A Toronto lawyer is raising concerns about Thunder Bay District Jail, where he says two of his clients were denied access to necessary psychiatric medications.
Devin Bains said a recent manslaughter trial was delayed because his client was unfit to continue without his medication.
Bains said a psychiatrist flew to Thunder Bay from Toronto to independently assess his client and determined he needed the medication. After that, the jail reinstated it.
"(What) needs to be asked ... is why that couldn't have been done within the jail itself," said Bains.
He said the problem has implications for the justice system as a whole.
"We of course don't want inmates… to be denied their right to trial or their opportunity to be heard because their ability to have a voice is interfered with by their psychiatric problems," said Bains.
He acknowledges his clients had been misusing their drugs in some way within the jail.
But Bains said medication should never be withheld for "disciplinary reasons."
"At the end of the day, it… meant… inmates were not receiving medication that they required to get by," he said.
Nine complaints specifically concerning psychiatric medication have been filed by inmates of the Thunder Bay jail over the last two years, according to the office of the Ontario Ombudsman.
Speaking on behalf of the jail, Ontario's Ministry of Correctional Services said it would be inappropriate to comment on a specific inmate's health and associated treatments. But in an email, spokesperson Brent Ross said the ministry has procedures in place to deliver health care services.
"Just like in the community, medications are prescribed by doctors," Ross wrote. "The medications are then administered to the inmates by a nurse. Ministry officials do not interfere with medical decisions or direct medical professionals to provide specific courses of treatment."
A difficult balance
According to one psychiatrist who practises in jails in Manitoba, it is difficult to balance patient care with security.
"This is the challenge — to prescribe needed medications for individuals who definitely require them to benefit and function better, but also to prevent those medications from either being misused or diverted," said Dr. Stanley Yaren.
Yaren said his ultimate responsibility is to advocate for his patients' mental health needs. "It's... not appropriate for (a) health care professional to be in a punitive role with an individual," he said. "We're there to provide for patients' wellbeing."
Yaren said if an inmate in his care is caught misusing medication, he tries to work with corrections officials to come up with a solution.
That could mean having a nurse supervise every dose, he said.
"Some arrangement would be made for it to be dispensed on a daily basis," he said. "And what might be further called for is for the individual to undergo 'mouth checks' (to make sure the inmate doesn't just pretend to swallow it)."