Introduction

Background

5.1 Correctional Service Canada (CSC) is responsible for the safe and secure custody of women offenders serving sentences of two years or more, and for preparing them for successful reintegration into the community upon release. It must also adopt programs and policies that are responsive to the unique needs of women offenders, including Indigenous women. Of the $110 million spent in the 2016–17 fiscal year on women offenders in custody, about $5.2 million was for correctional programs, and $4.4 million was for mental health services provided within CSC’s five regional institutions.

5.2 The number of women offenders serving federal sentences has increased by 38 percent over the last decade. In the 2016–17 fiscal year, 700 women offenders were in federal custody. A further 600 were serving the remainder of their sentences under supervision in the community. Most were serving two to four years, considered short-term sentences. During the same period, the number of Indigenous women offenders in custody increased. Currently, 36 percent of women offenders in custody identify as Indigenous (First Nations, Métis, or Inuit).

5.3 Many women offenders in federal custody

• have experienced some form of physical abuse,
• suffer from mental disorders,
• injure themselves or have histories of suicide attempts,
• have histories of drug or alcohol misuse,
• served previous sentences in provincial or territorial custody, and
• are parents of young children.

5.4 After the 1990 report Creating Choices: The Report of the Task Force on Federally Sentenced Women, CSC closed the Kingston Prison for Women, the only institution for federal women offenders at the time, and replaced it with five new institutions across Canada. In 1995, the first Healing Lodge for federal offenders, Okimaw Ohci Healing Lodge, opened in southern Saskatchewan. A second one, Buffalo Sage Wellness House, opened in Alberta in 2011 and is operated by an Indigenous community organization. In 2014, CSC expanded four of its five regional institutions by constructing stand-alone minimum security units outside the perimeter fences of the institutions.

5.5 Over the same period, CSC also introduced a new correctional approach for women offenders, recognizing that women offenders have different paths to crime than men offenders. In consultation with corrections experts, CSC developed programs to address the risk factors that are directly linked to women offenders’ criminal behaviour. The goal is to help offenders successfully reintegrate into the community and enhance public safety.

Focus of the audit

5.6 This audit focused on whether Correctional Service Canada assigned and delivered correctional programs, interventions, and mental health services to women offenders in federal custody—including Indigenous women offenders—that responded appropriately to their unique needs and helped them successfully reintegrate into the community.

5.7 This audit is important because women offenders’ ability to be granted early parole and successfully reintegrate into the community relies on Correctional Service Canada providing them with appropriate, supportive programs. Under the Corrections and Conditional Release Act, Correctional Service Canada is required to provide programs and services that respond to the needs of women offenders.

5.8 More details about the audit objective, scope, approach, and criteria are in About the Audit at the end of this report.

Findings, Recommendations, and Responses

Assessing women offenders’ security and rehabilitation requirements

Overall message

5.9 Overall, we found that Correctional Service Canada had not implemented an initial security classification process designed specifically for women offenders. Although Correctional Service Canada had examined options to improve security classification for women offenders, it continued to use the Custody Rating Scale, a tool developed more than 25 years ago based on a sample of male offenders. Correctional Service Canada also used this scale as its primary tool to refer women offenders to correctional programs, a use for which it was not intended. As a result, some women offenders risked being held at inappropriate security levels, and being required to take programs from which they could not benefit.

5.10 These findings matter because an offender’s initial security placement and subsequent security-level reviews affect her preparation for parole and successful reintegration into the community. Referral to appropriate correctional programs specifically designed to reduce a woman offender’s risk of reoffending can increase her chance of successfully reintegrating into the community.

5.11 According to Correctional Service Canada (CSC) policy, CSC must complete an intake assessment for each offender admitted into federal custody to determine the appropriate security level and correctional plan. For offenders sentenced to four years or less, these assessments must be completed within 70 days of admission.

5.12 CSC is required by the Corrections and Conditional Release Act to collect all relevant information about each offender admitted into custody to complete an intake assessment and correctional plan. This includes the nature of the offence, victim impacts, and the level of violence involved. At a minimum, this information is to be obtained from official documents, such as police reports, a judge’s comments upon sentencing, or a Crown attorney’s comments. If victim impact statements are available, CSC should include them in the assessment. CSC must request many of these documents from provincial or territorial authorities.

