Canada’s prisons have become the “asylums of the 21st century”. Yet despite evidence from the Mental Health Commission of Canada that the current criminal system is failing to address mental illness in our prisons, the Government of Canada continues to push a “tough on crime” agenda.
According to a report from the federal prison ombudsman, “10-12% of offenders entering the federal prison system have a significant mental-health problem.” Yet the report states that “serious funding, implementation and accountability gaps are hindering the delivery of mental-health services behind bars.”
The Canadian Psychiatric Association has also raised serious concerns that the “tough on crime” agenda and legislation in last year’s omnibus crime bill (Bill C-10) ignored the underlying issue of addressing the problem of mental illness in our prison systems. Despite calls for inclusion of mental health supports in the Bill C-10 debates, no action was taken.
Since 2007, Correctional Services Canada has made multi-million dollar investments to help better address mental illness in the prison system using a range of strategies, including: voluntary intake screening and assessment for mental illness; primary mental health care within correctional facilities; intermediate care in an "accommodation unit" where offenders "can still work on their correctional plan, but have the treatment and support they need to manage their illness"; intensive care regional treatment centres for offenders with acute mental disorders, such as schizophrenia; and transitional care that would "ensure continuity of care once they [offenders] left the institution."
Yet despite these investments there remain serious gaps. A CMAJ report called “Agony behind bars” suggests that over the past five years improvements have been made in diagnosing mental illness in prisons, but significant barriers to treatment persist, especially for the most severely ill inmates.
Canada's current focus on prioritizing incarceration over mental health supports and rehabilitation fails those of our nation’s mentally ill who end up in the criminal justice system. For many of these individuals, prison is their first entry point to accessing any form of mental health service. Providing better mental health care in prisons will not only provide these individuals with the treatment they need, it will improve public safety by addressing the underlying conditions that may have contributed to their incarceration; conditions that can lead to re-offence if left untreated.
Government silos are preventing better coordination between the health and justice sectors, and political ideology is allowing these problems to fester and grow. But we have a roadmap for addressing these problems. The federal prison ombudsman has identified gaps in the Correctional Service of Canada’s mental health framework and has recommended a series of measures where urgent progress is necessary. It is time to take action on these recommendations. It is time for us to invest as much in addressing mental illness in our criminal justice system as we are in getting “tough on crime”.
Lori Kleinsmith is a health promoter at Bridges Community Health Centre (CHC) in the Niagara region of Ontario. Follow Lori on Twitter @LoriKleinsmith