This document discusses mental health issues within Canadian corrections facilities. It notes that inmates have higher rates of mental illnesses like depression, anxiety, bipolar disorder, schizophrenia, and PTSD compared to the general population. Having mental illnesses presents challenges for both inmates and staff in the correctional environment. It also discusses the treatment and management of mentally ill inmates within the Canadian corrections system.
2. I have chosen to write on mental health in Canadian corrections. I will be talking about
the different mental illnesses that are prevalent, their effects on inmates and correctional
officers, as well as what treatment options are available within correctional facilities and
beyond the walls of correctional facilities.
3. The prevalence of mentally ill offenders in Canadian correctional facilities often cause a
situation that causes great professional, and legal dilemmas for staff because of the
legislative frameworks that is set out in the CCRA – the Corrections and Conditional
Release Act. The CCRA states that Correctional Services 1“shall provide every inmate with
essential health care and reasonable access to non-essential mental health care that will
contribute to the inmate’s rehabilitation, and successful reintegration into the
community.” It also obligates correctional staff to take into consideration the offender’s
state of health and health care needs in all decisions within the facility regarding
placement, discipline – including segregation, and supervision.
It is believed that 1 in 5 adults in Canada suffer from a mental illness of some sort, and
according to the Correctional Investigator of Canada, inmates serving federal sentences
of 2 years or more in Canadian penitentiaries are 2 to 3 times more likely to be suffering
from mental illnesses. Inmates may be diagnosed with illnesses including, but not limited
to; major depressive disorder, anxiety, bipolar disorder, schizophrenia, post-traumatic
stress, and other personality disorders.
One of the most common mental illnesses present within Canadian correctional facilities
is Major Depressive Disorder, more commonly known as Depression. Offenders who are
serving time in prison struggle to come to terms with the prisonization process – the
process in which the inmate’s personal belongings are taken away from them and the
sound of the prison doors closing behind them. Life inside of prison becomes real, so to
speak. They are stripped of their liberty, confined to restricted living conditions. Offenders
begin to feel sorry for themselves, and feel as if society has turned on them. When inmates
are faced with an unfamiliar amount of down time, they begin to grieve. The inmates may
engage in constant negative thinking, a feeling of restlessness and nervousness, a loss of
appetite and energy, irrational decisions, and in some cases, self-injurious behaviour
and/or suicide.
Anxiety disorders are another mental health concern within correctional facilities. A
common medical definition for Anxiety disorder is 2“A chronic condition characterized by
an excessive and persistent sense of apprehension, and fear”. Symptoms that are often
associated with Anxiety disorders are; restlessness, insomnia, panic attacks, high heart
rates and sweating, dry mouth, and resistance to change. These disorders may be
inherited genetically, however in correctional facilities, Anxiety disorders are often
developed as a result of the environment itself. Inmates are forced to adjust to a brand
new set of rules and conditions, and there are a lot of unknowns, as prison is such an
unpredictable place to live. An obvious fear for offenders, especially those who are serving
their first sentence, is their safety – they may be housed with other inmates who are
1: Corrections and Conditional Release Act [CCRA], 1992, c.20, s.86
2: Webster’s New World Medical Dictionary, 3rd Edition, p. 26
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4. incarcerated for violent crimes. However, an often overlooked worry that inmates have is
when it is time to leave the correctional facility and reintegrate into the community. For
example, they are faced with the challenges of once again providing for themselves and
their families financially, which means finding employment. Offenders will also feel
anxious about leaving the correctional facility due to their low self-esteem – they wonder
what their friends, family, and acquaintances think of them.
Bipolar disorder is a mental illness that causes significant and often unpredictable mood
swings. Those suffering from Bipolar may have moments with an excess in energy and an
intense feeling of happiness, called “a mania”, or on the contrary, they may feel super
worn down and experience depressive symptoms. While in a state of mania, offenders
are much more likely to become aggressive and hurt themselves, staff, or other inmates
as having such an unusually high level of energy leads to irrational and unpredictable
decision making. In fact, inmates suffering from Bipolar disorder spend more time in
segregation than the general population in prison.
Schizophrenia is a serious mental illness that provides many challenges for both inmates,
and correctional staff. The medical definition of schizophrenia is 3“a mental disorder that
is characterized by disturbances in thought (such as delusions), perception (such as
hallucinations), and behaviour (such as disorganized speech or catatonic behaviour), by
loss of emotional responsiveness and extreme apathy, and a noticeable deterioration in
the level of functioning in everyday life.
