Blair Crawford, Ottawa Citizen
Published on: April 19, 2016
Ontario’s John Howard Society is urging the province to put the Ministry of Health and Long-Term Care in charge of inmates’ health, taking away the responsibility now held by jail superintendents.
In a report released Tuesday, the society says the province “is facing a growing health crisis in Ontario’s correctional institutions,” a crisis made worse because health care behind bars has been left to the Ministry of Community Safety and Correctional Services.
Nearly 30 per cent of inmates are infected with hepatitis C, compared with 0.8 per cent of the general population, according to the report, called Fractured Care. HIV rates behind bars are seven to 10 times higher than in the Canadian population, and 80 per cent of inmates suffer from severe alcohol or drug addiction, according to the report.
Overcrowded jails where “double bunking has become the norm” raise the risk of violent injuries and increase the spread of antibiotic resistant infections such as MRSA, the report says. Compounding the problem, Ontario’s jails are short-staffed with 8.5 per cent of health care positions unfilled, including 29 per cent of its psychologist positions. That’s significant because inmates suffer mental illness at two to three times the rate of the general population, the report says.
“If our goal is ultimately to reduce crime and to have safer communities, we really want people who have mental health issues or chronic health needs, we want those to be identified, addressed and treated inside,” said Michelle Keast, director of research for the John Howard Society of Ontario.
“If the Ministry of Health and Long-Term Care is the one providing that care in the institution, then that continuity of care will carry over into the community,” she said. “That helps individuals reintegrate more effectively and hopefully reduces their chance of coming back into conflict with the law.”
The report acknowledges that providing health care is difficult for inmates because of the staff shortages, the need for security and the “revolving door” nature of provincial jails. But unlike convicted inmates in federal prisons serving sentences of two years or more, provincial inmates are guaranteed health care under the Canada Health Act no different than people on the outside.
“Under the CHA there is no distinction between a person incarcerated in a provincial institution and a person living in the community,” the report notes.
And because provincial inmates are usually released sooner rather than later, their health problems inside soon become health problems in their communities.
“The vast majority of people in our provincial correctional institutions will be returning to our communities and soon. This reality makes the health issues and conditions in Ontario’s correctional institutions a public health concern,” the report says.
In Nova Scotia, health care in provincial jails is covered by the health ministry, the report says, which has “improved the health and well-being of the correctional population, reduced health care costs and reduced the rates of recidivism in Nova Scotia.”
The report comes at a time when conditions at the Ottawa-Carleton Detention Centre on Innes Road have been under scrutiny because of overcrowding, short staffing, the misuse of solitary confinement and the suicide last week of Yousef Hussein, an accused serial rapist who hanged himself while in solitary confinement.
Yasir Naqvi, the minister responsible for correctional services, said the John Howard report “has merit” and pledged to work with Health Minister Eric Hoskins to improve health care inside Ontario’s jails. The ministry has already hired more nurses and mental health nurses and strengthened mental health supports, Naqvi said in a statement released Tuesday.
“We believe this proposal for a coordinated and continuous approach to health care in our institutions has merit and we are prepared to discuss all options that will further enhance health care both in our institutions and in our communities. I am encouraged by the positive results seen in other jurisdictions and I look forward to working with Minister Hoskins and our correctional partners as we explore opportunities to continue to improve the health care we provide.”