I would rather chew nails than drive near Toronto. I don’t mind Toronto drivers but I am not the best among them. I was quite prepared to drive there this morning but was offered a ride from a fine friend. Our team of three included two who to my surprise had never been to a jail before. This was important as their view was as significant as mine. We took the public tour of Ontario’s newest and largest super jail, Toronto South Detention Centre. It is rather large with over 1600 eagerly awaiting occupants; I’m just not sure it is super.

I met with and spoke with several correctional officers and my guides were accomplished administrators. My main focus was on how this new facility addressed the mental health needs of Ontarians. I was also curious to know how the new facility differed from what I experienced. I have nothing against corrections. I shook several hands today in familiar uniforms and would gladly do the same to each officer I have known.

The one correctional employee I spoke with seemed proud of how the new facility addressed mental health. It was he who mentioned the importance of mental health among the incarcerated. He informed me of the mental health professionals who would actually be inside the building. It must have seemed to him a novel idea to have on premise mental health care for a population where 24% have major mental illness. Do we laugh at the fact that this was not the case miles away at the old jail or cry at our utter disregard for the mental health care of a segment of society? We can point fingers and make judgements but we are all on trial for this sadness.

I was pleased to hear that the Center for Addiction and Mental Health (CAMH) was part of the onsite mental health care. I was disappointed the tour included little information let alone a view of how Ontarians with mental health care needs are dealt with within a correctional facility. It is unfortunate most Ontarians assume it has been dealt with appropriately in the past but sad that some do not care in any case.

 “So that’s 24/7 right?” “No, the mental health area would only be fully staffed during the day. It cost 600 million dollars to build Toronto South; let’s go all out and have a psychiatrist on site 24/7. It would seem a great place for business. If things are slow maybe one could talk to someone in segregation. I loved those house calls! Mental illness does not pay attention to a clock. I have had too many depressions that ignored months and have gripped the bars of a jail screaming when it was more quiet than dark but surely night. I hope I am misinformed because I find worry in the fact that correctional officers and administrators will have the night shift. If the administration of this facility has the ability to intercede in the care and treatment of people with a mental illness, the same design flaw exists that was harmful to me. Psychiatry is medicine so to give the prescription pad to corrections at any time of day seems foolish if not unethical.

Human decency can be denied in the name of security but the humane treatment of those with physical or mental illness is the right of not only Ontarians but Canadians. Not everyone expects to be in jail but you should be able to expect humane treatment while there. For those immune to arrest, rest assured these individuals will be treated like cows at times minus some of the dignity. For those of you concerned about mental health care within the correctional system I say there is still reason to be concerned.

I applaud the advances and me more than anyone hopes my concerns are only misinformation. One aspect of the tour that stood out as different was the accessibility to spirituality. I hope it takes root. In truth what I saw was more of the same thing. In the processing area or Admitting and Discharge the person with Schizophrenia is delivered in handcuffs by police and directed into cells where 20 men mingle in an area most of us would find distressing singly. Commands and hand signals direct them through a “public” strip search. All identity and attachment is relinquished to a stranger. A ring removed from a finger can be devastating within a delusion. Within a half hour I am lucky enough to see a nurse who I can inform I have schizophrenia but by this time my world is forever altered. If mental illness must be stripped upon entry it must be done with the mental state of the offender in mind. It can only be as important to security to have knowledge of mental illness immediately. If the police are not passing this information it needs to be discovered before processing becomes mistreatment.

Today I experienced what the general population can expect from this facility. I wasn’t moved by the machine that can x-ray my every orifice. I’m sure it’s easier on their eyes. Good for them. I’d have figured out a better way of searching ass when they invented radar for planes. 

Fresh air for these prisoners will come from the top grate of a 30 foot wall. Outside of temperature the area one would consider yard is in fact indoors. As part of containment, the minimization of staff and in the name of security visits will be held by video. We all like Facetime and Skype. It’s hard to defend what are often prematurely referred to as criminals but from a mental health perspective this seems alarming. I realize in jail they don’t put you in the sunshine with your cast even if it helps but to be out of the sunshine doesn’t make the break worse. They don’t allow open visits for people in wheelchairs but we would be fools not to if it helped them stand. A prisoner is a prisoner but if your treatment or conditions cause a deterioration of an identifiable illness it kind of takes the correct out of corrections.

I had a thought and wondered who the representative for those who have been incarcerated with severe mental illness was at the planning stage. It seems silly to ask but pure stigma if we don’t. If we do not look to those who are affected how can we assist those affected? The very problems we address are in fact mute if those with them were not consulted. We stumble blindly when we make mental health facilities without asking individuals with mental illness what is helpful and what is harmful. A correctional facility is more severely advised to consider the experience of those with mental illness as security must be worked into treatment. It is a challenge to design around mental illness but madness not to attempt.

I saw this facility through the eyes of my experiences. From what I can understand the periods I spent psychotic in isolation may now occur in a more hospital like setting with mental health professionals on site. I will be able to experience outside temperature at times but I am not allowed in the same room with a friendly face; someone I know and possibly the only one I do or can trust. I find some comfort in this facility but I would experience her worst regardless. I was high functioning at times and my only complaint some days would have been depression. My sense was that depression was welcome in the areas I toured.

If as a society we are going to accept that mental health care is administered at the point where the justice system becomes involved it must become a point of proper mental health care. If we accept that corrections are the deliverer of mental health care it must be recognizable as mental health care. If I get my prescription filled at Costco they don’t give me toilet paper.

I wonder if anyone has ever asked an inmate what might be most helpful to bring about the change all this punishment is supposed to elicit. I can stand in awe at the design, technology and security features but if they continue to accomplish the same things we’ve experienced for 50 years its tinsel on a toothpick. Is it really a feat to have a facility environmentally designed and constructed if it is only going to be filled with recycled ideas and ambitions?