding Brennan Guigue’s care, or more accurately, Brennan’s non-care, knowing too that this is an issue with hundreds and perhaps thousands of CSC prisoners.  I will address that with him.

**In the meantime, Brennan did meet with your Senior Investigator last week during his visit to Port-Cartier.  It did not go well from Brennan’s perspective.  Brennan said, “I sat there talking to him for ten minutes.  ‘I can’t help you,’ was his answer.  Useless.” 

It’s a challenge to be polite here given that the deficiencies in prison health care are so widely known and explain in part why the average age of death from natural causes in CSC custody is 60.  CSC cannot be unaware of its neglect while it intentionally ignores and deflects the calls for reform from many authors, including the OCI.

I appreciate the attention you’ve given this matter.

(**emphasis is ours)

The Office of the Correctional Investigator can only make recommendations to Correctional Service of Canada.  It has no authority to impose change.  All the same, their lack of support in the face of CSC neglect and intransigence is surprising.

This is not over.

…..WANT US TO BELIEVE THEY CARE.  They want us to believe they are acting according to the provisions in the Corrections & Conditional Release Act (CCRA).

“Federal prisons…..make’em care” on June 12 included a May 9 letter sent to Port-Cartier Institution’s Health Care Services Chief critical of the lack of mental health care services available to Brennan Guigue specifically and other inmates in general.  An addendum listed six individuals who were copied, along with covering letters for three on the list.

Within days of that letter’s arrival in Port-Cartier, Brennan Guigue was called to the institution’s health care unit to sign a release, allowing Correctional Service of Canada to respond.  Their answer came by letter dated May 24 from CSC National Headquarters in Ottawa.

To avoid any hint of biased editing, the complete response is copied here:-

May 24, 2022

Dear Mr. Klassen,

Thank you for your correspondence of May 9, 2022, addressed to Chief of Health Services at Port-Cartier Institution.  In your letter, you raise concerns about mental health services management and treatment for your adopted son, Brennan Guigue, while incarcerated at Port-Cartier Institution.

I am responding to your correspondence on behalf of the Chief of Health Services at Port-Cartier Institution.

According to documentation in Mr. Guigue’s electronic health care records, he was last assessed by a psychiatrist at Millhaven Institution on October 5, 2020.  The psychiatrist noted that Mr. Guigue was stable and no further psychiatric follow-up was required, however guidance was provided for him on how to access Mental Health Services if needed.

In November 2021, Mr. Guigue was transferred to Port-Cartier Institution.  On arrival, his health care records were reviewed by Health Services.  His diagnoses were noted, his medications were continued accordingly and his mental health needs were assessed as low.  Since then, Mr. Guigue has not voiced any mental health concerns to staff nor has he submitted a request to be assessed by Mental Health Services.  He is assessed by the nursing staff and the institutional physician as needed and his condition is described as stable.

In regards to the concerns you raised for referrals submitted by Parole Officers, correctional staff can submit a mental health referral if necessary.  Commissioner’s Directive 800 entitled Health Services, paragraph 11(a), requires all institutional staff/contractors to inform a health care professional of the condition of any offender who appears to have a physical or mental health care concern, whether or not the offender identifies a health concern.  However, there is no CSC policies stating that only Parole Officers can make such referrals.  The individuals federally incarcerated are provided with the information on how to access Health Services along with the process on how to submit an Inmate’s Request on admission and transfers to CSC institutions.

I would like to assure you that the Correctional Service Canada (CSC) is mandated, under the Corrections and Conditional Release Act (CCRA), to provide every inmate with essential health care and reasonable access to non-essential health care.  Our comprehensive legal and policy framework outlines what we must do to deliver our essential services and I can assure you that Health Services are always available to Mr. Guigue, and that he is receiving care in accordance to his actual diagnoses and needs.

Thank you for writing.

Sincerely,

Manjeet Sethi, A/Assistant Commissioner Health Services.

To a lay person, this would appear to be a reasonable response to issues raised in the May 9^th letter.  To everyone with CSC experience, it’s offensive.

June 24, 2022

Mr. Manjeet Sethi, A/Assistant Commissioner,
Health Services,
Correctional Service of Canada,
Ottawa, ON  K1A 0P9

Re:       Your May 24 letter re Brennan Guigue.

Dear Mr. Sethi:

I feel confident that I first dipped my toe into advocacy and activism before you were born, and certainly before Brennan Guigue in 1970. 

Over time, my focus honed primarily on prisons and the justice system, particularly after Brennan was adopted.  His health care needs were not being met by the practices in place, practices not always compliant with policy.  And so it is too with many others in the system.  This isn’t conjecture.  You have at least the same reports, studies, findings, and recommendations that are in my files.

