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Dr. Mary Bartram, MHCC’s director of policy

MHCC releases recommendations to support inmates during pandemic

Friday, July 16, 2021 @ 9:22 AM | By Amanda Jerome

On July 15, the Mental Health Commission of Canada (MHCC) released new research and recommendations emphasizing the impact COVID-19 has had on incarcerated and recently released persons.

According to a press release, the “COVID-19, mental health, and substance use in correctional settings policy brief provides decision-makers with guidance and recommendations on how to improve supports for justice-involved people.”

“In Canada, between 65 and 70 per cent of people who are incarcerated are living with problematic substance use. Furthermore, 73 per cent of federally incarcerated men and 79 per cent of federally incarcerated women live with one or more current mental health problems or illnesses,” the release added.

 MHCC’s director of policy, Dr. Mary Bartram

Dr. Mary Bartram, MHCC’s director of policy

MHCC’s director of policy, Dr. Mary Bartram, told The Lawyer’s Daily “overall, the pandemic has really taken a toll on mental health and substance use in jails and in prisons, so the importance of addressing gaps in supports for people around those issues is even more pressing now than it was prior to the pandemic.”

Bartram noted that from a legal perspective the pandemic “really shone a light on the importance of protecting people’s rights and balancing public health measures with the importance of upholding rights in correctional settings, whether it’s freedom of movement or the importance of maintaining social connection [and] access to health care.”

“The report does focus in on the risk of conflating solitary confinement with medical isolation,” she explained, adding that it’s important to make “a clear distinction” between the two and not use the same space.

She also stressed that people should be “mindful of the mental health impact of medical isolation given how much [it] resembles solitary confinement.”

“In some ways, isolation is something we’ve all been dealing with the mental health impacts of and in a congregate setting, like a jail, prison or a correctional setting, it’s hard to get away from how isolation, especially full medical isolation for people who have symptoms or have COVID, resembles solitary confinement,” Bartram said, noting that solitary confinement is distressing and has proven to be a contentious issue in correctional settings and amongst policy makers.

Bartram believes that minimizing the association with solitary confinement, such as not using the same setting that’s used for medical isolation, is helpful.

“We’ve seen good use of things like providing calling cards for people to be able to connect with loved ones [and] family while in medical isolation… and the importance of regular check-ins from health care providers who can monitor the mental health impact. Those are all things that have happened, but we need to really carefully monitor that it’s happening consistently everywhere,” she stressed, noting that the MHCC report highlights the importance of being transparent in reporting the use of these practices, especially on whether there’s been a disproportionate impact on Indigenous or racialized people.

“We need to be very careful in monitoring the use of those practices because they do edge so closely to solitary confinement,” she added.

Bartram also noted that the “risks of getting and dying from COVID are elevated in jails and prisons.”

“We’ve got a whole lot of people with higher rates of chronic disease, which puts them at greater risk living in close quarters,” she explained, noting that the pandemic has been “stressful and anxiety provoking” on the whole for people in the general population, but for incarcerated individuals at increased risk it’s been “a tough experience.”

“You’ve got this increased risk from COVID, and you already have as well more people with mental health and substance use issues in correctional settings than in the general population, and then you add the mental health impacts of isolation and physical distancing and reduction in freedom of movement, not being able to see people, like have family visits, not being able to continue with going outside of correctional settings for work for people who had that prior to COVID. That’s a lot of things taken away and you add on top of that disruptions in access to mental health, substance use and health services,” she said, noting that the delivery of services in correctional settings was “strained to begin with.”

“All of that adds up to some pretty big challenges and yes, there was a lot of early releases that happened, but it exposed some of the gaps in decarceration. People with high rates of emergency room admissions, higher rates of overdose, higher rates of psych hospital admissions for people who experienced that early release, just pointing to the lack of continuity in services and supports for people,” she explained, adding that the MHCC’s report calls for a “national decarceration strategy.”

Bartram stressed that the pandemic has “been worse for Black and Indigenous people in jails and prisons.”

“They’re highly overrepresented in the correctional population, particularly in some provinces, like 75 per cent in Manitoba and Saskatchewan. We need to take a really good look at how to do better by Black and Indigenous people in correctional settings,” she added.

The news release announcing the report also noted that the MHCC will be issuing a “comprehensive inventory of the mental health and substance use services that are currently available in Canada for people transitioning from the criminal justice system” in the coming weeks.

“Organized by province and territory, and available in both official languages, this interactive inventory will be regularly revised to ensure its programs and services are up to date,” the release added.