5.13 CSC uses this information when it determines the initial security classifications of offenders: maximum, medium, or minimum. A security classification is an assessment of the level of supervision required in the institution, of escape risk, and of risk to public safety in the event of escape. CSC policy requires that staff review an offender’s security classification at least once every two years to assess whether an offender may be placed at a lower level. A review may also be done earlier at the discretion of CSC staff, based on an offender’s behaviour. Reducing an offender’s security level when appropriate can indicate progress and reintegration potential. Also, an offender is more likely to be granted parole from a lower level of security.

Corrections staff frequently overrode security classification tools

5.14 We found that Correctional Service Canada (CSC) had not implemented an initial security classification process specifically for women offenders. Instead, CSC determined women offenders’ initial security levels using the Custody Rating Scale, a tool developed more than 25 years ago based on a sample of male offenders. We also found that, when making initial security classification decisions, CSC staff frequently overrode the recommendations of the security classification tool.

5.15 For reviewing an offender’s security classification, CSC developed and implemented a tool specifically designed to weigh the safety and security risks of women offenders, the Security Reclassification Scale for Women. But we found that CSC staff frequently overrode its results, placing twice as many women offenders in higher levels of security than recommended by the tool. As well, staff often did not complete women offenders’ security-level reviews (which are a potential means to support their successful reintegration into the community) before they were eligible for release on parole.

5.16 Our analysis supporting this finding presents what we examined and discusses the following topics:

• Information required for intake assessments
• Initial security classification
• Security reviews

5.17 This finding matters because an offender’s initial security classification and subsequent reviews affect the potential for parole and for successful reintegration into the community. Accurate security-level classification is also important for the safety of offenders and staff.

5.18 Our recommendation in this area of examination appears at paragraph 5.28.

5.19 What we examined. We examined whether Correctional Service Canada (CSC) obtained official documents, as required, to complete its intake assessments of women offenders, and whether its process for assigning initial security classifications was appropriate. We also reviewed whether CSC staff conducted timely reviews of women offenders’ security classifications.

5.20 Information required for intake assessments. We found that in nearly all cases in the 2015–16 fiscal year, Correctional Service Canada (CSC) obtained an official document concerning the offence to complete the intake assessment. However, CSC obtained the victim impact statement prior to completing the intake assessment in only 74 percent of the cases for which statements were available. CSC also requires other information about offenders—such as information about previous offences—but it often did not receive all of the requested information in time to consider it in its intake assessments.

5.21 Agreements with the provinces and territories govern CSC’s access to the information about an offender that is needed to complete intake assessments. Most agreements date from the 1990s, and some have expired. In response to our previous audit recommendation in 2016 about intake assessments, CSC initiated a process for updating these agreements, including new electronic document transmission and detailed time standards.

5.22 Initial security classification. We found that Correctional Service Canada (CSC) used a Custody Rating Scale designed for male offenders for its initial security classification of women offenders. Developed more than 25 years ago, the scale—based on a sample of male offenders—is a statistically based measure of an offender’s security risk while inside an institution. CSC used that scale, along with staff’s professional judgment, to determine whether to set a woman offender’s initial security level at maximum, medium, or minimum (Exhibit 5.1).

5.23 In response to concerns raised in a 2003 report by the Canadian Human Rights Commission, CSC committed to develop an initial security classification tool specific to women offenders. CSC worked to develop a new initial classification tool for women offenders, but found that it did not significantly improve classification results. In 2012, CSC reviewed the use of the Custody Rating Scale for women offenders and found that its ability to predict their safety and security risks could be improved. The research found that certain factors considered by the scale could be re-examined to better assess the risks posed by women offenders, such as substance misuse or family dysfunction. To date, CSC has made no changes to the way it uses the tool for initial security classification.