As for Brennan Guigue, I appreciate you have only what’s been put in front of you to form a response to my May 9^th letter.  At a minimum, I’d characterize your material as incomplete.  From your May 24 letter, “I can assure you that Health Services are always available to Mr. Guigue, and that he is receiving care in accordance to his actual diagnoses and needs,” is factually incorrect.  But that is not for me to argue here.

It is notable that our exchange of letters drew only upon Brennan’s concern for his psychological well-being, and CSC’s response to that.  His physiological challenges include a diagnosed but untreated condition that’s potentially lethal, but again, that’s not relevant here.

Mr. Sethi, what is important is you have, as an officer in the national headquarters of Correctional Service of Canada, offered an interpretation of health care policy and its practices, as well as an address to one specific circumstance.

For that I thank you.

Charles H. Klassen

There will be a frank second letter to Mr. Sethi. 

Before that though, what’s next is Brennan Guigue’s experience with the Office of the Correctional Investigator’s examination of this claim.

WHY IS CORRECTIONAL SERVICE OF CANADA AFRAID to let in the light?  Why is it concerned about inmates speaking to the press?  Why is Minister Mendicino not bothered by the delay in releasing the revised Commissioner’s Directive 022 – Media Relations?

The changes to CD 022 haven’t come up here since an addendum to the February 27, 2022, posting, “Justice & Prisons….in the news #3.”  There, a February 21 letter to the community safety minister referenced CSC spokesperson Colette Cibula February 8^th letter where she wrote, “I can assure you that it is now nearly complete.”

Back on May 6 of last year we told CSC Commissioner Anne Kelly that, “It has been at least a year since you undertook this review….this project is relatively minor…but the changes will also eliminate any suspicion that the Service is trying to prevent inmate contact with the media…..”  Is the two-and-a-half-year span from initiating a CD 022 review without publishing an update a move CSC hopes will blunt expectations, or is this delay simply bureaucratic gridlock?

Time to bring this to the front burner again:-

June 18, 2022

Colette Cibula, Associate Assistant Commissioner,
Communications & Engagement, Correctional Service of Canada,
Ottawa, ON  K1A 0P9

Re:      Commissioner’s Directive 022 – Media Relations

Dear Ms. Cibula:

The third paragraph of Commissioner Kelly’s February 24, 2020, letter to Correctional Investigator Zinger began, “A revision to CD 022 is currently underway.”  The fifth paragraph ended, “We expect that the revised CD 22 will be available by the end of June 2020.”

The Commissioner was responding to Dr. Zinger’s December 18, 2019, letter with his concerns for the media relations directive.  At the time she wrote, Ms. Kelly seemed to anticipate a six-month turnaround, but she could not of course foretell COVID-19’s impact on the process.

Your February 8, 2022, email to me noted the revision to CD 022 was “still underway,” but was “nearly complete,” and CSC was “finalizing internal reviews” before publication.  It’s now two-and-a-half-years from the OCI’s letter, the on/off COVID protocols have eased, and there’s been four months to complete internal assessment. 

I write simply to stress the interest some quarters in the community have for an imminent circulation of the revised CD.

Yours truly,

Commissioner Anne Kelly, Minister Mendicino, and the Office of the Correctional Investigator were copied, of course.

As a by the way, Ms. Cibula’s February 8 letter, referred to the “renewal” of CD 022 as “still underway.”  She continued, “It was delayed as the tempo of media relations as well as the need for communications with inmates, staff, stakeholders increased significantly during the pandemic.”

Inmates?  This infers inmates were consulted in the process.  It’s unusual for CSC to care what inmates think but that seems to be what Ms. Cibula indicates.  We submitted an information request on April 20 asking for the number of inmates involved in the communications, and in which institutions they are housed.  To date, there’s hasn’t even been an acknowledgement, but the difficulty in getting information from the federal government in any and all its bodies is coming under increasing criticism.

Would you believe Correctional Service of Canada still says its health-don’t-care is health care?  That’s next.

Canada’s Auditor-General Karen Hogan added her voice to charges that Correctional Service of Canada facilities “haven’t taken action” to address systemic racist barriers faced by Indigenous and Black prisoners.  Her report, released on May 31, is only the latest condemnation of our prison industry’s practices in its treatment of racialized offenders.

