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Response from the Correctional Service of Canada Response to the Annual Report of the Correctional Investigator 2005-2006

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PRIORITY 4 – MENTAL HEALTH
Improved capacities to address mental health needs of offenders

There are an increasing number of offenders with mental health disorders, and mental health problems are up to three times more common in correctional institutions, than among the general population. Consequently, CSC needs to provide a full-spectrum response to the broad and multi-dimensional mental health needs of the offender population.

To this end, CSC has developed, and is working toward the implementation of an overarching multi-dimensional Mental Health Strategy. CSC has been successful in securing funding to implement the Community Mental Health component of the Strategy.

However, funding will be required to fully implement the remaining components. Currently, CSC is working in collaboration with other government departments to secure this funding as part of an inter-departmental process to strengthen mental health in Canada.

CI’s Recommendation 2:

I recommend that the Correctional Service demonstrate compliance with its legal obligation to provide every inmate with essential mental health care and reasonable access to non-essential mental health care according to professionally accepted standards, and that all mental health care units and regional treatment centres be accredited within one year.

CSC’S RESPONSE:

CSC will continue to provide every inmate with essential mental health care. However, CSC is currently limited in its capacity to improve mental health care without a significant increase in funding.

CSC agrees with the recommendation that all treatment centres should be accredited and currently four of the five regional treatment centres are accredited.

CSC has a comprehensive Mental Health Strategy to improve mental health service delivery. The proposed Strategy is a full-spectrum response to the mental health needs of offenders and provides a coherent national approach:

  1. thoroughly screen all offenders, fully assess those showing signs of mental disorders, develop formal treatment plans as appropriate, and gather information on the true nature of mental health problems for federal inmates;
  2. provide treatment to inmates suffering mental health problems using dedicated primary mental health care teams in all CSC institutions;
  3. create intermediate care mental health units in selected men’s institutions, to provide more specialized mental health care treatment to those inmates requiring daily support in a safe and secure environment;
  4. upgrade staffing and facilities at mental health treatment centres to bring them to the level of psychiatric hospitals with respect to care for inmates with acute mental health problems; and
  5. continue to provide comprehensive support to offenders in the community to ensure their safe reintegration.

The community portion of the Strategy is funded and underway while CSC seeks funding to implement the remaining portions of the Strategy.

It is expected that the community portion of the Mental Health Strategy will enhance reintegration for offenders with mental health problems by increasing the options for mental health support and intervention in the community thereby increasing reintegration success and public safety.

With regard to regional treatment centres, Shepody Healing Centre is the only remaining unaccredited treatment centre and is targeted for accreditation in 2008.

With respect to women offenders, an eight-bed Structured Living Environment (SLE) house is located at each women offender institution to address the needs and risks of women who have mental health problems and are classified at minimum and medium security levels. The SLE has 24-hour supervision and an inter-disciplinary team who receives additional training including specialized mental health training. In its September 2005 inspection at Nova and Grand Valley Institution for Women, Her Majesty’s Inspectorate of Prisons for England and Wales highlighted the SLE’s as being an impressive model. For women who require intensive mental health care intervention, CSC has a separate unit for women at the Regional Psychiatric Centre (Prairies) and at l’Institut Philippe Pinel de Montréal.

CI’s Recommendation 3:

I again recommend that the Service take immediate steps to sensitize and train all front-line staff to appropriately identify disruptive mental health behaviour and respond accordingly.

CSC’S RESPONSE:

CSC’s Mental Health Strategy reinforces its commitment to training staff in this area, and to assist staff to achieve and maintain the level of competence required to carry out their duties.

Training for front-line staff in the identification and response to behaviour arising from mental health issues is currently in development. Institutions will be encouraged to include the mental health training module in their existing training plans while CSC seeks additional resources to allow for a formal delivery strategy to be developed. The delivery of the training to all front-line staff is contingent on having adequate funding, given that the funding required far exceeds financial capacity at this time.

As part of the Community Mental Health Initiative, the staff of parole offices, Community Correctional Centres (CCCs) and Community Residential Facilities (CRFs) will receive annual mental health training, beginning in fiscal year 2006-07. In addition, staff of the CRFs for women offenders will also receive additional mental health training this fiscal year.

As well, all front line staff and all staff in the Structured Living Environments in the women offender institutions are trained in Dialectical Behaviour Therapy (DBT), which targets emotion dysregulation and the various behavioural difficulties associated with it.

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