Province says it is on target for transfer of health services in jails

ST. JOHN'S, N.L. — Psychiatric and psychological services at both Her Majesty’s Penitentiary (HMP) in St. John’s and the Newfoundland and Labrador Correctional Centre for Women (NLCCW) in Clarenville were flagged in an independent report in December 2018, with a call for additional resources.

“Psychiatric and psychological services are limited in both institutions and the current allocation of positions is inadequate to meet the increasing mental health problems,” wrote former RNC Supt. Marlene Jesso, in her “Deaths in Custody Review” report to the Department of Justice and Public Safety.

recommended a review of staffing. She also recommended looking at moving responsibility for health services at the sites from the portfolio of Justice to Health and Community Services.

The Department of Justice and Public Safety was already working with Health and Community Services, under the direction of ministers Andrew Parsons and Dr. John Haggie, to undertake the transition. It was recommended in 2017 by the all-party committee on mental health and addictions.

The transition remains on schedule for later this year, The Telegram was told.

“A steering committee comprised of representatives from Justice and Public Safety, Health and Community Services, the four regional health authorities, as well as community representatives, has been established and will be providing advice and recommendations on matters pertaining to the transfer of health services in the correctional setting, including human resource requirements,” a Justice spokesperson stated in an emailed response to questions.

Prompted by Jesso’s report, The Telegram recently took a closer look specifically at psychiatric services — just one aspect of mental health care at the province’s largest correctional facilities (with nurses, psychologists and family physicians also serving individuals in custody).

At HMP, there are two part-time psychiatrists: Dr. David Craig, scheduled for one day a week, and Dr. Jasbir Gill, on two hours a week.

Craig is also responsible for the facility in Clarenville. He is there for a scheduled clinic roughly once a month. According to the Department of Justice and Public Safety, he attended the facility 12 times in 2017 and 14 times in 2018. He also had telemedicine and video conferencing sessions. In 2017, he took part in 25 such sessions. In 2018, that increased to 37.

“We rely on our health care professionals to determine the best administration of care for our inmates. In many cases, telemedicine and video conferencing is appropriate and an accepted approach to care. If it is determined that further care is necessary, the psychiatrist will meet with the inmate in person or arrangements are made to have the inmate transferred to a health care facility,” the department spokesperson stated.

The “Deaths in Custody Review” report notes an inmate in mental health crisis must be assessed by a psychiatrist. After that assessment, a decision is made to release them, maintain a suicide watch or transfer them to the Waterford Hospital for treatment.

“In rare cases when Dr. Craig is unavailable, an inmate of HMP or the (Clarenville facility) can be transferred to the lock-up to be seen by the on-call psychiatrist,” The Telegram was told.

The lock-up has an on-call list of four doctors. Each is on call 24 hours a day, for one week a month.

Jesso’s report noted the wait for a psychiatrist at HMP and Clarenville.

“Depending on the psychiatrist’s work schedule, an inmate may not be seen for up to four days. The current practice may result in a gap between the crisis and access to a medical professional,” she stated.

The department says the four-day wait would not happen to anyone in crisis.

“If an inmate is deemed to be in a mental health crisis they are seen by a psychiatrist in-person within 24 hours. If it is determined that the inmate is not in crisis, we acknowledge that it could be more than 24 hours before an in-person visit with a psychiatrist,” the Justice department stated.

Outside of the correctional system, Eastern Health said mental health services on the Avalon can be accessed by going to an emergency room at any time, including the Waterford Hospital, or by simply calling the confidential mental health crisis line (1-888-737-4668). There are non-emergent counselling options in addition to emergency services, including the Doorways walk-in service.

For patients not in crisis, an urgent referral will have an average wait time for a psychiatrist of roughly six months (a median on the Avalon of 179 days in the period of October to December 2018).

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