Over the last 20 years, the Office of the Correctional Investigator, Status of Women Canada, the Canadian Human Rights Commission, Public Safety Canada, and the Auditor-General’s office, along with academic studies, have released numerous findings and reports citing outstanding issues with the prison industry’s attitude towards Black and Indigenous prisoners.  From the moment they come under CSC control, these men and women are more often sent to higher security institutions compared to their white peers and aren’t paroled as often as others when they first qualify for early release.

A Globe and Mail 2020 investigation found that Correctional Service of Canada’s risk-assessment tools, for instance, continued to be systemically biased against Black and Indigenous inmates.  All the while, CSC acknowledges the concerns that come to its attention, agrees there are steps to be taken, and will even move to initiate apparent remedies.  Nonetheless, from day one to warrant expiry, racialized men and women are held hostage by intransigent internal elements seemingly impervious to the demands for change.

Last year, a proposed class-action lawsuit was filed against the federal government on behalf of tens of thousands of current and former prisoners for its racist and discriminatory use of risk mechanisms.

Correctional Service of Canada can no longer be trusted to do what it must, some who study prison environments say.  Change must come from “higher government echelons”, they say.  What does that suggest about the lack of government oversight of federal prisons all along?  Is CSC free to run its own show?

Okay, so now Public Safety Minister Marco Mendicino has finally “ordered” CSC to establish the position of a deputy commissioner of Indigenous corrections.  That’s a start.  CSC Commissioner Anne Kelly has told the minister she’s on board and the minister “expects the CSC will hit the ground running to……work to address systemic racism and the overrepresentation of Black and racialized Canadian and Indigenous peoples in the justice system.”

But hold on.  CSC spokesperson Esther Mailhot, probably one of the agency’s communications and engagement staffers, reported that while they’re in the process of setting up this new office, she added that this is a “complex issue.”

Red light, red light.  We dropped off a letter to the minister:

June 5, 2022

The Honourable Marco Mendicino, Constituency Office,
Toronto, ON  M6A 1A3

Re:      Deputy commissioner for Indigenous corrections.

Minister Mendicino:

I have a February 24. 2020 letter from CSC Commissioner Anne Kelly to Correctional Investigator Dr. Ivan Zinger, in response to his of December 18, 2019.  Ms. Kelly’s letter confirms that a revision to Commissioner’s Directive C-022 – Media Relations is underway to make it Charter compliant, as Dr. Zinger recommended.  The Commissioner expected the revision would be available by the end of June 2020.  As of now, no revision has appeared.

Okay, so COVID slowed things down but for how long would the government allow productivity to be impacted by the virus?  I have a February 8, 2022, email from Associate Assistant Communications & Engagement Commissioner Colette Cibula addressing the delay. “The renewal,” she wrote, “is still underway.  It was delayed as the tempo of media relations as well as the need for communications with inmates, staff, stakeholders increased significantly during the pandemic.  I can assure you that is now nearly complete.  We have conducted external consultations and are finalizing internal reviews before publishing it.”

As for your order to have CSC establish an office of deputy commissioner of Indigenous corrections, CSC spokesperson Esther Mailhot said this is a complex issue that requires collaboration, including with various levels of government and Indigenous communities.

How many years do you think will pass before you notice nothing has happened?

Yours truly,

Oh, that’s right.  The ‘new’ media relations policy has still not been published.
That’s next.

…..MAKE’EM CARE?

Brennan Guigue had something to say here about prison industry health care over the last two weeks, and what he had to say could pass as only an introduction to what could be said.  And what could be said could be said by thousands of offenders behind the walls.

We jumped in too……

May 9, 2022

Chief of Health Care Services,
Port-Cartier Institution,
Port-Cartier, QC  G5B 0N2

Re:  Brennan Wayne Guigue, FPS#104902C

Health Care Services Chief:

Brennan Guigue is my adopted son.  His FPS # dates from 1993 with his first incarceration.

He has a long history of interactions with health care services in several institutions.  There continues to be unresolved issues with his physical health, but I write here about a recent request he made for help with his mental health.

He asked health care at Port-Cartier for an appointment with a mental health care professional about 2/3 months ago.  He was told his parole officer would have to make a referral.  Does Correctional Service of Canada now rank parole officers as health care professionals?  Really?  I doubt parole officers are qualified to make inmate health care decisions; that is, if a parole officer even deigns to see a client.  As it was, his request for a referral went nowhere.

Brennan Guigue diagnoses include borderline personality disorder, complex PTSD (childhood trauma), bi-polar disorder, clinical depression, and anti-social personality disorder.  This is a part of his file unless a CSC staffer somewhere overuses a ‘delete’ key.  Yet, despite many requests over long years, he has never received any psychological/psychiatric treatment.  And please don’t suggest he file a grievance.  That process is simply a sop.

