Psychiatry services at HMP a life, safety issue: citizens’ rep

Josh Pennell
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The latest report by the citizens’ representative shines a light on complaints made about psychiatric services for inmates at Her Majesty’s Penitentiary (HMP).

Barry Fleming’s 2012-13 report was released last week.

“We were getting a steady stream of complaints from inmates who were alleging that they were being cut off their psychiatric medication once they were incarcerated,” Fleming says.

The claims proved difficult to investigate, however. Each complaint meant looking at an individual’s medical history before incarceration and after. For people without medical training, this was no easy task. So the investigation process shifted, says Fleming. Several years ago, the Department of Justice reviewed the province’s prison system.

One of the comments made by the psychiatrist at HMP — Dr. David Craig — was that he was conservative in his prescription practice.

“So instead of us having to investigate individual complaints from inmates, we took a broader, more systemic, look at the issue,” says Fleming.

“And we came to the conclusion that it was unfair for the inmates to have to go through a particular process of having their psychiatric medication reduced or eliminated once incarcerated.”

The first best choice, as far as Fleming and his staff were concerned, was getting a new psychiatrist for HMP, a recommendation Justice rejected. But the department contracted an out-of-province psychiatrist to do a review, which was released last year.

That review concluded the psychiatric services provided at the province’s correctional facilities were comparable to those offered at other correctional institutes in Canada, but they could be improved. One recommendation was that psychiatric practices should not substantially vary for inmates before and after incarceration.

“We think that if those recommendations were properly implemented, the concerns that we had would have been addressed,” says Fleming.

“It’s an open question as to what extent these recommendations have been implemented,” he adds.

An ombudsman’s job is to shed light on an issue, Fleming says.

“I like to say to the people that our jurisdiction is a mile wide and an inch thick,” Fleming quips.

Those involved in defence work and non-government organizations with an interest in the subject must keep pressure on the issue of psychiatric services at HMP, he says.

In provincial court recently, defence lawyer Joan Dawson did just that in the case of Elijah George, a young Nigerian man who has lived in Canada since last year. George is charged with sexually assaulting a nurse and assaulting another nurse while he was a patient on the psychiatric ward of the Health Sciences Centre in St. John’s in May. He is also charged with voyeurism.

Dawson expressed concerns to the judge about sending her mentally ill client back to HMP because when he was recently there, she said Craig took George off the medication prescribed for him at the Waterford Hospital by Dr. Nazir Ladha, the province’s top forensic psychiatrist.

Dawson applied to have George remain in custody at the Waterford Hospital for the duration of his trial.

“For a psychiatrist at the Pen to ignore the recommendations of the province’s top forensic psychiatrist, who prescribed certain medication, is terrible. (Craig) should have to consult with Dr. Ladha,” Dawson commented to reporters following the proceedings at provincial court.

When asked recently by The Telegram if she thought the ombudsman’s recommendation of a new psychiatrist for HMP should be followed, Dawson said there was more to the issue than that.

“I think there has to be more communication back and forth,” she said. “This has been an ongoing issue for years, but what is so appalling is that the community is not up in arms.”

The application to have George remain at the Waterford was granted. Dawson could not be reached by deadline for further comment on the citizens’ representative annual report.

Fleming says his work as an ombudsman must be carried out with a fair amount of confidentiality, but the issue of psychiatry services at HMP was too serious not to bring to the court of public opinion.

“We really did consider this a life and safety issue that really required, I think, some type of action.”

Fleming stressed the overall medical treatment of inmates is fairly good. He said another area of complaint his office hear involves the provision of dental services at HMP.


Watch this week and next for other stories by Josh Pennell and Andrew Robinson from the Citizen’s Representative report.



Organizations: Department of Justice, Waterford Hospital, Health Sciences Centre

Geographic location: Canada

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