Mentally ill inmates kept in 'grossly inadequate' conditions

Advocates for prisoners are raising concerns about the conditions for mentally ill inmates who were recently transferred to a former segregation unit at Millhaven Institution after the closure of Ontario's Regional Treatment Centre.

Prolonged isolation at Millhaven Institution could worsen mental health problems, advocates say

Prisoners with the most acute mental illness are being locked up in prolonged isolation and unkempt, chaotic and "grossly inadequate" conditions, two years after the United Nations called on Canada to end solitary confinement for inmates with mental disorders.

Documents released under Access to Information reveal that the correctional investigator of Canada raised concerns about the isolation, lack of programming and "gross neglect" of maintenance and hygiene at Ontario's Millhaven Institution.

Records also refer to the "chilling" image of a mentally ill offender in leg shackle restraints at the unit that holds prisoners with schizophrenia, major depression and other mental disorders transferred there after the closure of the Regional Treatment Centre in Kingston last fall.

The records, which include photographs, emails and correspondence, were obtained by the John Howard Society of Canada and provided to CBC News Network's Power & Politics.

The society's executive director, Catherine Latimer, called the former segregation unit "totally unsuitable." A lack of program space and the stark, isolated environment runs counter to a therapeutic setting for mentally ill patients.

"It's underground, it’s small cells intended for punishment, and another coat of paint has not really converted it into a treatment centre where effective help can be rendered to these people," she said.

Regional Treatment Centre shut

After the closure of Kingston Penitentiary and the Regional Treatment Centre, offenders with the most acute mental illness were transferred to the maximum-security Millhaven Institution. Others were taken to the medium-security facility at Collins Bay before being transferred to a new unit at Bath Institution.

Latimer said the federal government has developed a strategy to address mental health needs of prisoners, but has failed to implement it with the proper supports and professionals. And that could ultimately have dire consequences for public safety, she warned.

Huge concerns, operationally and as well from the clinical staff. As a side note, the chaos is overwhelming.—Office of the Correctional Investigator

"The last thing we want as a society is someone to come out of prison with less mental health than when they went in," she said. "I think we need to be very worried about this."

Prolonged segregation exacerbates mental health issues — and prisoners become more prone to suicide, self-harm and acting out, she said.

The situation at Millhaven comes after the Canadian Human Rights Commission recommended "strictly prohibiting" the use of segregation for persons with serious or acute mental illness in an April 2012 report to the United Nations Committee Against Torture.

A UN special rapporteur determined that prolonged solitary confinement of people with mental disorders can amount to "cruel, inhuman or degrading treatment or punishment, or even torture."

Ombudsman's warning

The documents show that the correctional investigator of Canada, Howard Sapers, warned that the former segregation unit — which is in the oldest part of the prison complex, built more than 40 years ago — was not fit for patients with mental illness.
Millhaven is 'grossly inadequate as a psychiatric facility,' prisons ombudsman Howard Sapers warned Corrections Canada in 2012. (Sean Kilpatrick/Canadian Press)

"Despite efforts to remodel the unit and its surrounding infrastructure, my impression is that it is grossly inadequate as a psychiatric facility by both community and correctional standards," he warned in a July 12, 2013, correspondence to correctional service commissioner Don Head.

"The unit is basically a narrow corridor with aging cells with little natural light, poor ventilation and no common areas.…. Given the lack of common areas, it is foreseeable that many of the most mentally disordered and in need of treatment in the Ontario Region will remain locked in their cell for unacceptable periods of time."

In an interview with CBC News, Sapers said some issues of hygiene and disorder have been addressed since his office's site visit, when the photographs were taken. But the core issue is inappropriate infrastructure, leaving many inmates in cells for 23 hours a day.

He has recommended against prolonged segregation for federal inmates and a total prohibition on solitary confinement for those with mental disorders.

Records after a site visit by his office last September note that a psychiatrist does interviews in the yard because there was no room to conduct interviews with patients. It also noted constant construction with loud drilling and banging — noise so constant and so loud that it was difficult to hear people speaking beside you.

To see him suffer and to not get the health treatment that every Canadian has a right to.…that really devastates me—Farhat Rehman, mother of mentally ill inmate

One email states: "It is unlike their plans they shared with us. Huge concerns, operationally and as well from the clinical staff. As a side note, the chaos is overwhelming."

Another says: "The one picture with the feet in Pinel restraint is chilling. Many suggest gross neglect re: maintenance and hygiene."

Letters that Head sent in response to Sapers in August and September, 2013 indicate the correctional service was taking steps to ensure "consistent and quality levels of care" for mentally ill offenders.

"It was decided that Millhaven could provide the necessary and appropriate therapeutic environment which has been re-designated by the Minister of Health and Long-Term Care," he wrote.

"There will be constant monitoring by institutional management as well as National Headquarters Health Services. Thank you for bringing this matter to my attention and I look forward to working with you to make the new RTC Unit at Millhaven a success."

Schizophrenia exacerbated

But Farhat Rehman of Ottawa said her son’s mental condition has deteriorated since his transfer to Millhaven.

He was deemed unfit to stand trial owing to mental illness for four years before he was found guilty of second-degree murder in the stabbing death of his friend and mentor. She said the punitive measures and restricted visits have exacerbated his schizophrenia — and now he is hearing voices.

"To see him suffer and to not get the health treatment that every Canadian has a right to.… that really devastates me," she told Power & Politics host Evan Solomon.

Heavily drugged and suffering from paranoia, her son now spends 23 to 24 hours a day lying in his cell. During her last visit she was told he couldn't come see her because he was "comatose."

She worries her son could become another "statistic" — a prisoner who dies behind bars.

"What is the alternative that the Canadian public is proposing I would ask them — that my son stay there and become another case like Ashley Smith? I don’t think anyone wants that."

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