90 Days

When a prisoner is incarcerated health care becomes the responsibility of the government. Individuals in jails and prisons are neutered of any capability to seek out or enlist assistance.  When we are dealing with individuals with mental health concerns, availing oneself of health care is often not within the capabilities of the offender as symptoms often further reduce an inmate’s ability to vocalize and enlist assistance. If an individual is incapable of insight into their illness they are also incapable of being proactive with regards to their health. It then becomes imperative for the authorities to institute conditions and opportunities to address the needs of the offender.

The conservative government thinks they are dealing appropriately with the mental health needs of inmates by ensuring “proper” mental health screening takes place within 90 days. Would a similar time frame be acceptable to Canadians if we were speaking about a physical illness? An inmate with diabetes, heart disease or many other conditions could in fact perish with the same concern. Mental illness seems less fatal but within the prison population it can easily be just that. I was two steps from being beaten with the symptoms and delusions I experienced while incarcerated.

Some prisoners are prone to manipulation and bullying and the mentally ill make for easy prey. Thankfully, I was taken under the wing of prisoners who ruled the units I was held in. They let me sit at their table and were instrumental in my weight loss program. My meals were divided and through delusion my liquid intake consisted of licking my hands when I washed them. Weight Watchers was financially not an option so I am forever grateful.

It seems incongruent that members of parliament almost end up with a pension after 90 days while those with mental health care needs are exposed to the same time frame for assessment. It is further incredulous that after 90 days solitary confinement can be considered treatment. MP’s would wet themselves after two days but the mentally ill are expected to endure as they hold no value after the handcuffs are fastened.

When an inmate is first processed they are given a Tuberculosis test within the first 24 hours. If the overall health of the prison population can be compromised by a physical illness is it not realistic to assume mental health matters are as important? As Canadians we would be alarmed if a broken bone was considered important within a 90 day time frame but we go about our merry way when mental health concerns are dealt with in this fashion.

We can be pleased and comfortable that these issues affect prisoners but the stigma leaks into our communities and infects and affects all who are touched by mental illness. The conservative approach is a display of unhealthy and unacceptable attitudes; it is stigma in action cemented in policy. It is an affront to Canadian values and it is disgraceful. There are hundreds of organizations and countless individuals who devote resources to combating what the conservative government institutes as policy.

Some would say I have gone too far in calling conservatives immoral. If it is moral to expose individuals with a mental illness to conditions which exasperate their illnesses, I stand corrected. We are not mending the broken bone but insisting prisoners walk with fractures. A tough on crime policy is misguided but when it becomes a tough on mental illness policy it becomes an affront to every Canadian affected by mental illness.

“Jails top ombudsman’s concerns”

This headline is from an article I tore out of The Toronto Star on Tuesday, June 25, 2002. I would have used scissors but they were not part of our “kit” at the correctional facility I was incarcerated in.

The article by Richard Brennan begins with “A mentally ill, deaf woman was confined to a segregation cell in an Ontario jail for two months without regular access to a shower or fresh air the province’s ombudsman reported yesterday.”

Within two years I was in the process of being found Not Criminally Responsible on account of a mental disorder and faced the same. I guess I could be angry looking back on it and the fact that the ombudsman was powerless in her role. I could be angry society saw little need to address the issue. Instead I am saddened that eleven years later we are dealing with the same issue.

Is the problem systemic or societal? The system is seriously flawed if in 11 years we are unable to change. When a mentally ill woman in a jail is subjected to segregation rather than mental health services and society does not scream for answers it smells of stigma. These situations have persisted because our attitudes persist. We still do not perceive mental health as the pivot of overall health.

What is the benefit of making mental illness a joke or using it as a putdown or slang?  We stumble on our own stigma and twist uncomfortably in its shadow when we or a loved one is affected. We are careless with our attitudes and we become prisoners behind the stigma they create.

The ombudsman said the Tories’ hard-line, no frills approach to prisoner care has only exacerbated the problem. The then Public Safety and Security Minister Bob Runciman said jails are not meant to be fun places. These are not county club settings. We’re not the federal government…you do the crime, you do the time. Many of the complaints are frivolous.”