Brennan Guigue’s mental health challenges are at the root of his criminality, just as it is with hundreds of men and women in custody who, like him, want help.  But Correctional Service of Canada opts out of opportunities to improve offender outcomes and boost public safety.

I wonder why that is?

Charles H. Klassen

This was worthy of sharing with others on the same date, others like:-

Jennifer Wheatley, Assistant Commissioner, Health Services,
Correctional Service of Canada, National Headquarters,
Ottawa, ON  K1A 0P9

…..and,

Regional Director, Health Services, Correctional Service of Canada,
Regional Headquarters, Quebec,
Laval, QC  H7N 5Y3

…..and, with an added covering letter,

Dr. Ivan Zinger, Correctional Investigator,
The Office of the Correctional Investigator,
Ottawa, ON  K1) 6L4

Enclosed is a copy of a May 9, 2022, letter to the Chief of Health Care Services at Port-Cartier Institution in Quebec, where my son, Brennan Guigue is incarcerated.

This is not a complaint on behalf of my son.  I’m simply sharing my annoyance after decades of advocacy and as I enter the late stages of my life that CSC seems impervious to the sound of any voice but its own.

Mark Twain is reported to have said, “When we remember that we are all mad, the mysteries disappear, and life stands explained.”  Brennan, who is adopted and half indigenous, gets tired of telling me that when I ask ‘why’ questions about what goes on with Correctional Service of Canada, I must begin by reminding myself that, “They don’t care.”  By starting with that, the mysteries disappear, and CSC stands explained.

I’ll buy that.

Thank you for the work you do.

…..and, also with a covering letter,

The Honourable Marco Mendicino, Minister of Community Safety,
House of Commons,
Ottawa, ON  K1A 0A6

The enclosed letter is self-explanatory, and it’s not sent to you for comment.  Indeed, I suspect this will not be put in front of you.  The self-interests of the ministry bureaucracy you oversee won’t benefit from a wider distribution.

As such, the people on your staff who direct you and guide your purpose are more properly responsible for the harm they do.  You and your recent predecessors permit the manipulations that compel your support of their designs to thwart the restructure and reform of Correctional Service of Canada, to the detriment of all Canadians and the security of our communities.

For that, the Ministry of Community Safety is shamed and shameful.

…..and, again with a covering letter,

Patrick White, The Globe and Mail,
Toronto, ON  M5A 1L1

The attached is self-explanatory.  I’m including you in the distribution simply to share my annoyance with our prison industry.

I passed my 80^th birthday in March, and with decades of advocacy behind me, and coping with a federal government agency that must be dragged screaming and flailing toward change and reform, I see no reason to be polite with obstinate public servants.  As it is, CSC does its best to work around what is forced upon it.

Have you ever had exchanges with one of their “communications and engagement” personnel?  Now that’s a treat.

….and, of course, Brennan Guigue was copied, too.

Ten days after these letters were dispatched, Brennan Guigue was called to the institution’s health care unit to sign a release form, freeing CSC to discuss his file.  To date, there’s been no contact from anyone involved with Correctional Service of Canada..

The Office of the Correctional Investigator was the first to respond.  That’s for another time.

 

 

On April 2, 2022. Quinn Borde, an inmate from Collins Bay Institution died while in our custody.
At the time of his death, the inmate had been serving a sentence of 23 years for offences relating to attempted murder, firearms, robbery, aggravated assault, assault causing bodily harm, and failure to comply, since May 9, 2008.
The inmate’s next of kin have been notified.

On April 8, 2022, Dany Bernatchez, an inmate from Atlantic Institution died while in our custody.
At the time of death, the inmate had been serving a sentence of 13 years and one month since January 19, 2017, for pointing a firearm, disguise with intent, robbery, uttering threats to cause death/harm, assault causing bodily harm, riot, hostage taking, prison breach with violence, break enter and commit, possession of a schedule II substance, prohibited weapon in vehicle, discharge of restricted/prohibited firearm with intent, intimidation of a justice system participant/journalist, failure to comply with probation order, mischief in relation to other property, conspire to commit indictable offence.
The inmate’s next of kin have been notified.

On April 14, 2022, Roger Mathurin, an inmate from Mission Institution died while in our custody.
At the time of death, the inmate had been serving an indeterminate sentence, which commenced on January 9, 1973, for second degree murder, manslaughter, and other offences.
The inmate’s next of kin have been notified.

