Ottawa considers closing some prison psychiatric beds: Watchdog

June 2, 2014 – Anna Mehler Paperny, Global News

Ottawa is considering closing psychiatric beds in federal prisons barely a month after announcing a new strategy on inmates with mental illness, the federal prison watchdog says.

At the same time, it has cut back on nursing hours, even as federal prisons are seeing more assaults, more injuries and more use of force – medical incidents that corrections officers, even ones trained in first aid, aren’t prepared to handle.

Corrections Canada would not confirm by deadline it’s considering closing psych beds (“It’s complicated,” a spokesperson said over the phone).

Public Safety Minister Steven Blaneysaid barely a month ago he’s “very well aware” that inmates with mental illness are more likely to be assaulted and die. A Global News investigationrevealed they’re most at risk in the specialized psychiatric prisons designed to give them better care.

IN DEPTH: Death Behind Bars

So it seems strange that, even as Blaney rolls out a new strategy for inmates with mental illness (not unlike a 2010 strategy that has yet to be implemented) his department is reducing nursing resources and closing psychiatric beds.

Corrections Canada is cutting more than $300 million from its budget even as it undergoes one of the largest expansions in its history to accommodate an influx of aging, ill inmates with increasingly complex needs.

In an emailed statement, spokesperson Sara Parkes said the reduction in nursing hours was the result of an April 1 “reallocation of health services resources” that’s “cost neutral” and “ensures essential health services will continue to be met.”

Prison watchdog Howard Sapers said the possibility of closing some psychiatric beds remains an “active discussion.” And he wants to give Corrections the benefit of the doubt: It’s possible the resources saved by closing those beds will be put to better use, he said.

“I want to be really fair about this. Closing a bed in a regional psychiatric centre does not necessarily mean that patient won’t get care some other way.”

But it makes him “nervous” that they’re being taken away when the need is so great.

“The knowledge that I do have suggests to me that we haven’t become more efficient, that people aren’t less ill, and so I’m very nervous about decreasing capacity.

“… I’m not concluding that this is a bad thing. What I’m saying is there are important and significant questions around any plan to reduce capacity, whether you’re talking about nursing capacity or inpatient treatment capacity.”

And reducing nursing hours is especially worrisome, he said. Prisons need more access to nurses – not less.

“Anything that’s less than round the clock coverage is inappropriate,” he said. “Where there is not 24/7 nursing coverage and a critical incident happens, we find there is inadequate medical emergency response.”

And it’s misleading to think correctional officers, who have basic first aid training but little more, could simply call 911 in an emergency: Many prisons are so remote it would take an ambulance ages to get there.

“We’re seeing in institutions the number of injuries go up, the number of assaults go up, the number of use of force incidents go up, especially involving pepper spray. …  If someone is assaulted or someone is pepper-sprayed or somebody is injured, having to wait until the next shift comes on duty for a medical  examination means someone could potentially be dealing with a health risk that could become far worse because of a delay in treatment.”

Jason Godin, vice-president of the  Union of Canadian Correctional Officers, says they’re particularly concerned about cutbacks in nursing hours: If there’s an incident at night – even if they’re giving inmates access to medication – they’re out of their depth and beyond their training, he said.

“We’re not the medical experts. They are. And there’s all kinds of concerns as to who’s going to monitor the inmate taking the medication. …  Now we no longer have a healthcare professional to make a medical assessment of inmates. So that’s our primary concern.”

If an inmate’s hurt or sick and there’s no nurse on duty, Godin said, the correctional manager will assess whether a health-care professional is needed – worrisome, he noted, given that it should be someone with health care expertise making that assessment.

Godin noted that previous investigations and inquiries – Ashley Smith’s inquest included – have underscored the importance of 24/7 medical care.

“At the end of the day, we’re completely limited in our capacity to respond.”

Parkes said 24-hour care is available at the five federal treatment centres – the same centres Global News found are the deadliest for the most vulnerable inmates.

“In facilities where 24-hour health care is not available,” Parkes wrote in an email, “procedures are in place to access community-based hospital care in the event of an emergency.”

Note: Corrections Canada responded to our questions Tuesday afternoon, saying it’s “not closing any beds, including beds in our regional hospitals and treatment centres,” and the department is reviewing “the level of mental health services to ensure that our limited resources are aligned to prioritize and best meet the diverse needs of mental health offenders. Those offenders that require hospital level care will continue to have access to hospital beds.”

In a follow-up email responding to a question about that review, the department said it had “provided all information available on this topic.” 

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