I guess at that time it was acceptable to wash your hands of individuals once they become involved with the justice system. I guess at that time if there were frivolous complaints all could be ignored. I guess back then mental health care was a frill.

Ombudsman Clare Lewis was a voice ignored but I will quote her anyway.

“I’m not asking that people be mollycoddled. But, by golly, if we are going to incarcerate people – and we do in large numbers – then we have an obligation to see that they are treated rationally, with dignity and with some degree of respect.”

 We continue to leave politicians with enough indifference that they do not act. Indifference is stigma in action.

Toronto South Detention Centre

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?

 

The Spank of Equality

Now that many Canadians are aware of the inability of the Correctional Service of Canada to administer mental health care to inmates, I wonder what concern is in the minds of citizens. Many news stories pass quickly from our minds if they seem to enter at all. It is my assumption that few are talking about it around water coolers if indeed the prime minister has one.

They are criminals and mentally ill at that; they don’t show up on polls. Maybe if mental illness did show up on a poll, government could recognize its importance.

As individuals, we try to build ourselves up as something. Unfortunately, in this endeavor it is easier to be something if someone else is nothing. If we stand tall because others are below us, it is really just an illusion. Concern, care and compassion can be eroded by judgements.

Can we really say we have compassion and respect for others if these individuals are excluded?

What exactly are the miraculous changes that occur in a person to make them this or that? We dance about becoming, forgetting about the being…human being. We are all human despite clothes, location or position. We do not all get the same birthing spank of equality. The arithmetic can be simple when we look at another’s misfortune: ‘if they were as smart as me or worked as hard they wouldn’t be where they are’. When another’s difficulties are simple, we can absolve ourselves of involvement and have little need to stand back in awe of our complex good fortune.

It will take political will and money that many would rather see in a road but if a car is empty of understanding and compassion, it might as well stay parked.

I guess like any news story, it is only one if we make it so.

Realigious

I was looking over some jail letters I wrote years ago. My mother, an aunt and a family friend saved all the letters I wrote during my confinements. It’s interesting to read my observations and perspectives. I saw much more than bars when I was behind them. I learned lessons that the same time in school may never have yielded. I wrote the word “parity” and its definition on January 16, 2002. “A state of being equal and a theory in physics that any substance and its mirror image counterpart have the same physical properties.” I would like to argue against this theory as any mirror I stand in front of has less hair and more weight than I know I posses but I see its truth. A rock in front of a mirror is nothing more or less than itself. It has cracks and has no reason to deny them. It will not lose stature as a rock if it reflects flaws.

I am not always pleased with my receding hairline but it is mine. I can still smile with it, I can carry a conversation; it really doesn’t take away from who or what I am. When I can recognize myself as I am; full of warts but fine thanks just the same I can be who I am. It is more reflection and less deception when I can see myself as light and dark. When we see our true substance and the mirror image as the same it in fact creates “parity” itself. “The state of being equal.” If I see myself as I truly am there is no maneuvering into being better or worse than others. We are all the same.

There is little need to be anything in solitary confinement; the Hole. Whatever you are is all you live with. There is no need to say or do anything to alter your position as there is no one to posture for. I often crawled about my small space scratching notes on my papers and upon the walls and floor. My life had more importance than any time I was a free man. There was nothing to fear in nothingness. What would fester in your mind if it had nothing to occupy it? What if there was no phone, computer or company? Who and what do you connect with when you are the one and only for days, weeks or was it months? When it was just me most of my thoughts had spiritual significance. Realigious experiences and perspectives are often a symptom of mental illness. Maybe some are but wouldn’t that make God crazy?

“Shotgun”

I remember when I was finally transferred from jail to the forensic hospital. As I exited the jail handcuffed and shackled I was at first struck by the open space. Being transferred is usually pleasant and a little like watching a movie. You see and hear things you are unaccustomed to. Green grass or the sound of tires on pavement. There were several jail nurses sitting at a table outside on break. I bowed my head and thanked them. They did what they could.