Contrary to popular belief, those who are diagnosed with schizophrenia are not usually
violent towards others. In fact, they are far more likely to experience self-injurious
behaviour than they are to act violently towards others. The majority of offenders
diagnosed with schizophrenia are incarcerated under minor offences, for example, Theft
Under $5000, and many of the crimes that they commit are crimes against family – this
may be due to the delusions and false perceptions associated with schizophrenia.
People diagnosed with schizophrenia can experience thoughts in their heads that
everyone is out to get them. Furthermore, they may even hear voices telling them to act
in certain ways that are completely irrational. This results in the schizophrenic person to
act with very paranoid and unpredictable behaviors that follows them into prison once
they are incarcerated. The delusions and hallucinations in schizophrenics presents a huge
challenge for the criminal justice system. In order to use the mental illness as a legal
defence, it must be proven that the crime committed was committed during a time that
3: https://www.merriam-webster.com/dictionary/schizophrenia, 1st paragraph
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5. the person was experiencing these delusions and/or hallucinations, which is extremely
difficult. Once incarcerated, correctional officers and medical staff have a difficult time
treating schizophrenic inmates as their paranoia often leads to resisting any sort of
treatment.
Post-traumatic stress disorder, commonly referred to as PTSD, is very prevalent in
corrections, not only for inmates, but also for correctional staff. Post-traumatic stress
disorder is a psychiatric condition that can occur after experiencing or seeing critical
incidents such as violence, abuse, neglect – particularly in childhood and adolescence,
and serious accidents, to name a few. An unfortunate reality of prison is that violence can
occur frequently, and out of nowhere. Inmates and staff are susceptible to witnessing
beatings, stabbings, suicides, death threats, riots, and murder, all of which that can lead
to symptoms of PTSD. It is normal to experience symptoms such as nightmares, reliving,
avoidance, anger, difficulty sleeping, anxiety, and negative emotions after experiencing
or seeing a critical incident, however, PTSD is when these feelings are prolonged for
several weeks or months and continue to affect everyday life.
4A study done by Correctional Services Canada from 2011-2016 shows us the prevalence
of post-traumatic stress disorder in correctional staff. The results showed that 357
correctional officers working in Federal correctional facilities report being diagnosed with
PTSD. Broken down by region it resulted in the Pacific Region showing 78 diagnosis’, the
Atlantic Region showing 79 diagnosis’, the Prairies Region showing 69 diagnosis’, Ontario
showing 27 diagnosis’, and the Quebec Region showing 104 diagnosis’. Furthermore,
this study by Correctional Services Canada broke down the top 5 institutions for post-
traumatic stress diagnoses. At the top of the list was the Dorchester Penitentiary in the
Atlantic Region, with 53 employees suffering from PTSD. Second on the list was the
Regional Reception Centre in Quebec with 47 employees. The third institution was Port
Cartier Institution, also in Quebec, with 26 employees. Fourth on the list was the Pacific
Institution with 25 employees, and finally the fifth highest was the Saskatchewan
Penitentiary in the Prairies with 20 reported employees with PTSD. At the conclusion of
the study, the Atlantic president of The Union of Canadian Correctional Officers, Jeff
Wilkins, 5stated that he felt the study didn’t accurately portray the prevalence of Canadian
correctional officers living with PTSD as some choose to suffer in silence. Jeff Wilkins said
“When something traumatic happens at an institution, there’s quite often the sense of ‘I
need to be strong. I can’t tell anybody what I’m feeling at nighttime or when I’m home
with my family.’ And I think there’s still that stigma.”
Correctional officers are front-line workers when it comes to witnessing violence and
crisis situations, their job as first responders put them in a position to be vulnerable to
4: CBC article highlighting a CSC studies’ data obtained through the Access to Information Act. http://www.cbc.ca/news/canada/nova-
scotia/canada-prisons-corrections-ptsd-first-responders-coverage-1.2735583
5: CBC article highlighting a CSC studies’ data obtained through the Access to Information Act. http://www.cbc.ca/news/canada/nova-
scotia/canada-prisons-corrections-ptsd-first-responders-coverage-1.27355833
6. developing PTSD, in fact, they top many lists as one of the professions with the highest
PTSD rate among workers.
Personality disorders cover a wide array of psychological issues, characterized by several
different behavioural and thought patterns, 6often separated by 3 different clusters.
Cluster A personality disorders include paranoid personality disorder, schizoid personality
disorder, and schizotypal personality disorder. Though some symptoms are common with
other illnesses, personality disorders are an illness in themselves. Cluster A symptoms may
include, but are not limited to; unjustified suspicion, tendency to hold grudges, inability
to pick up on normal social cues, limited range of emotional response, and anger. Cluster
B personality disorders include antisocial personality disorder, borderline personality
disorder, histrionic personality disorder, and narcissistic personality disorder. Cluster B
symptoms may include, but are not limited to; expectations of constant praise and
admiration, excessive concern with physical appearance, self-injurious or suicidal
behaviour, and lying. Cluster C personality disorders include avoidant personality
disorder, dependant personality disorder, and obsessive-compulsive personality disorder.