On April 19, 2022, William Gordon Fell, an inmate from Bath Institution’s Regional Treatment Centre, died while in our custody of apparent natural causes.
At the time of death, the inmate had been serving an indeterminate sentence, which commenced on June 23, 2003, for second degree murder.
The inmate’s next of kin have been notified.

These reports of the deaths of 4 men in the custody of Correctional Service of Canada are from its web site’s home page, in a space allocated to also record newsworthy large seizures of   contraband entering its prisons.  Some time ago, CSC often and usually included the age of the deceased and a cause of death.  That is rarely the case now, but it continues to always label the person as “an inmate” along with the offences for which the inmate was convicted, the length of sentence and the date it began.  The notice always ends with “the inmates next of kin have been notified.”

There is no acknowledgement that the deceased was a person, perhaps with a partner or parents or siblings, was maybe a parent themselves.  CSC can claim privacy prevents some disclosures, although that information is as much a part of the record as what is published.  Or, perhaps CSC just sees inmates as objects warehoused in a cage, rather than clients of its correctional facilities.  No, one should not need convincing that we have a prison industry in Canada and not a correctional service.

)()(

Correctional Service of Canada averages about 58 deaths in custody every year.  There were 53 in the 2021 fiscal year, categorized as 5 murders, 9 suicides, 1 from unnatural (non-natural) causes, and 38 from natural causes.  Just what are natural causes?  A death by natural causes rules out everything external.  The deceased did not take their own life, they were not murdered, and they didn’t die in an accident or from a drug overdose. Death is due to a natural disease process like an infection, cancer, heart disease or all things that take a life.

According to Dr. David Fowler, president of the American National Association of Medical Examiners, “if I’m playing a sport and have a heart attack, or shovel snow and have a heart attack because I stressed myself, that’s natural.”  On the other hand, he added, if shovelling snow caused hypothermia, that could be considered an accident.

The average age of inmates whose death is attributed to natural causes is 60.  The Office of the Correctional Investigator wonders why CSC hasn’t learned from the statistics and developed strategies to prevent premature deaths.  One remedy of course is to treat sick inmates rather than neglecting sound medical practice in favour of putting budget and security interests ahead of lives.

)()(

Adelina Iftene, in her article, “Life and death in Canadian penitentiaries,” published in the October 2020 edition of Canadian Family Physician, points out that inmates over 50 (which is considered geriatric in our prisons) have higher rates of mortality and morbidity for most illnesses.  They experience a process of accelerated aging, have health problems of people 10 to 15 years older in the community, and a life expectancy of around 62 years, compared with the average of 82 years in Canada.

Prisons were never meant to be nursing homes, she says, and yet they are increasingly in that position, a situation that is inhumane, unethical, and legally problematic in her opinion.  This despite the obligation that Correctional Service of Canada must look for alternatives to prison infirmaries when someone becomes terminally ill.  Parole by exception is the only compassionate alternative and is a bureaucratic and lengthy process of little use to the dying.

Acetaminophen with codeine, and morphine are the only pain medications available, according to the CSC National Drug Formulary.  Dr. Iftene cites the example of an inmate with a stage 4 cancer who was transferred to a minimum security from a medium security institution for better care.  Because CSC policy demands new arrivals wait for assessments before meds are prescribed, this inmate was left in his cell for a week, screaming and sweating, with no pain medications at all.  Other inmates collected money to buy regular acetaminophen from the canteen in an attempt to give him relief.

)()(

As for suicides, the numbers in our federal prisons represents only a portion of inmates who are suicidal or ideate suicidal behaviour.   An inmate in distress who looks for help from CSC health care is more than likely to end up in a bare cell, wearing a “baby doll” that can’t be torn, and sleeping on a bare concrete slab until health care staff can be convinced that the urge has passed.  That’s constitute “treatment.”  Yet, CSC rightly claims its phycologists and psychiatrists take up a chunk of its health care budget, but exactly what they are doing and for how many offenders they are doing it is a question looking for an answer.

“They don’t care.”
Seasoned inmates know that underpins the who’s, why’s. where’s, what’s, and when’s of Correctional Service of Canada.
“They don’t care.”

……TO EXPECT ANYONE TO CARE

The College of Family Physicians of Canada’s 2016 overview of health care in jails/prisons had three key points.
1)  The health of persons who experience detention or incarceration in provincial, territorial and federal facilities is poor compared with the general Canadian population.
2)  Health status data can be used to improve health care services and health for this population, with potential benefits for all Canadians……The time in custody provides an opportunity to intervene.  (Emphasis is ours.)
3)  Information on health status is also important for defining areas of focus for improving health and health care…..the lack of data on some key indicators of health is striking.