I climbed into the kennel of the transfer van. It was basically like being a bean stuck to the inside of an empty tin can. I didn’t have much of a view and can recall no landmarks. I knew I was heading to St. Thomas but did not recognize the fact until we parked.

After I left college and my lifelong dream of being a Conservation Officer, I applied to several police forces. At that time there were many more interested in police work than were ever hired. I did have one interview. It was with the St. Thomas Police Force.

I should have been more specific when I prayed to ride in a police vehicle in St. Thomas. I should have specified it was the front seat I was interested in. I’m pretty good at reading people and I sensed that the two officers who transferred me would be unappreciative of me yelling “Shotgun.”

The 5 Star Hotel

There was an article in the local paper speaking to the issue of some kinks in the new Southwest Centre for Forensic Mental Health. I won’t speak specifically to the electronic issues of the new facility. I don’t see it as newsworthy to report on a building that has problems upon start up. Don’t they all? It may be alarming to staff to have a patient in an area they shouldn’t be in but I doubt if it is a first. As a member of the public and having the benefit of a tour I can see exit from the actual building being unlikely. The staff is trained to deal with these situations and they have the backup of hospital security.  St. Thomas itself has a police force and the Ontario Provincial Police Detachment is less than a kilometer away. Making it far would again be unlikely. I wonder what the underlying sentiment is.

Seeing the comments following the article illustrates at least one issue.

I was at the opening and noticed…

Each patient has their own room, bathroom, DVD player and flat screen, comfortable lounge areas, outside courtyard with fountain, quiet room with wall fountain, lazy boy chair and sheepskin carpet, washer/dryer for every 6 patients, refreshment area with TV for every 6 patients, windows everywhere, fancy expensive hospital beds for people who are not physically sick or handicapped and patients are playing with controls and staff can’t fix it.

Sad to see a 5 star hotel where people are housed that have committed violent crimes, yet seniors and more deserving mental patients and handicapped people are in one star facilities.”

When we talk about stigma it takes on an obtuse form. These comments bring into focus the specific nature of the attitudes that lead to stigma.

“fancy expensive hospital beds for people who are not physically sick or handicapped…

Apparently this person is unaware of the fact that mental illness can be debilitating. It can be a permanent disability for some individuals. I feel sorry for the writer of these comments. If they ever fall in with the one in five who deal with mental illness they will be throwing away a good mattress. If people with mental illness are not worthy of a comfortable bed I suspect this person wouldn`t be either. It makes complete sense though to build a new facility and use 20 year old beds. A few of the old windows were usable as well.

This person seems to think there are degrees of value and worse that they are responsible for allocating it. For this person a judgement needs to be made to determine if someone is deserving. I have seen many forms of mental illness and experienced several. Try as I might I can`t think of any that are not deserving of compassion, respect, dignity or even comfort.

“Sad to see a 5 star hotel where people are housed that have committed violent crimes…”

It`s sad that this person was so preoccupied with making judgements that they didn`t listen to the guide clearly dispel this fallacy.

I would be curious to know what judgement needs to be made when a senior with a mental illness commits a crime. They are a senior so they are worthy of a comfortable bed but I guess they should sleep on concrete because their mental illness brought them into conflict with the law. Seniors sometimes find themselves involved with forensic mental health. Would grandma lose her worth in such a situation?

“more deserving mental patients”    Is my mental illness worth less than another?

This all reminds me of the hierarchy among prisoners. Your position in the pecking order was determined by your crime. It was an act that determined your worth. When you are literally stripped of everything you must create some other measure of value. Sex offenders were the lowest with a sub category reserved for pedophiles. I was often fascinated by the dynamics this created. The main fault of such a system is that in order to create your false sense of worth someone else has to be devalued. Jail is in some ways a mirror for the rest of society.

Inequality serves the purpose of overcoming feelings of inadequacy. We create a wider social pecking order and do our best not to be seen near the bottom. Prejudice is a tool to devalue another and discrimination is the application of attitudes whose underlying purpose is to create a false sense of worth in self.

The values we place on each other are a social construct; a fallacy that can and does lead to prejudice and discrimination. It is a house of cards if our worth is dependent on the devaluation of others.

We all put our pants on one leg at a time.