Opinion

‘It’s hell for inmates in there’: COVID precautions in prisons are worsening mental health

The injustices and mental health issues exposed in our correctional-services facilities during the pandemic are only the tip of the iceberg.

While rates of mental illnesses were four to seven times higher in prisons than in the general population before the COVID-19 pandemic struck, these alarming statistics have been exacerbated by the response in our prison systems and its effect on racialized groups. Indigenous and Black adults comprise 23 per cent and 9 per cent of federal offenders, respectively, yet only 4.3 per cent and 3 per cent of Canada’s population. Not only are these groups overrepresented, but many do not have access to appropriate, culturally sensitive supports required while in custody.

Canada’s current correctional-services facilities encompass several types of institutions. Provincial jails are for those awaiting trial, many of whom are unable to afford bail or alternate legal aid; those have been found guilty and sentenced for two years less a day or less; and sometimes immigration detention. Federal prisons house those who have been found guilty and sentenced to two or more years.

Class-action lawsuits against the Correctional Service of Canada (CSC) on behalf of federal prisoners aim to address CSC’s inadequate COVID-19 response as well as the ongoing utilization of segregation practices. According to a report published by the Office of the Correctional Investigator (OCI) in February, the rate of COVID-19 infections in Canadian federal prisons is approximately 10 per cent – five times higher than the rate among the general population during the same period. In provincial institutions, the situation is similarly bleak with more than 1,200 inmates in jails across Ontario testing positive for COVID-19 since December 2020. Even more alarming is the emergence of new outbreaks linked to variants of concern in correctional services facilities.

The downstream consequences of COVID-19 precautions in jails and prisons have been largely ignored. Lockdowns in prisons and jails have meant that inmates are stuck in their cells with other inmates for days at a time.

Current inmates and family members emphasized how COVID-19 has drastically amplified existing inequities at a February town hall held by Think 2wice, a grassroots organization based in the Greater Toronto Area (GTA) that advocates for culturally relevant programming across all correctional services facilities and supports individuals and families through art-based programming, mentorship supports and advocacy work. The town hall, entitled the State of Corrections (SoC), connects community advocates, those with lived experiences at incarceration facilities, and their loved ones.

At the SoC, Mr. X, whose name we are withholding to protect his privacy and who is currently awaiting trial at the Toronto South Detention Centre (TSDC), described the inadequate control, prevention and management of COVID-19 cases, as well as the implementation of lockdown measures that have heightened anxiety and fear at these institutions.

As Mr. X described, “When the big outbreak happened, we were locked down … we only got out for 20 minutes a day for a shower; and that’s not every day, that’s every two days, every two to three days.” Further exacerbating the isolation, in-person visits have been restricted since the beginning of the pandemic, and at some institutions, even video visits have been limited.

This concern was also brought up in the OCI’s February 2021 report, in which nearly 500 inmates complained of limited access to fresh-air exercise and yard time. In some instances, prisoners not in “medical isolation” were nonetheless kept on excessive and extended lockdowns in cells for up to 23 hours per day.

These conditions mirror solitary confinement, which Canada’s Bill C-83 abolished in 2019. Solitary confinement has been demonstrated to lead to long-term and debilitating trauma and psychological suffering.

While infection control through isolation and segregation remains at the forefront of many policies, the detrimental effects of isolation on an individual’s mental health cannot be overlooked. A recent study identified the increased risk of adverse mental health outcomes including depressive, anxiety and stress-related disorders in addition to elevated levels of anger in individuals isolated for one week or longer compared to those who were not isolated. Moreover, there are concerns that pre-existing mental health disorders may be exacerbated by isolation and quarantine in correctional facilities.

The situation in Canada’s prisons and jails requires urgent attention. The perpetuation of collective inequities, excessive lockdowns and inadequate measures being taken to prevent, manage and care for incarcerated individuals affected by COVID-19 are compounding to repetitively convey one message to inmates – your mental health and well-being are not valued.

Mr. X’s story represents just one of many detailing the devastating impacts of COVID-19 on the well-being of those in Correctional Services facilities.

This narrative must be shifted. We have a responsibility as current and future health-care providers to advocate for these individuals.

We urge readers to engage with Think 2wice’s ongoing initiatives, including its SoCs, to better understand the diverse perspectives of individuals impacted by COVID-19 in incarceration systems. We encourage readers to write letters of advocacy and support to local policy-makers outlining the current situation at correctional-services facilities.

In addition, we call on our federal and provincial public health institutions to collect comprehensive data on incarcerated populations. We require evidence-based reports to corroborate the multitude of lived experiences inmates have shared and provide greater transparency on the COVID-19 situation in incarceration systems. This includes race-based data to better understand the impacts of COVID-19 on overrepresented and marginalized populations. We advocate for the establishment of an independent third-party complaints department so that inmates feel safe to voice concerns without fear of retaliation.

Finally, we implore federal and provincial governments and the CSC to recognize the impact of inadequate COVID-19 policies and practices on the mental well-being of inmates. To do so, we propose a collaborative effort by local and federal correctional oversight bodies to provide free hygiene products, sanitizers and personal protective equipment for all inmates, increased access to sunlight and fresh air, the abolishment of excessive lockdowns, and ultimately, the humane treatment of inmates that is cognizant of their intrinsic human rights.

As Mr. X concluded at the SoC, “It’s hell for inmates in there. That’s all I have to say.”

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Authors

Juweiriya Ahmed

Contributor

Juweiriya Ahmed is a second-year medical student at the University of Toronto. She completed both an Honours Bachelor of Science in Neuroscience (2017) and a Master of Science in Neuroscience (2019) at Western University.

Kevin Jia Qi Chen

Contributor

Kevin Jia Qi Chen is a second-year medical student at the University of Toronto. He completed a Bachelor of Health Sciences at McMaster University (2019).

Dorothy Qian

Contributor

Dorothy Qian is a second-year medical student at the University of Toronto. She completed a Bachelor of Health Sciences at McMaster University (2019).

Laura Diamond

Contributor

Laura Diamond is a second-year medical student at the University of Toronto. She completed an Honours Bachelor of Arts and Science in Cognitive Science at McGill University (2018) and a Master of Science in Global Health at McMaster University (2019).

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