The federal Office of the Correctional Investigator (OCI) has released a review of Correctional Service of Canada’s (CSC) mental health strategy. The report is an investigation of federal offenders’ access to mental health care and the quality of the care they receive.
The review, conducted from April to November 2009, examined six areas that form the basis of CSC’s continuum of care, including intake, primary care, intermediate care, tertiary care, community care and staff development. Mental health human resources, governance and administration, stigma, and discrimination are also explored.
The OCI report notes that mental health and health care services for federal offenders is not covered by the Canada Health Act, Health Canada or provincial and territorial health services, and therefore, CSC assumes this responsibility. Information from the CSC indicates that prevalence rates for mental health issues among federal offenders is growing and significantly exceeds that of the general population. At admission, 11 percent of federal offenders had a mental health diagnosis, 21.3 percent were prescribed psychiatric medication and 14.5 percent of male offenders had a past psychiatric hospitalization. Female offenders are twice as likely as male offenders to have a mental health diagnosis at admission. The suicide rate for federal offenders is more than seven times the Canadian average, while the number of serious self-harming incidents in prisons is rising. The report also notes that the mental health care needs of offenders exceed the capacity of the CSC to meet the growing demand.
The OCI identifies several key issues with regards to the CSC’s Mental Health Strategy. Although this strategy was launched six years ago, an official, comprehensive and approved strategic planning document is lacking. CSC has received incremental and permanent funding to enhance mental health services in areas such as intake, primary care, in-patient care, community care and staff training; however, the funding is not adequate to support existing services. With regards to mental health human resources, CSC is currently working to address issues such as recruitment, retention, remuneration, professional scopes of practice, roles and responsibilities, accountability, and liability.
With regards to the mental health services offered to offenders, the report states that security is often a higher priority than treatment. CSC staff report a number of security barriers that hinder access to treatment, many of which can be dealt with by relatively straightforward operational changes. Furthermore, offenders are rarely involved in the development, implementation and evaluation of programs and services. With regards to administration and governance, the OCI calls on CSC to develop a senior position in the organization that is responsible for all mental health services.
See “Under Warrant: A Review of the Implementation of the Correctional Service of Canada’s ‘Mental Health Strategy,'” September 2010, available atwww.oci-bec.gc.ca. For more information about the CSC’s Mental Health Strategy, see “Quick Facts,” Correctional Service of Canada, January 2010, available at www.csc-scc.gc.ca.