From the equality of rights springs identity of our highest interests; you cannot subvert your neighbor's rights without striking a dangerous blow at your own. Carl Schurz

Friday, July 1, 2011

Canada's largest mental health institutions: Prisons

Decades ago recognizing that the institutionalisation of the mentally ill was cruel,unjust and counter productive, we started closing these facilities and embarked on a policy of community care.Well it appears that we have come full circle.

The numbers are sobering, from the annual report of the Office of the Correctional Investigator of Canada, the number of mentally ill offenders in the federal prison system has more than doubled in the past decade, with approximately 36% of male prisoners and more than 50% of female inmates showing some form of mental health issues.

Because of their illness, prisoners with mental disorders are more likely to run afoul of prison rules, which often leads to institutional charges and long periods in segregation. Segregation is particularly harmful to those dealing with mental health issues as Howard Sapers, the Correctional Investigator of Canada.states in his report.

In the past year, I have been very clear on the point that mentally disordered offenders should not be held in segregation or in conditions approaching solitary confinement. Segregation is not therapeutic. In too many cases, segregation worsens underlying mental health issues. Solitary confinement places inmates alone in a cell for 23 hours a day with little sensory or mental stimulation, sometimes for months at a time. Deprived of meaningful social contact and interaction with others, the prisoner in solitary confinement may withdraw, «act out» or regress. Research suggests that between one-third and as many as 90% of prisoners experience some adverse symptoms in solitary confinement, including insomnia, confusion, feelings of hopelessness and despair, hallucinations, distorted perceptions and psychosis.

The United Nations Human Rights Committee has said that the practice may, in some instances, be a violation of international law, amounting to cruel, inhuman or degrading treatment or punishment.

The use of prolonged segregation for managing prisoners can rarely be justified. There is growing international recognition and expert consensus that the use of solitary confinement should be prohibited for mentally ill prisoners and that it should never be used as a substitute for appropriate mental health care.

“We are primates, we are made to socialize, but in segregation you have no contacts, you can't speak to anyone. My friend died three months ago, he hung himself in the hole. Now I am in the hole. Sometimes you look at what you got and take it from there. If all you have is boredom, sometimes just getting excited and creating commotions (see Ashley Smith) is better than nothing. I am starting to crack... I am so bored and so cut off from interaction I can't take it anymore. I can't even see another man's eyes when I speak to him, can you imagine what that feels like?”
(A segregated maximum security offender in his own words, November 2009.)

Some more sobering numbers. In some maximum security institutions, as much as a third of the population can  be in segregation.There were over 7,600 placements in administrative segregation in 2008–09. The average number of accumulated days in segregation is 95. The long-term segregation population (over 120 days) is growing, and snapshot data from April 12, 2009, shows that 177 inmates had spent more than 120 days in solitary. Close to 40% of inmates spent more than 60 days in segregation. This would test the sanity of even the most stable of minds,add in mental health issues and the end result can only be one of greater harm.

Segregation isn't the only form of abuse in our prison system, as we have seen in the Ashley Smith case some of the techniques used to restrain prisoners who are "acting out" border on torture. I like many Canadian am outraged by her treatment, but in case you think that this may have been an isolated case, here is a case summary from the report. What you are about to read is to me anyways reminiscent of Abu Ghraib and Guantanamo Bay. 

Case Summary: In the period just prior to conditional release, a female offender engages in a number of self-harming incidents that increase in both severity and duration. Despite documented mental health concerns and poor institutional adjustment, she spends the vast majority of her sentence in segregation. On almost every occasion of self-harm, her behaviour is met with overly restrictive, punitive and security-based interventions that often necessitate use of force, including the adoption of the standing control restraint technique to manage her. (This technique requires the offender to stand, in leg irons and high profile rear wrist locks, until self-injurious behaviour ceases, which can be hours.) In this case, pressure was applied to the rear wrist locks to induce discomfort when she was not compliant or had attempted to drop to the floor. Despite a number of consultations between Region and National Headquarters on the best method/ technique to restrain this offender from self-injuring, it appears that a comprehensive clinical management plan to address this offender's chronic mental illness was never fully implemented. Significantly, the challenging “adjustment” behaviours that this offender presented while in custody have virtually ceased since her conditional release into the community.

I seems clear to me that we don't need to build more prisons, instead what we need to do is invest in mental health in a very significant way. Do this and not only will we be doing the right and proper thing but at the same time freeing up space in our prisons eliminating the need for more prisons even as Harper and his gang ramp up the already too high rate of incarceration in this country.Would this not be a better use of our tax dollars?


  1. We emptied our asylums but our motives weren't as altruistic as we claimed. The "community care" alternative was never as well funded or as viable as we had hoped. A lot of the more deeply disturbed, truly insane, became street people who recoiled from rather than embrace social services. We failed these people and we're still failing them.

    With genuine reservations I believe we must revisit the role of the state in mental health care and establish proper diversion mechanisms to keep these people out of prisons where they truly don't belong.

  2. MoS I lived near the Queen st hospital at the time and can echo your comment that the out patient service were nonexistent.

    The neighbourhood was flooded with ready made victims and those who would victimize them, Hence my interest in the subject.

    We can and must do better.

  3. There's a history of the former Toronto Asylum available from Amazon, TROPING THE ASYLUM: AUTHORS AND AUTHORITIES AT THE TORONTO ASYLUM. It's $20, but there's a cheap kindle edition for $3 that you could read on your computer (if you don't have a Kindle). It suggests that what's going on at CAMH right now (big non client-centered developments spear-headed by the CLARKE's "HEAD HUNTERS"), was a long time coming, but come it did (unfortunately).

    While you're at it, you might like to take a look at THE SUPPORT WORKER OF EMILE DURKHEIM HOUSE, at the same place....

    Yes, who can do better!

  4. Hi Anon Thanks for the tips

  5. Thanks for this. I used to live a block or two from 999 Queen West (after the renumbering). I heard horror stories about the abuse of patients in the building; it seems their eviction has only resulted in different abuses.

    1. Yeah I grew up in Parkdale where many ended up The bastards were lined up to exploit these folks They had little to no support