5.24 We found that, in each of the past three fiscal years (from 2014–15 to 2016–17), staff overrode the Custody Rating Scale’s results in about 31 percent of intake security assessments. However, CSC research found that its staff’s final security classification at intake—allowing for overrides—was more accurate than the scale’s recommendations.

5.25 Security reviews. Correctional Service Canada (CSC) has developed a security reclassification tool specifically for women offenders: the Security Reclassification Scale for Women. This scale considers the offender’s behaviour while in the institution, including her progress in correctional programs, and positive contact with her family. CSC research validated the scale for use with women offenders, with positive results. Although CSC policy requires an offender’s security level to be reviewed at least every two years, CSC research found that this scale can produce a valid security-level reassessment for review periods as short as six months.

5.26 Nonetheless, we found that CSC staff frequently overrode the results indicated by the Security Reclassification Scale for Women. From the 2014–15 through 2016–17 fiscal years, staff overrode the tool’s recommendation in 37 percent of security-level reviews, leading to twice as many offenders being placed at a higher level of security than recommended by the scale. Research on offender security classification indicates that, in general, overrides should not exceed 20 percent of all reviews. As well, CSC’s own research concluded that security-level reclassifications based on overrides were less accurate than those initially proposed by the scale.

5.27 CSC policy requires staff to review a woman offender’s security level at least every two years and allows for earlier reviews at staff’s discretion. We found that reviews were completed as required but that half of them took place after the offenders were eligible for release. This is important because research has shown that when offenders can be safely moved to lower levels of security before release, they are more likely to successfully reintegrate into the community. Offenders are more likely to be granted parole from minimum security than from higher levels.

5.28 Recommendation. Correctional Service Canada should examine ways to improve the initial security classification process to appropriately consider the risk factors for women offenders. Where appropriate, security classification reviews should continue to be used to support an offender’s successful reintegration into the community. The level of overrides of the security reclassification scale should be monitored to ensure the scale is being used as intended.

The Agency’s response. Agreed. Correctional Service Canada (CSC) acknowledges that research results continue to demonstrate that the current approach to the security classification of women offenders allows for the protection and safety of the public, other offenders, and staff. While CSC’s security classification instruments have been shown to predict the occurrence of the most relevant institutional behaviours and outcomes, CSC will be undertaking a comprehensive analysis of the security classification and reclassification process to identify risk factors relevant to women offenders. The results from this analytical review will be used to develop gender-informed policy, training, and tools, as required. As was previously done for initial security classification and to support an offender’s timely preparation for parole and successful reintegration into the community, CSC will create an automated information report to monitor security reclassification timelines and overrides at the national, regional, and local levels.

An inappropriate tool was used to assign correctional programs

5.29 We found that Correctional Service Canada (CSC) used the Custody Rating Scale as its primary tool to refer women offenders to correctional programs, even though it was not designed for this purpose. CSC has yet to implement an appropriate tool for referring women offenders to correctional programs.

5.30 Our analysis supporting this finding presents what we examined and discusses the following topic:

• Program referrals

5.31 This finding matters because correctional programs specifically designed for women offenders can increase their chances of successful reintegration into the community. To be most effective, higher-intensity correctional programs should be targeted at offenders at higher risk of reoffending.

5.32 Our recommendation in this area of examination appears at paragraph 5.36.

5.33 What we examined. We examined whether Correctional Service Canada used appropriate tools to assess a woman offender’s need for a correctional program.

5.34 Program referrals. We found that Correctional Service Canada (CSC) used the Custody Rating Scale to base its referral of a woman offender to a correctional program. However, the scale was designed to determine security classification, not to assign correctional programs. CSC developed the Criminal Risk Index as a more appropriate tool to assign correctional programs. However, by the end of the period covered by the audit, CSC was not yet using this tool for women offenders.

5.35 Without an appropriate program referral tool, many women offenders may have been required to take correctional programs from which they could not benefit. Most women offenders were initially assessed as having a low risk of reoffending and would not normally have been assigned to a correctional program. However, we found that most low-risk women offenders were referred to moderate-intensity correctional programs because of overrides of the Custody Rating Scale. CSC’s preliminary analysis indicated that replacing the Custody Rating Scale with the Criminal Risk Index for all offenders will result in fewer women offenders being referred to moderate-intensity correctional programs and twice as many being referred to high-intensity programs.

