Hot! Prisons grapple with increase in mentally ill female inmates

TheGlobeandMail.com – news/national
Published Wednesday, Jan. 26, 2011. Last updated Thursday, Jan. 27, 2011.   Kirk Makin — Justice Reporter

A wave of mentally ill women is flooding into the Canadian penitentiary system, sparking calls for reform and the creation of treatment facilities that already exist for male offenders.

Across the country, prisons are grappling with the problem of a sharp increase in mentally impaired inmates. But the issue is particularly acute with women.

Female offenders are twice as likely as their male counterparts to be diagnosed with a mental-health condition when they’re admitted to prison, according to a recent report by the federal Correctional Investigator. Moreover, the number of women admitted to penitentiaries with mental problems doubled from 1997 to 2009.

Some experts see the deteriorating situation as a sign that enlightened policies have broken down under the weight of sheer numbers and the realities of prison culture.

“You now have people in correctional facilities with the severest mental illnesses you could possibly find,” said Colin Cameron, a psychiatrist at Ontario’s St. Lawrence Valley Correctional and Treatment Centre. “Recognizing the challenges faced by Correctional Service Canada, their needs really haven’t been well met.”

On Friday, the Royal Ottawa Mental Health Centre and the Brockville Mental Health Centre, along with Senator Robert Runciman – who spearheaded the creation of a unique, therapy-first facility for male offenders – will try to do the same for women.

Mr. Runciman said they will select a successful tender in a competition to prepare a business plan for a women’s treatment facility. He said he hopes to submit it to the federal government in March. “The need is clearly greater on the female side of the federal system at the moment,” Mr. Runciman said. “We are going to make a lot of noise about this.”

One of the biggest concerns is access to proper care.

Women in maximum security, who often suffer the most serious mental problems, are not permitted to enter in-prison psychiatric units because they are deemed too dangerous. Many are instead confined to isolation cells or subdued by chemical and physical restraints. Untreated, they are likely to emerge from prison in even worse shape than when they went in.

“Women subjected to these conditions tend to develop new mental-health conditions and symptoms,” said Kim Pate, executive director of the Canadian Association of Elizabeth Fry Societies. “Quite frankly, we are also seeing more bizarre behaviour as a response to conditions. The women with the most significant mental-health issues tend to be in maximum security, but they never have access to the very treatment units they most need.”

The glut of mentally impaired female offenders epitomizes a problem plaguing the entire penal system. Tougher laws and sentences have created a pressing need for more prison cells, but the needs of the mentally ill are playing a small role in federal expansion plans.

While the male prison population of about 13,000 has changed little over the years and still dwarfs the female population, the number of female offenders has skyrocketed from 210 to 500 in the past 20 years.

It also encompasses a higher rate of mental illness.

By some measures, 40 to 45 per cent of female offenders have serious mental afflictions – and some experts claim that this underestimates the problem. Kelly Hannah-Moffat, chair of the sociology department at the University of Toronto, said close to 100 per cent of female offenders suffer from a debilitating mental problem such as psychosis, clinical depression, schizophrenia or coping strategies that involve self-harm.

“It is really hard to find somebody who doesn’t have some of those issues,” she said.

Why do female offenders exhibit so many mental problems? Women have higher rates of depression and mood-related issues, said Nicole Loreto, a spokesperson for Royal Ottawa Health Care Group, which has created a specialty of women’s health. “Mood disorders involve a complex interplay of women’s biology, hormonal makeup and psycho-social pressures.”

An overwhelming majority have also suffered sexual or physical abuse. “A history of trauma is a risk factor for the development of depression and to some degree schizophrenia,” Ms. Loreto said.

Federal Correctional investigator Howard Sapers has estimated the suicide rate among female offenders at seven times the Canadian average. Many act out violently or mutilate their bodies to express anger and frustration.

“When someone has a heart attack, we would never presume that the problem can be handled in a prison,” Ms. Pate said. “So why do we think that someone with significant mental-health issues can be handled in a prison setting?”

Ms. Pate attributed the growing number of mentally ill female offenders to well-meaning judges who erroneously believe that women are going to get proper psychiatric treatment in prison.

“The judges never anticipate that they are going to be put in segregation in the most austere conditions,” she said. “There is a presumption that services that no longer exist in the community – or never did – are being provided in a prison setting and can meet the therapeutic needs of women. But our experience is quite the opposite since those units opened.”

Ms. Pate said she went to a Saskatchewan penitentiary recently to see a psychotic inmate who was strapped to a hospital bed, her arms and legs immobilized and atrophied.

“I had to look through a mail slot and up through her legs to speak to her,” Ms. Pate said. “This was a woman with a history of sexual abuse. … My sense was that her behaviour was certainly exacerbated by prison.”

Shoshana Pollack, a sociology professor at Wilfrid Laurier University, said that prison and treatment simply don’t mix well. “They are concerned with controlling and predicting the likelihood of the person committing another offence – which is a very different mandate than healing, dealing with and confronting experiences of trauma.”

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