Three years ago last month, 19-year-old Ashley Smith wrapped a ligature around her neck, cutting off her flow of air. The teen, who had a long history of mental health issues, died on the floor of a dark segregation prison cell in Kitchener, ON.
First jailed at 15 for throwing crabapples at a neighbourhood postal worker, Smith racked up a series of minor offences while in custody, expanding her sentence from four months to four years. Before committing suicide she had tried to harm herself in 168 documented incidents. In the year leading up to her death, the Moncton, N.B. teen had spent over two-thirds of her prison time in segregation.
In a report released this spring, Canada’s correctional investigator Howard Sapers called Smith’s death “preventable”, saying that it was “the inability of federal and provincial health-care and correctional systems to provide her with the care, treatment and support she desperately needed.”
The issue of mentally ill offenders in Canadian prisons was something Sapers had sounded alarm bells about before. But Smith’s death, he said, put everything into sharper focus.
Sapers is a serious man. His previous political experience as a member of Alberta’s Legislative Assembly comes across in his steady speech. This is a man who chooses his words carefully. These days, he’s paid to be critical of the country’s federal penitentiaries, investigating grievances, pointing out systemic flaws and making recommendations to the Correctional Service of Canada (CSC), and, in turn, the federal government.
In a recent interview, Sapers said that too many Canadians with mental illness end up in prisons, and once they’re there, the system is failing to meet their needs.
Sapers is quick to point out the situation is not the making of our corrections system. “The prison system does not choose its clients,” he said. “The correctional service receives what the police and prosecutors and courts send it.”
On Monday, Sapers tabled his annual report on Parliament Hill. In its pages, he shines a glaring spotlight on the increasing “criminalization of the mentally ill”, whereby pathological behaviors become crimes and produce convictions, and the failures of a system that, he admits, was never intended to manage them in the first place.
The report outlines how the number of offenders with significant mental health issues behind bars has doubled in the past five years, now making up 12 per cent of the prison population. One in four inmates is currently taking prescribed medication for a psychiatric condition.
The situation is most dire amongst women, with over 30 per cent having previously been hospitalized for psychiatric reasons. According to the report, federal prisons are now warehousing the largest psychiatric populations in the country, with very little capacity to treat underlying mental health issues.
“Criminalizing and then warehousing the mentally ill burdens our justice system and does nothing to improve public safety,” says the report.
Sapers argues that a few issues have combined to create the burgeoning problem of the mentally ill behind bars.
“The first is that we’re seeing an increasing number of mentally ill offenders being sentenced to federal penitentiaries. The second is that the capacity to treat those people, to deal with their illness, has not increased at the same rate as the demand for those services has increased.”
Many criminal justice experts have argued that trends in recent decades to de-institutionalize mental hospitals, resulting in the closing of thousands of psychiatric beds across the country, has contributed to the flux.
“There are people in need of long-term treatment and hospitalization who aren’t getting it,” said Dr Helen Ward, clinical director of the forensic service at the Royal Ottawa Health Care Group. “They end up on the street, they start acting out or doing something illegal, or even something considered a nuisance, and they end up getting arrested and thrown in prison.”
It’s an issue public safety minister Peter Van Loan has addressed as well. “Over the past three decades, we have progressively moved toward a community and outpatient system of de-institutionalizing the mentally ill from provincial facilities, only to discover that we are re-institutionalizing them as prisoners,” Van Loan said during a standing committee on public safety and national security this spring.
Having been sent this vulnerable population in greater numbers, prisons are grappling with how to best manage them.
Craig Jones, prisoners’ rights advocate and executive director of the John Howard Society, admits that meaningful change within prison walls is difficult because its counter-intuitive to what we as a society think prisons ought to be. “Prisons are essentially about security, so every other issue has to be subordinate to that,” he said.
Sapers agrees. “If you have a population of offenders who are locked up, held in segregation and have restricted access to the outside where community members come in contact with prisoners less frequently, then running the prison is actually a little bit easier.” He adds that Canada’s prisons have been “hardening” in this way for quite some time now.
Sapers advocates for what he calls “dynamic security,” a balancing act between security concerns and concentrating on helping people to eventually cope in open society.
“What we know about correctional practice is that offenders will come back to prison less frequently when they are held in an environment that is constructive. Where their physical and mental health needs are addressed, and where they have access to programs that deal with the issues that brought them into conflict with the law in the first place,” he said.
The CSC declined a request for an interview. But did say in an email that one of their key corporate priorities in the last few years has been to improve their capacity to address and treat the mental health needs of federal offenders.
For Sapers, these initiatives could go a long way if there were resources allotted to back them up. “There is a thrust to build up program capacity and to get inmates into programs more quickly … Correctional Services Canada has about a $2.3 billion budget. It spends about 2 per cent of its budget on correctional programs. I don’t think that represents a very good balance between security and correctional treatment,” he said.
Dr Stan Yaren, President of the Canadian Psychological Association, has considerable experience working with mentally ill offenders. “Corrections has recognized this and they have made serious attempts to deal with it. But in terms of trying to develop a policy of initiatives to deal with it. The experience I have of being in the system is that these initiatives have fallen short in terms of implementation. It’s due to poor resources, but also in part to a lack of integrated planning.”
Both Sapers and Yaren say there needs to be a greater emphasis placed on recruiting and retaining qualified mental health staff, and more resources devoted to bringing together a variety of social services that could provide a more strategic approach when dealing with mentally ill Canadians who come in contact with the law.
This September, Ashley Smith’s family launched an $11 million lawsuit against the federal government, who, they say, is responsible for her death. Her mother, Coralee Smith, will never get her daughter back.
For Sapers, the system “must and can do better.”