5.36 Recommendation. Correctional Service Canada should implement an appropriate referral tool to assign women offenders to correctional programs in line with their risk of reoffending.

The Agency’s response. Agreed. Correctional Service Canada has developed and will be implementing a new referral tool that improves the assignment of women offenders to correctional programs, as well as the assignment of Indigenous male offenders to correctional programs (in response to Report 3—Preparing Indigenous Offenders for Release—Correctional Service Canada in the 2016 Fall Reports of the Auditor General of Canada).

Delivering correctional programs and interventions

Overall message

5.37 Overall, we found that Correctional Service Canada’s delivery of correctional programs did not allow many women offenders to complete their correctional programs in time for parole. In addition, few offenders were employed in CORCAN establishments (a key employer in Correctional Service Canada facilities) or were granted work releases. We also found that few Indigenous women offenders had access to culturally specific correctional programs or interventions because of limited availability.

5.38 These findings matter because timely access to effective correctional programs and employment opportunities can help offenders successfully reintegrate into the community.

5.39 The Corrections and Conditional Release Act requires Correctional Service Canada (CSC) to provide programs and services that respond to women offenders’ unique needs and help address their criminal behaviours. The Act also requires CSC to provide culturally appropriate services to Indigenous offenders to support their successful reintegration.

5.40 Correctional programs are designed to target factors relevant to offenders’ criminal behaviour to reduce their risk of reoffending. CSC research showed that women offenders have different paths to crime than male offenders and that their correctional programs require a different approach than those for men. According to Creating Choices: The Report of the Task Force on Federally Sentenced Women (1990), correctional interventions for women should be governed by five core principles:

• empowerment,
• meaningful and responsible choices,
• respect and dignity,
• a supportive environment, and
• shared responsibility.

These principles have framed CSC’s correctional programs for women offenders.

5.41 In 2011, CSC updated its correctional programs for women offenders to improve access and participation and to better support successful reintegration. Skills such as problem solving, emotional regulation, and consequential thinking were key elements of these programs. CSC also developed culturally specific programs for Indigenous women offenders that included holistic treatments within a skills-based approach.

The length of correctional programs hindered early release

5.42 We found that Correctional Service Canada (CSC) had not assessed the effectiveness of its correctional programs in addressing the factors associated with a risk of reoffending. We also found that CSC took too long to deliver correctional programs to women offenders, often preventing them from being prepared for their parole hearings when they were first eligible. On average, half of the offenders serving short-term sentences did not complete their correctional programs before they were first eligible for parole. This presented a barrier to the timely preparation for release for the majority of women offenders, who were first eligible for release on parole six months after admission.

5.43 Our analysis supporting these findings presents what we examined and discusses the following topics:

• Correctional program effectiveness
• Correctional program completion

5.44 Timely delivery of correctional programs is important for women offenders because most serve short-term sentences (four years or less) and are eligible for parole within one year of admission. Even minor delays in program delivery can delay parole hearings—reducing the time offenders spend supervised in the community and, in turn, their chances of successfully reintegrating.

5.45 Our recommendation in this area of examination appears at paragraph 5.51.

5.46 What we examined. We reviewed Correctional Service Canada’s research to determine whether its correctional programs were appropriate for women offenders. We also reviewed case files for women offenders released over the past three fiscal years to determine whether they completed programs in time for early release on parole.

5.47 Correctional program effectiveness. Correctional Service Canada (CSC) evaluated its correctional programs for women offenders in 2015 and found that they did not significantly reduce the likelihood of readmission to federal custody. A later evaluation of its correctional programs for Indigenous women offenders in 2016 found that they helped to reduce the likelihood of readmission. Women offenders typically had low rates of reoffending while under supervision in the community. For this reason, both evaluations noted difficulties in demonstrating whether correctional programs for women offenders reduced readmissions into custody.