The College recommended that provinces and territories transfer responsibility for inmate medical and mental health care from their ministries of justice to the ministries of health.  Similarly, delivery of medical and mental health care services in federal prisons be “separated completely from the Department of Justice Canada.”

Today, the CFPC continues to speak out on the care prisoners receive.

)()(

The Corrections and Conditional Release Act requires Correctional Service of Canada to provide health care to federal prisoners.  This was confirmed in law by Harnois v Canada (Attorney General) in 2010 when an inmate with multiple medical conditions went before the Federal Court to compel CSC to allow him to receive treatment from the same physician who looked after him in the community.

In part, the prisoner claimed a right to a doctor of his choice because the CCRA does not limit this right.  The Court decided that if legislators wanted prisoners to have a right to a doctor of choice, it would have been clearly indicated in the Act.  Further, the Court confirmed the Act makes an institution’s doctor the arbiter of an inmate’s health care.  The Court wasn’t asked to rule on limitations in CSC’s formulary but did find that available treatments met medical standards.

One last point to be taken from this decision is the Court noted the absence of a complaint or grievance from the inmate.  The inmate didn’t file a grievance against CSC over the treatment and care he received.  The grievance process is primarily a sop, of little importance or value offered to stop complaints or unhappiness, as one dictionary defines it.  Inmates should be warned though that this is a necessary step for the record, regardless of how little import it has.

)()(

Legal actions against Correctional Service of Canada citing health care deficiencies are ongoing and will persist, given that advocacy groups will join the lawsuits.  One that has attracted media attention began with 39-year-old federal inmate Michael Devlin, in custody since he was 17, who claims his care for a bad back was not up to medical standards while in custody at Atlantic Institution in New Brunswick, or Springhill Institution in Nova Scotia, or in Millhaven Institution in Ontario.  The John Howard Society has joined in the action because Devlin’s experience is shared by many prisoners helped by the organization.

Catherine Latimer, the Society’s executive director, said the statement of claim, filed with the Supreme Court of Nova Scotia, “indicates that he’s experienced the deterioration of his health and considerable amount of pain and suffering, as a result of the delays in his treatment, and the inadequacy of the treatment that he received.  We will be introducing evidence from prisoners from across the country who have experienced similar issues to Mr. Devlin.”

Latimer remembers the case of a prisoner who was in pain due to deteriorating hip joints and required hip replacements.  CSC told him the surgery was expensive and he would have to wait until he was paroled, even though he was not parole eligible for another 30 years.  Treatments are often delayed because health care for paroled inmates becomes a provincial responsibility.

Leandra Keren’s summation from her December 1^st Toronto Star column:  “Prisoners are denied their liberty, not their right to health care.  The inhumanity and injustice of excluding them from our universal health care protections and allowing them to suffer needlessly with inadequate medical services must end.”

Right?  Right!

Next:  Poor health care can lead to poor outcomes….including death.

 

……TO NEED HELP

When Kingston Penitentiary was still a prison years ago and not the tourist attraction it’s become, an inmate with a toothache followed procedure and filled out a request to see the dentist.  And then he waited, as is also a part of procedure with health-care in the prison industry.  And he waited.  By the time two other inmates were hospitalized and put on intravenous antibiotics because of delays in dental care, this inmate was in pain constantly.

His family had had enough, stepped up and wrote to the Assistant Commissioner, Health Services at the Correctional Service of Canada national headquarters in Ottawa.  She acknowledged the family’s concern, passed the information to the Deputy Commissioner at the regional headquarters in Kingston, who called the family with assurances that something would be done.  That’s not usual.  Does it pay to go to the top?

And something was done.  This prisoner was escorted to a dentist in the community, where an examination had the dentist concerned and distressed.  He told this man that he had been asked to only do an assessment, but he couldn’t believe that the prison had left him in the state he was in, and he would help him if he wanted.  Three teeth were removed, possibly four, and they were extracted in blackened pieces.  The inmate didn’t care; he only wanted relief.

)()(

This dentist knew the fault did not lie with dentistry.  He knew CSC contracted for a dentist to service inmates in the institution for a specified number of hours/visits per week, or month.  What couldn’t be done within those parameters was left undone.  And this community dentist couldn’t complain after seeing this patient.  CSC is a major employer in Kingston and his practice would easily be negatively affected if he spoke up.

“We believe that that’s really the crux of the issue.  When your jailor is your health-care provider, it creates an irreconcilable set of conflicts,” said Catherin Latimer, executive director of the John Howard Society of Canada.  “As the jailor, you’re preoccupied with security issues and fiscal issues, and those often trump the medical needs of the individual prisoner.”

