Hon. Sylvia Jones
Ministry of the Solicitor General
18th Floor, George Drew Building
25 Grosvenor Street
Toronto, Ontario M7A 1Y6
Dear Solicitor General Jones:
Thank you for providing the Ontario Human Rights Commission (OHRC) with the opportunity to tour Hamilton Wentworth Detention Centre (HWDC) on July 15, 2019.
I am writing today to provide a summary of what we learned based on:
- A tour of the facility
- Engagement with Superintendent Bruce Laughlin, senior command, and senior Ministry of the Solicitor General (MSG) leadership
- Engagement with the program team at HWDC, including social work and healthcare
- Engagement with correctional officers and representatives from the union
- Engagement with members of the Community Advisory Board for the HWDC, including review of its report submitted to MSG on March 28, 2018
- Private interviews and correspondence with female and male prisoners and their family members
- Relevant media coverage
- Coroner’s Inquest jury recommendations and related government commitments.
As you know, the OHRC has toured jails and correctional centres across Ontario since 2016 as part of monitoring MSG’s progress in implementing the Human Rights Tribunal of Ontario (HRTO) Order in Jahn v Ministry of Community Safety and Correctional Services. Moreover, the OHRC has a statutory mandate under s. 29 of the Human Rights Code (Code) to initiate reviews and inquiries into conditions that may lead to incidents of tension or conflict in a community or institution, and to report to the people of Ontario on the state of human rights in Ontario.
We also note that Community Advisory Boards (CABs) established under s. 14.1 of the Ministry of Correctional Services Act play an important role in increasing transparency and accountability through submission of an annual report to the Minister. While not obligated to do so, CAB members at HWDC noted that the previous government posted these reports online and formally responded to them. They were hopeful that the government would adopt the same practice with their report submitted in March 2018. They also noted that they had not met with MSG leadership since the change in government. We encourage MSG to work collaboratively with its Community Advisory Boards (CABs) and to draw on their unique insights to improve conditions of confinement for prisoners and working conditions for front-line staff.
Accommodating prisoners with disabilities
The OHRC is concerned that prisoners with mental health disabilities continue to be placed in segregation despite the HRTO’s Order in Jahn. We are also concerned that prisoners do not have adequate access to health-related resources to meet their needs.
Staff and management confirmed that many prisoners at HWDC have mental health disabilities. We were impressed with the innovative approaches being employed by HWDC management and staff to respond to these needs — including housing prisoners with mental health disabilities on units and ranges where staff have specialized training from St. Joseph’s Healthcare Hamilton.
The OHRC was also impressed with the accessibility unit at HWDC, which allows people with mobility-related needs to be accommodated in a safe environment with full access to approved mobility devices. This is a marked improvement from other institutions where we were told that prisoners requiring a wheelchair were, for example, kept in segregation or relied on assistance from other inmates to get around.
That said, prisoners noted extensive wait times to see a medical doctor or psychiatrist, which also impedes timely access to medications. The OHRC also met with two prisoners with diagnosed mental health disabilities who were or had recently been in segregation. We were not able to conduct effective interviews with them due to their mental health issues.
Accommodating prisoners with addictions
We encourage MSG to shift from a security-focused approach to addictions to one rooted in human rights. MSG is well-placed to interrupt the cycle of addiction and incarceration by offering intensive addictions treatment and support, and working with the Ministry of Health and community partners to make sure that prisoners can seamlessly access support in the community on release.
While Ontario is making efforts to better detect and prevent drugs from entering the institutional environment, everyone we spoke to at HWDC expressed concern about drug overdoses, related deaths and the increased demand for addiction-related treatment and support.
MSG and HWDC have implemented several measures to better detect contraband substances such as opioids. For example, all prisoners admitted into the institution must submit to an x-ray body scan. They are placed in a “dry cell” (i.e. without a toilet) if they are suspected of bringing in a contraband substance. We also understand that HWDC has access to drug-sniffing dogs.
Unfortunately, Correctional Officers noted that they are not adequately trained to accurately and reliably analyze results from the x-ray body scanner, while prisoners noted that they were sometimes placed in the dry-cell out of an “abundance of caution” rather than due to reasonable suspicion. Correctional Officers also questioned the effectiveness of using drug-sniffing dogs, noting there was an overdose one hour after the dogs last went through the institution. In the end, it was acknowledged by all that drugs are easily accessible within HWDC.
Under the Code, people with addictions are protected from discrimination and must be accommodated to the point of undue hardship. Best practices for accommodating people with drug addictions in prison include:
- Clear policies and procedures requiring accommodation of mental health disabilities to the point of undue hardship based on a harm reduction or medical management approach
- Clinical oversight over all aspects of screening, assessment and treatment, and appropriate staffing expertise, levels and training (including for emergency interventions such as administering naloxone)
- Treatment that is voluntary, individualized, evidence-based based and accessible to all prisoners who need it. Treatment should include a combination of medically-assisted detoxification, medically-assisted treatment (long-acting opioids) and psychosocial support
- Correctional authorities should work with health and social service providers to ensure continuity of services upon release into the community.
HWDC adopts some of these best practices. Upon admission, it appears that prisoners are screened for possible drug-use or addiction-related issues. Ontario has approved positions at HWDC to assist with addictions screening, treatment and support, including two part-time psychiatrists, two part-time doctors, a psychologist, a pharmacist, four full-time addictions nurses, two addictions counsellors, etc. However, both staff and management admitted that there was high staff turnover in these roles and that many of the positions were not filled.