Cluster C symptoms may include but are not limited to; desire to be in control, obsessive
about minor details, fear of having to care for themselves, fearing disapproval, sensitive
to disapproval, and avoiding social interaction.
Cluster A, B, and C personality disorders all present unique challenges within the walls of
correctional facilities. It is a challenge for correctional staff to understand and monitor the
behaviours of those diagnosed with personality disorders, recognize their behaviours as
part of the mental illness, and treat them in an approach that is appropriate. For example,
rather than punishing the offender for a certain action, instead, finding an appropriate
program or medical attention that they may be referred to.
In addition to behavioural and psychological disorders, it is common that mentally ill
offenders often have a history of substance abuse as well. According to Correctional
Services Canada, 7“upon admissions to federal custody, almost 70% of federal offenders
are assessed as having some level of substance abuse problems requiring intervention.”
Furthermore, during a survey given to inmates, results showed that 8“34% of offenders
admitted to injection drug use prior to incarceration and 11% indicated they have injected
since being in custody.”
Each of these mental health complications, along with substance abuse, offer a wide
array of challenges for inmates and staff inside of a correctional facility, and will continue
to pose these challenges. For example, mentally ill inmates, especially those suffering from
6: Blog by Neel Burton, M.D, Psychology Today. https://www.psychologytoday.com/blog/hide-and-seek/201205/the-10-personality-disorders
7: Article written by Fraser McVie, Correctional Operations & Programs, Correctional Service of Canada. http://www.csc-
scc.gc.ca/research/forum/e133/e133c-eng.shtml. Paragraph 2
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7. psychosis and/or maniac tendencies – which cause aggression, loss of control, and
irrational decisions, are highly more likely to end up in segregation rooms, meaning they
are secluded from general population and placed in confinement. The issue with placing
mentally ill offenders in isolated environments is that it is not conducive to rehabilitation
and therapy.
In the grand scheme of mental health, there is little that we know and can truly
understand at this point. There is a rising number of people, particularly prison inmates,
diagnosed with a mental illness, thus an increase in needs that they require.
Suicide awareness in Canadian prisons is paramount and requires the undivided attention
of all staff due to the frequency of inmates committing, and attempting suicide. 8In fact,
federally sentenced offenders have a suicide rate that is 7 times higher than Canada’s
national average. It is for this reason that during the admission and discharge process in
Canadian jails, trained correctional staff are to go through a security screening and risk
assessment with every offender to determine their placement within the facility as well as
any health and mental health concerns, including a suicide risk assessment. During the
suicide risk assessment, staff interview offenders to evaluate several suicide risk factors.
These may include demographic factors, offence characteristics, psychiatric history and
substance abuse, suicidal history, and asking offenders what their concerns are regarding
to being incarcerated.
The main demographic factors that staff need to consider during risk assessment are age,
marital status, and ethnicity. It is believed that in Canadian prisons, suicide risk increases
with age, and while it seems something unimportant, along with other factors, it may
lead staff to increase supervision. The marital status becomes an area of concern in prison
because inmates suffer from a sense of deprivation and separation from their loved ones,
this tends to lead to depressive behaviour and needs to be continually evaluated by staff.
Last but not least, ethnicity is taken into account. In Canada, the over-representation of
Aboriginals in our correctional facilities is very evident, and with that, come certain
concerns regarding their unique backgrounds. Aboriginal offenders have a higher suicide
rate than any other ethnicity housed in Canadian prisons.
It is important for staff to note the nature of the inmate’s offence, and the length of their
sentence. It’s been reported that inmates who are convicted on violent crimes and/or
crimes related to other people, are at greater risk of self-injurious behaviour due to their
feelings of guilt. In regards to sentence length, inmates who are serving long term
sentences, and particularly life sentences, are often a greater risk of suicide due to their
feelings of hopelessness.
8: Mental Health and Corrections [PDF], Howard Sapers, Correctional Investigator of Canada. http://www.oci-
bec.gc.ca/cnt/comm/pdf/presentations/presentations20120318-eng.pdf. Slide 6
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8. Evaluating an inmates’ psychiatric history and substance abuse may be one of the most
important factors during the admissions process, it gives staff the opportunity to identify
official diagnoses and take a proactive approach to evidence-based programming that fits
the offender’s needs.