5.48 We also found that CSC had not evaluated the effectiveness of correctional programs in targeting risk factors relevant to reoffending among women offenders, such as substance misuse. This finding is important because a large proportion of women offenders were identified as having issues with substance misuse upon admission (94 percent of Indigenous women offenders and 71 percent of non-Indigenous women offenders), and correctional programs were the primary means to address these issues.

5.49 Correctional program completion. We found that only half of all women offenders were able to complete their programs by the time they were first eligible for parole. This presented a barrier to the timely preparation for release for the majority of women offenders who were serving short-term sentences. The successful completion of correctional programs is a key factor in determining whether offenders may be recommended for early release on parole.

5.50 Correctional programs take an average of three months to complete once begun. We found that only one institution among the five started women offenders in their correctional programs soon after admission so they could complete them well before parole eligibility. We also found that Correctional Service Canada had not examined the optimal timing, intensity, or duration of these programs to help offenders be prepared for their parole hearings when they are first eligible.

5.51 Recommendation. Correctional Service Canada should examine the effectiveness of its correctional programs for women offenders to ensure that they appropriately address risk factors relevant to reoffending. Correctional Service Canada should also ensure that correctional programs are delivered at the appropriate time, intensity, and duration to support an offender’s preparation for a parole hearing by her first day-parole eligibility date.

The Agency’s response. Agreed. Correctional Service Canada (CSC) remains committed to delivering structured interventions that address the risk factors directly linked to supporting women offenders to safely and successfully reintegrate into the community. CSC recognizes a variety of reintegration successes achieved for women offenders in the 2016–17 fiscal year, including by year-end, the highest recorded number of women being released on day parole (282 in 2016–17 and 207 in 2015–16) and on conditional release (651 in 2016–17 and 574 in 2015–16), the greatest number of women successfully reaching the ends of their sentences in the community (227 in 2016–17 and 186 in 2015–16), and the lowest number of women on conditional release being revoked with an offence (23 in 2016–17 and 31 in 2015–16). While similar trends are observed for men offenders, the reintegration successes observed for women exceed those achieved by men. In addition, CSC’s programs addressing the unique and diverse needs of women offenders have been developed and implemented, with the aim of improving effectiveness outcomes across several program areas. Per CSC’s regular evaluation cycle, an evaluation is under way to examine the effectiveness of these interventions.

Indigenous women offenders had uneven access to correctional programs and interventions

5.52 We found that some Indigenous women offenders did not have access to culturally specific correctional programs and that Pathways Initiatives and Healing Lodges were not available at all five federal women’s institutions.

5.53 Our analysis supporting these findings presents what we examined and discusses the following topics:

• Correctional programs
• Pathways Initiatives and Healing Lodges

5.54 This finding matters because Indigenous women who enter federal custody have a different background, history, and culture than non-Indigenous women offenders. Correctional Service Canada is required by the Corrections and Conditional Release Act to provide culturally specific programs to support their successful reintegration.

5.55 Our recommendation in this area of examination appears at paragraph 5.61.

5.56 What we examined. We examined whether Correctional Service Canada provided culturally specific correctional programs and interventions to Indigenous women offenders.

5.57 Correctional programs. We found that Correctional Service Canada (CSC) provided culturally specific programs for Indigenous women offenders but not at all institutions. Overall, only one quarter of Indigenous women offenders serving short sentences and taking culturally specific correctional programs were able to complete them by their first parole eligibility date. Indigenous offenders could participate in either general or culturally specific correctional programs. We found that twice as many Indigenous women offenders completed their correctional programs by their first parole eligibility date when they took general rather than culturally specific programs.

5.58 Of the Indigenous women offenders released in the 2016–17 fiscal year, we found that most had completed culturally specific correctional programs. However, institutions with relatively few Indigenous women offenders provided only limited access to such programs, which delayed their preparation for parole hearings. At one institution, none of the six Indigenous offenders had taken culturally specific correctional programs, despite all having a healing plan and working with an Elder.

