Vulnerable populations take many forms in Canada. These populations range from persons with chronic illness, indigenous people, immigrants to our country, our children, and those will mental illness. Imagine being a person with any of these factors that make you vulnerable and finding yourself in a prison system. The stressors are now magnified and resources are less and less. No longer is there the advocacy of family, community groups, or your health professional. You are left to maneuver a new system, also topped by the fears of prison life.
Canadian prisons have been under scrutiny these past few years for the access of health services for those inmates suffering mental illness. New headlines are filled with story after story that speaks of crowded prisons, lack of programming, lack of access to health care professionals and overall very poor conditions. Inmates recount isolation for days and days in what they refer to as the SHU (special handling unit), a place where day is night, night is day, and there is no interaction with anyone. Imagine the feelings for those with existing mental illness, and for those persons who are aware of suffering inmates and have no ability to help.
According to the John Howard Society,( Fact Sheet retrieved March 21 2019) a group that assists persons who have been in prison, they report that 21.3% of male inmates had been prescribed psychiatric medication. Corrections Canada,( Mental Health Strategy for Corrections Canada, retrieved March 20 2019) states that on average, 11-13 federal inmates commit suicide annually, which is approximately 7 times higher than the national average. They also report rates of mental illness in men average 28% and rates for women needing further psychiatric evaluation is 62% It is interesting to note that the literature finds no difference in these statistics for aboriginal and non aboriginals. To say that our prison systems need access to better mental health services is an understatement.
It is interesting to notes that the Canada Health Act ( CHA),a federal legislation for publicly funded health care in Canada does not extend to federal prisons. This act ensures all the provinces and territories have commonalities and basic standards of coverage across out country yet Corrections Services Canada (CSC) has the sole responsibility to provide health services of all federal inmates. What a massive undertaking.
The Canadian government has been taking a deeper dive into the Mental health needs of its citizens, as well as the provision of services to the prison population. The Mental Health Commission of Canada (2017) has laid out a framework for the provision of mental health interventions/treatment. This document is rooted in patient centered care and the principles that people need to be able to help direct their care. It considers the needs of the indigenous population and provides guidance for work within that group. There is also a Senate committee that has reviewed Mental Health services in Canada. This report addresses items like the establishment of the Aboriginal Healing Foundation to address issues specific to that population.
Why am I referencing these trends in the country when we are talking about prison care? CSC has been developing their strategy to manage the people who enter their doors with mental illnesses, they have been working with groups and taking guidance from documents as listed above. They are addressing their assessment period, treatment options, prisoner safety against self harm, staff education and strengthening community partnerships. All these lines of business must be addressed to help the person as the core of this issue, our vulnerable population; the man, woman, child, aunt, uncle, friend, brother or sister who happens to find themselves in prison, with a mental illness or any other factor that increases their vulnerability. While CSC may be responsible for the healthcare services of inmates, there is nothing in the literature that says they cannot use the resources of the public system, follow care plans that exist in communities, and use the expertise of others who are working with the mentally ill in our communities’ and follow these strategies that are there for the general population. These people will be released to our communities and our families, and we need to help ensure they are physically and emotionally well when this day arrives.
References
Advancing the Mental Health Strategy for Canada ( 2017-2022) https://www.mentalhealthcommission.ca/English/who-we-are/annual-report/framework-action-2017-2022 Retrieved March 22 2019
Mental Health Strategy for Corrections in Canada https://www.csc-scc.gc.ca/health/092/MH-strategy-eng.pdf Retrived March 19 2019
Out of the Shadows at last, Transforming Mental Health, Mental Illness and Addiction Services in Canada The Standing Senate Committee on Social Affairs, Science and Technology https://sencanada.ca/content/sen/committee/391/soci/rep/rep02may06part5-e.htm#_Toc133223332 Retrieved March 20 2019
Corrections Canada presentation : http://www.oci-bec.gc.ca/cnt/comm/pdf/presentations/presentations20120318-eng.pdf Retrieved March 19 2019
John Howard Society Fact Sheet, https://johnhoward.ab.ca/docs/factsheets/FactSheet110402-PrisonsAndMentalHealth.pdf Retrieved March 19 2019
Scheyett A, Vaughn J, & Taylor MF. (2009). Screening and access to services for individuals with serious mental illnesses in jails. Community Mental Health Journal, 45(6), 439–446.
Willmott Y. (1997). Clinical. Prison nursing: the tension between custody and care. British Journal of Nursing, 6(6), 333–336.
Commentaires