The John Howard Society wants to see CSC out of the health-care business and care for federal prisoners delivered by those who provide health-care in the community under the Canada Health Care Act.  Having jailors deliver health-care inevitably leads to substandard and unaccountable care.  JHS is not the first to make this recommendation; the Office of the Correctional Investigator has chimed in over the years more than once.

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An active inmate in his mid-40s suffers a knee injury in the gym.  He thinks a few days rest is the solution.  The discomfort continues, he asks for help and is diagnosed with either a tear in a tendon or a meniscus by the institution’s doctor.  Surgery is the remedy.  That was almost three years ago.  COVID has negatively impacted hospital services, but restrictions are being lifted and hospital procedures have resumed.  This inmate recently had a virtual doctor’s appointment to revisit his untreated injury.  The doctor’s response was, “We’ll have to see what can be done about that.”

Leandra Keren, an articling fellow with the John Howard Society of Canada who was quoted in the previous entry, “Prison is no place to be unhealthy, sick or injured,” went on to write in her December 1 Toronto Star contribution from last year, “The fox is providing the hens with health-card…..In the eyes of CSC, medical staff, prescription drugs, and specialist consultations, all constitute major costs which detract from CSC’s budget…..This, along with the punitive culture of prisons, results in the mistreatment of prisoners through the denial of their health-care.”

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Did you know…..?
Offenders transferred to a federal prison are assessed by a nurse at reception.  Prescription and over the counter meds are discontinued pending a review by the institution’s doctor.  An inmate does without while waiting. 
Correctional Service of Canada has its own formulary, a list detailing the medicines that may be prescribed.  A doctor cannot prescribe meds the list doesn’t cover which can have a negative impact on treatment options.  As one example, consider the range of drugs available for bi-polar disorder.  Patients may not respond well to one drug, or may get relief for a time, and alternatives are a necessity.  At CSC, only limited meds may be authorized.

Did you know…..?
An inmate who has a complaint against the health-care received from a doctor or a nurse in a federal institution cannot file a complaint with the regulatory colleges for either profession. By doing so, that nurse or doctor against whom the complaint is made cannot continue to treat a patient filing the grievance.  That inmate then has no health-care at all until the matter is resolved.

Next….there’s always a next with prison health-care.

……TO BE UNHEALTHY, SICK, OR INJURED.

Health care services in our federal prisons have been skewered here before, just as what Correctional Service of Canada passes off as essential care for offenders has and is also harpooned by its many critics.  And while health care consistently invites the greatest number of complaints from inmates, the Service continues to follow the beat of its own drummer in the face of recommendations that would improve outcomes and reduce costs.

One can wonder why.  Well, perhaps not.  Speculation infers troublesome scenarios suggesting CSC has interests that trump its mandate to work for a successful reintegration of prisoners back into the community.  No matter.  Voices of concern will persist, knowing a day of reckoning will come.  Hell will freeze over.

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The Canada Health Act specifically excludes federal prisoners from its definition of “insured person.”  The Corrections and Conditional Release Act assign Correctional Service of Canada (CSC) the obligation to ensure prisoners receive essential health services and care contributing to rehabilitation and social reintegration.  CSC is self-insured for health care services.  It’s both insurer and hospital.  Funding comes from its budget.  As Leandra Keren wrote in a Toronto Star contribution last December, this “result(s) in a health-care standard that is woefully inadequate inside our federal prisons.”

She went on to note that prison populations have more severe needs….high rates of addiction and other mental illnesses, high HPV rates, chronic diseases, and conditions connected to aging.  “….federal prisoners wait months to see a physician who may not believe in employing a harm reduction approach to treating addiction, or who denies you a prescription that you’ve been taking for decades before arriving at prison due to pressure from CSC surrounding cost and security.”  In practice, this means the prisoner is at the mercy of the health services CSC provides.

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An inmate fills out a request form asking to see a doctor, dentist, nurse.  Then the wait.  The wait may generate a second request.  Hopefully, the inmate is taken to health services before either their release date or death, whichever is first.  In one instance a few years ago, an inmate asked a nurse what they do with an urgent or emergency request.  “We don’t pay attention to that,” she told him.

A report released last year authored by academics Jane B. Sprott, Anthony N. Doob, and Adelina Iftene on prison solitary confinement practices included a comment that applies to the whole prison arena.  “Many Canadians do not care how our prisoners are treated.  They are seen simply as people who committed offences.  But Canadians should care if they care about human rights; or if they care that a government organization is being allowed to operate outside of the law.”

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Prison health care earns severe scrutiny.  There’s more to come next time.