We are pleased that all prisoners — whether remanded or sentenced — are able to begin or continue drug-replacement therapy programs while incarcerated. We understand that demand for these health services is very high, with roughly 20% of men and women at HWDC requesting access to these programs. Staff noted that there are insufficient staff resources to meet this demand, and that nursing staff must be relieved of other duties to assist with administering drug replacement therapies. In light of the ongoing opioid crisis — and systemic healthcare-related problems more generally — every effort should be made to make sure that institutions are able to fill and maintain all available health-related positions.
Correctional Officers noted that they have been able to successfully administer naloxone to prevent deaths in many cases. We echo the CAB in commending MSG for launching the “Take Home Naloxone Program” for prisoners on their release. This is significant because one in 10 overdose deaths in Ontario occur within one year of release from a provincial jail.
Social work and health care managers noted challenges related to ensuring continuity of drug replacement therapies for prisoners released back into the community. For example, we heard that HWDC staff are not trained to administer the Global Appraisal of Individual Needs Short Screener (GAINS-SS), which is a pre-condition for admission into community treatment programs. This means that prisoners released by HWDC cannot immediately enrol in community treatment programs. Staff also noted that prisoners often face delays in activating provincial health coverage after leaving HWDC, which also poses challenges to obtaining treatment in the community on release. MSG should work with the Ministry of Health to make sure that all systemic barriers to effective community treatment are addressed.
At a systemic level, the OHRC encourages Ontario to develop appropriate policies and procedures that clarify the obligation to accommodate addictions to the point of undue hardship, and that adopt the best practices discussed above. This is consistent with the CAB’s recommendations in their March 2018 report and recent Coroner’s Inquest Jury Recommendations that emphasize the need for clinical management of addiction within prisons and the need for enhanced pre-release planning.
It is worth noting that Correctional Officers are on the front lines of a mental health and addictions crisis in the broader Hamilton community, which has increased their workload and on-the-job stress. Officers reported that they do not receive adequate training to meet these challenges. Officers who have witnessed or been involved in overdose-related emergencies or deaths are not relieved of their duties for even a few hours and are not proactively screened for PTSD.
Accommodating prisoners’ creed-related needs
Ontario should provide correctional staff with clear guidance on the proper accommodation of prisoners’ creed-related needs and provide appropriate resources to meet these needs.
We understand that HWDC will soon have a permanent structure devoted to Indigenous spirituality. We are also pleased to learn that Indigenous prisoners are offered the opportunity to smudge. However, limited access to yard time means that access to smudging is irregular. We also understand that the institution only has one Native Inmate Liaison Officer, which limits access to spiritual services.
A number of prisoners we spoke to raised issues about accommodation of creed-related needs, including meals, prayer space and access to spiritual services. Unfortunately, the Chaplain could not provide us with demographic data on the creed-related identity of prisoners at HWDC. Without this information, it would be difficult to design programming to meet the unique needs of prisoners at HWDC.
In its March 2018 report, the CAB highlighted issues with access to faith-based special diets. The failure to adequately accommodate creed-related needs raises serious Code issues and should be resolved quickly.
MSG cannot meet its obligations under the Code if its policies are not implemented at the operational level. That said, the OHRC has identified a potential conflict between the 2019 Spiritual and Religious Care Policy and the 2007 Restricted Diets Policy that should be remedied to make sure that staff have clear guidance on how to meet Code obligations related to religious diets.
MSG’s Spiritual and Religious Care Policy and its accompanying Questions and Answers confirm that validating a person’s creed or religion is contrary to MSG’s obligation under the Code, and that staff should assume that a prisoner’s beliefs are sincere even if they make exceptions or show inconsistencies in their religious or spiritual practice, including their adherence to a religious diet.
However, MSG’s older Restricted Diets Policy, which we understand is still in use, indicates that “validation of requests for special religious diets is required for all new admissions” and that “if [prisoners] are observed and documented eating food that is not part of the diet, the Superintendent may…suspend or terminate the diet.” These statements are inconsistent with the Code and with MSG’s updated policy. The Restricted Diets Policy should be amended to accurately reflect MSG’s Code obligations relating to religious meals.
Conditions of confinement
HWDC is extremely overcrowded. Cells that were originally designed to house a single person now regularly hold three people. When the jail is locked down, for example due to ongoing staff shortages, prisoners can spend multiple days locked in their cells. For vulnerable prisoners, especially people who are young or have mental health disabilities, overcrowding increases stress and anxiety which can lead to “voluntary” admission to segregation, use of intoxicants, violence or other harmful behaviours.
Rule 12 of the Mandela Rules states that “Where sleeping accommodation is in individual cells or rooms, each prisoner shall occupy by night a cell or room by himself or herself,” noting that even in the event of temporary overcrowding, “it is not desirable to have two prisoners in a cell or room.” HWDC falls well short of this standard.
Prisoner yards are small and paved, and are sub-divided into what are best described as small chain-link cages topped with razor wire, ostensibly so that segregated or incompatible prisoners can receive their yard time concurrently. However, due to overcrowding and incompatibility issues, staff cannot guarantee that prisoners have access to the yard on a daily basis. Indeed, prisoners told us that they often only have access to yard time every few weeks. Rule 14 of the Mandela Rules speaks to the importance of access to natural light, fresh air and ventilation. Rule 23 requires that prisoners have at least one hour of suitable exercise in the open air daily. HWDC falls well short of these standards.
Thank you again for allowing me the opportunity to visit HWDC. Please do not hesitate to contact me directly to further discuss these issues.
Renu Mandhane, B.A., J.D., LL.M.
cc: Hon. Doug Downey, Attorney General
Hon. Christine Elliot, Minister of Health
Paul Dubé, Ontario Ombudsman
Justice David Cole, Ontario’s Independent Reviewer
Kelly Hannah-Moffat, Ontario’s Independent Expert on Human Rights and Corrections
St. John O’Neill, Community Advisory Board for HWDC