In regards to the offender’s suicidal history, it is important to ask the offender about
previous suicide attempts, as well as any history of suicide in their family. It’s been
documented that at least half of the federally sentenced offenders who successfully
commit suicide have had at least one previous attempt prior to incarceration, and that
those with a history of suicide in the family are at greater risk.
During the end of the suicide risk assessment, staff will ask offenders about any concerns
they have regarding being incarcerated. This will help staff find ways to help the offender
adjust to prison life.
There are several concerns and challenges that Canadian correctional facilities and staff
are faced with in regards to housing such a high number of mentally ill offenders. The
first challenge being the prison environment itself. Correctional facilities are often over
crowded, which leads to inmates being obligated to share cell space with one another.
Sometimes this is a large adjustment for offenders and can add a load of anxiety in their
lives as they will need to adjust to life inside of prison as well as making sure they feel safe
with another inmate living in their cell. There is already a heightened risk of violence
within the walls of correctional facilities due to the unpredictable nature of inmates. This
leaves offenders, and particularly new offenders, with a feeling of restlessness and
caution. In addition to the overcrowded population, and sometimes violent environment,
two more key factors are the noise inside of the facilities as well as the lack of natural
sunlight and fresh air that inmates must get used to. Those housed within correctional
facilities often face depressive symptoms due to the lack of sunlight, some offenders may
get only 30 minutes of sunlight and fresh air per day. It may take months, or even years,
for the nerves of an inmate to calm and adjust to their environment. This is not necessarily
conducive to the rehabilitation and therapeutic options that correctional facilities are
supposed to be providing.
Due to the nature of the environment that they work in, correctional officers are subject
to tons of stress. There is the stress of being a front-line correctional officer, dealing with
inmate complaints in a timely manner, witnessing violence, and responding to emergency
situations. Correctional facilities are such an unpredictable environment, so stress is to be
expected, but there is another type of stress that affects correctional officers, and that is
organizational stress. Organizational stress comes from several sources in corrections. The
first being the relationships between correctional officers and their management. When
management chooses to implement new strategies to fulfill every day duties, it can render
front-line officers confused, and frustrated as this adds pressure onto their job. It is often
that the front-line correctional officers put up a shield of resistance towards employees
with management positions as they feel management doesn’t understand the struggles
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9. of working on the front-line and working under sometimes hostile conditions. In addition
to relationships at work, relationships at home are hindered as well. Correctional officers
may be mandated to work very long hours, overtime, and make trips to court on their
days off. This often leads to officers feeling large amounts of stress due to the lack of sleep
they may be getting, and also having to miss time away from their families. Officers begin
to feel guilty, and as if their job is consuming their life outside of work.
Although correctional staff work so hard to provide safety and security to the correctional
facility, it often goes unnoticed by the general public. It is rare that correctional officers
receive any sort of praise by the media, in fact, the media are quick to point out even the
smallest of mistakes that staff may make inside of the walls of their facility. This is another
cause of organizational stress among correctional officers as they are essentially always
working under a microscope because of the legal liabilities they may be held responsible
for, as well as the criticism of the general public and the beating of the media that will
take place if any of their mistakes is made public.
The stress of working as a correctional officer, particularly on the front-line, is highlighted
in an 9interview between Harriet Fox, correctional officer, and Ellen Kirschman, a police
and public safety psychologist for over 30 years, when asked about things that are not
taught to new correctional officers, Ellen Kirschman stated that “there isn’t sufficient
preparation for dealing with the emotional challenges of the job”. She went on to argue
that organizational stress, and balancing their work and social life, often outweighs the
stress of the duties of front-line officers. Harriet Fox went on to ask Ellen Kirschman about
any advice she had for dealing with the stress of being a correctional officer to which Mrs.
Kirschman emphasized the importance of proper rest, and exercise. “Motion is lotion, use
it or lose it. They are both true. Exercise is better than almost anything. In fact, exercise
appears to help a host of things including mental alertness, resistance to cancer, strong
bones, better sleep, and stress management.” In regards to sleep, Mrs. Kirschman
suggested to “practice good sleep hygiene. Go to sleep at a routine time. Bedrooms
should be dark, quiet, cool and pleasant places dedicated to sleep and sex.”