A POSTSCRIPT to “Prisons & Racism” from October 10, 2021:-

“CSC management and staff treat racialized staff as though they are inmates, and not like equals.”

Well, that’s a mouthful.  It’s from the statement of claim supporting a proposed class-action lawsuit against Correctional Service of Canada by its own employees, filed on January 11 of this year.  According to the plaintiff’s lawyer, Aden Klein, his firm has been contacted by many potential class members.  “It seems that the racism is so widespread that there are a countless number of people that are affected,” he said to Global News on January 28.

Correctional Service of Canada’s response included, “racism and discrimination have absolutely no place in our society,” and, “CSC does not tolerate these behaviours and is committed to providing a workplace that is healthy, supportive and free of harassment and discrimination.”

The lawsuit must be certified by the court if it can proceed, and that can often take from one to three years.

Imagine.  If CSC’s staff feel compelled to act against their employer, what does that say about how CSC treats inmates, and racialized inmates particularly?

Nova Scotian social worker Robert Wright was asked by the defence back in 2014 to testify at the sentencing of a 16-year-old Black offender for attempted murder after he shot his 15-year-old cousin in the belly.  The prosecutor argued against allowing the testimony, claiming Mr. Wright wasn’t qualified as an expert.

Justice Anne Derrick, then of the Nova Scotia Provincial Court allowed him to speak. She cited his qualifications as a past executive director of the province’s child and youth strategy, as a PhD candidate in social work and as an instructor at Mount Saint Vincent University.

He is also coincidentally a seventh- or eighth-generation Black Nova Scotian and knew from his life’s experience that he was qualified to speak on behalf of the convicted offender.  One of six children raised by a single mother, a mostly absent father, witness to domestic violence and alcoholism, a celebrated athlete sister murdered in her mid-20s and a brother who did time for robbery made him ‘expert’ on the topic he addressed.

What Robert Wright wrote in an assessment and said in court was that the prosecution’s depiction of the 16-year-old as a hardened and remorseless criminal, a conclusion supported by several psychological assessments as an unsalvageable youth necessitating a long adult prison sentence, missed one pertinent point:  what it means to grow up Black in Nova Scotia.  After considering the family history, the “racial trauma” pervasive in the African-Canadian community because of mistrust, rivalries and violence, the judge sentenced him as a youth, noting an adult sentence would most probably give him little chance at rehabilitation.

Mr. Wright’s testimony was the first of its kind for Black offenders in the province and it led to more race-based reports, by him and other clinicians, triggering changes in the sentencing of Black offenders.  By the summer of 2021, Nova Scotia’s top court issued a 5-0 ruling written by that same Justice Derrick, telling judges in the province to consider the race-based issues of Black offenders at sentencing, or risk having their sentences thrown out on appeal.

With federal government funding, what are known now as Impact of Race and Culture Assessments are about to spread across the country.  Provincial courts aren’t required to give special consideration to Black offenders, and while accepted as important and helpful, Ontario courts for instance underscore that offenders do exercise free will.

Just as Gladue Reports offer some guidance when determining the fate of indigenous offenders, Impact of Race and Culture Assessments will do much the same for Blacks caught up in the criminal justice system.

Keeping people with a potential for redemption out of the hands of the prison industry benefits us all.

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“Stymied, Stigmatized and Socially Excluded”, a 2020 report released by the Community Advocacy & Legal Centre located in Belleville in eastern Ontario, is a study conducted on the civil legal issues confronting people released from the Quinte Detention Centre.

The challenges there for people released from that provincial institution are mirrored across the provincial/federal prison industry spectrum from coast to coast.  How does a person with a criminal record steer a path through a labyrinth of social and civil legal issues from housing to employment to income assistance to counselling to potent and timely mental health/addiction programs to discrimination and harassment?  How does a person avoid the ripple effect of a criminal record, stuck in a cycle of recidivism and poverty, one door after another shut in their faces?

The John Howard Society of Ontario, prompted in part by the Belleville study, developed a resource for use by front-line workers assisting people released back into the community who almost always also need help dealing with multiple problems related to their criminality and for which they didn’t know help was available.  “Knowing your rights is very important,” said a peer counsellor with the JHS Ontario’s York Region office.

jhslearninghub.ca is accessible by anyone, and though intended for front-line workers at the John Howard Society and other community service agencies, it’s designed to be easily understandable and useful to family, friends, and supporters of offenders before, during and after incarceration.  Yes, this is on Ontario initiative, but is or will be replicated across the country.

Next – Oh no, it’s still not safe to get sick or get hurt in prison!