There is a high burnout rate for correctional officers and Mrs. Kirschman attributes this
burnout to the reality of what officers may see early in their careers. She stated
“corrections officers and other first responders see more terrible things in the first few
years of their careers than most of us see in a lifetime. Corrections work changes people,
for the good and for bad.” Mrs. Kirschman’s final words of advice in regards to dealing
with the often negative environment of correctional facilities is to *“counter balance the
negative aspects of law enforcement with positive activities outside the job.” She suggests
you keep in contact with your non-law enforcement friends, give back to the community
9: Interview between Harriet Fox & Ellen Kirschman from article on CorrectionsOne. “How can correctional officers deal with stress on the job”
https://www.correctionsone.com/officer-safety/articles/7522826-How-corrections-officers-can-deal-with-stress-on-the-job/
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10. when possible, stay away from negative people, and have not only have goals related to
work, but outside of work as well. When your work load increases, you must find a
balance between reducing the demand in your life elsewhere, while maintaining a good
relationship with your family.
There are mental health treatment options for both inmates and correctional staff such as
programs, counselling, and institutional methadone clinics for those suffering with
substance abuse. Also, as previously stated, every offender goes through a mental health
screening assessment during the admissions process.
It is important to note that for inmates in provincial correctional facilities in Canada – in
other words, inmates whose sentence is less than 2 years – treatment options are often
not effective as the turnover rate is relatively high, with the average sentence being
roughly 6 months. Typically, inmates serving shorter sentences, or remanded offenders,
are reluctant to take part in any programming or other treatment options and therefore
the provincial governments tend to shy away from providing large amounts of their funds
to these programs. This is different in Federal correctional facilities – meaning offenders
serving 2 years or more – often have a higher participation rate and more effective
programming as they can take part in a longer, more extensive treatment plan.
Furthermore, 10Correctional Services Canada has a permanent annual budget of 16.6
million dollars to go towards mental health within their prisons and can therefore
financially accommodate for these programs and services.
Correctional Services Canada has clearly defined their 11key principles in regards to their
mental health treatment: The first principle that CSC emphasizes is the fact that the
offenders are the center piece in terms of their recovery. They must be willing to
collaborate and work with staff to develop and monitor their individual treatment plans;
the second principle that CSC implements is a holistic approach to healing, combining
medical, social psychological, and spiritual recovery; the third principle takes into account
the diverse backgrounds of all offenders and that need to be treated on an individual
basis. They place an emphasis on women and Aboriginal offenders; the fourth and fifth
principles are in regards to balancing the confidentiality of the offenders as well as
supporting a continuum of care between community partners once the offenders are
released from the correctional facility.
Entry-level mental health counselling is made available for correctional staff through their
union’s benefits plan. Provincially, this varies depending on which union the correctional
staff throughout Canada fall under. However, federal correctional officers are covered
10: “Towards a continuum of care” article on CSC website. http://www.csc-scc.gc.ca/text/pblct/health/tcc-eng.shtml Table 1
11: “Towards a continuum of care” article on CSC website. http://www.csc-scc.gc.ca/text/pblct/health/tcc-eng.shtml Paragraph 3 “Key
Principles”
8
11. under UCCO – the Union of Canadian Correctional Officers. 12Correctional staff
throughout Canada are currently asking for more focus on the prevalence of PTSD and
seeking more help.
Housed offenders dealing with substance/opiate abuse problems are given access to
methadone clinics in 13every province throughout Canada except for Prince Edward
Island, and Newfoundland and Labrador. In federal correctional facilities, 14this initiative
is called the Methadone Maintenance Treatment Program and aims to treat those
addicted to drugs as well as slow the spread of HIV and Hepatitis C due to the spread of
needles within their correctional facilities.
12:”Correctional officers plead for federal help including national treatment centre” article from The Canadian Press, written by Kristy Kirkup
http://nationalpost.com/pmn/news-pmn/canada-news-pmn/correctional-officers-plea-for-federal-help-including-national-treatment-centre.
Paragraph 10
13:”Methadone maintenance expands inside federal prisons” article written by Barbara Sibbald. http://www.cmaj.ca/content/167/10/1154.1.
Paragraph 14
14:”Methadone maintenance expands inside federal prisons” article written by Barbara Sibbald. http://www.cmaj.ca/content/167/10/1154.1.
Pararaph 14
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12. When speaking about the subject of our correctional system in Canada, it is crucial to
recognize the prevalence of mental health issues and substance abuse within the walls
of our facilities. Through my research I have learned about the different mental illnesses
that are present in jail – such as depression, anxiety disorders, schizophrenia, PTSD and
different personality disorders, and identified what challenges they present to offenders
and correctional staff, as well as what treatment options are in place.
I feel it is important for the government to continue to fund mental health research and
treatment initiatives, particularly in federal correctional facilities where the offenders are
serving longer sentences. While we continue to understand and recognize mental illness,
I believe we will do an even better job at helping inmates with their recovery and re-
integration into the community, ultimately leading to a reduced rate of recidivism as long
as there is an appropriate continuum of care plan in place.