5.59 Pathways Initiatives and Healing Lodges. Pathways Initiatives provide Indigenous offenders with intensive, one-on-one counselling and support consistent with Indigenous values, traditions, and beliefs. These initiatives operated at three of the five women’s institutions, and each accommodated up to 10 offenders. We found that participation levels varied across the three institutions. The largest unit—in the Prairie region, where the largest number of Indigenous women offenders were in custody—consistently operated close to capacity. We noted that Correctional Service Canada (CSC) engaged Elders on contracts to provide spiritual counselling and guidance within each of its women’s institutions.

5.60 Healing Lodges are correctional institutions that use traditional healing approaches to help women offenders reintegrate into the community. CSC operated one Healing Lodge in Saskatchewan (Exhibit 5.2) and funded another in Alberta, accommodating a total of 72 women. We found that the lodges operated at 90 percent capacity in each of the past three fiscal years, despite a recent increase of 16 beds. No Healing Lodges operated in other regions that had smaller numbers of Indigenous women offenders in custody. CSC has not examined whether Indigenous women offenders have sufficient access to Healing Lodges across its institutions.

5.61 Recommendation. Correctional Service Canada should ensure Indigenous women offenders have sufficient and timely access to correctional programs at each women’s institution, according to each offender’s need and preference. Correctional Service Canada should ensure there is sufficient access to its Pathways Initiatives and Healing Lodges to meet the needs of Indigenous women offenders, and should examine alternative interventions in institutions with small numbers of Indigenous women offenders.

The Agency’s response. Agreed. Many culturally specific services and interventions are provided to Indigenous women to prepare them for safe and timely release into the community. Recent Correctional Service Canada (CSC) research studies have confirmed that both Elder services and the Aboriginal Women Offender Correctional Programs contribute significantly to reduced reoffending.

As part of the new National Indigenous Plan, CSC is currently implementing Aboriginal Intervention Centres (AIC) at men’s sites to improve timely access to correctional programs and facilitate specialized case management practices to improve reintegration results for First Nations, Métis, and Inuit offenders. A revised AIC model that takes into consideration the unique reintegration needs of Indigenous women has been developed, and this model is scheduled to be implemented at women offender sites by summer 2018. This will ensure timely access to correctional programs and the existing Aboriginal Corrections Continuum of Care interventions such as Pathways, Elder services, and the support of Aboriginal Community Development Officers and Aboriginal Community Liaison Officers. CSC will also expedite inmates’ completion of Aboriginal correctional programs by broadening the pool of available facilitators. Programs and interventions will be more closely integrated and aligned with case management, to strengthen the potential for successful reintegration of Indigenous women offenders, while increasing the participation of Indigenous communities in the care and custody of Indigenous women offenders. CSC is also committed to addressing the spiritual and cultural needs of Indigenous women offenders and will explore alternative and individualized interventions at institutions where the Indigenous population is limited in numbers.

Few women offenders received on-the-job training with CORCAN to help them obtain employment upon release

5.62 We found that Correctional Service Canada provided few women offenders with employment opportunities with CORCAN or with work releases (permits to leave institutions temporarily for work) to help them obtain employment upon release.

5.63 Our analysis supporting these findings presents what we examined and discusses the following topics:

• CORCAN employment
• Work releases

5.64 Many women offenders lack marketable job skills. On-the-job training while in custody can support their successful reintegration upon release.

5.65 Our recommendation in this area of examination appears at paragraph 5.71.

5.66 What we examined. We examined whether women offenders participated in meaningful employment opportunities and vocational programs within institutions and obtained work releases in the community.

5.67 CORCAN employment. CORCAN is a special agency that provides offenders with meaningful employment while in custody to improve their job skills and chances for employment upon release. CORCAN employment was available at four of the five women’s institutions, but not at the Healing Lodges.

5.68 We found that CORCAN employed few women offenders. In the 2016–17 fiscal year, only 29 women offenders participated for three months or more—the minimum time needed to gain employability skills. More women offenders participated in vocational programs that taught specific skills, with 1,700 vocational training certificates issued in programs such as construction, landscaping or horticulture, food services, and workplace safety.

5.69 Work releases. We found that only 45 women offenders were granted a work release in the 2016–17 fiscal year. A work release is a permit to leave the institution and enter the community on a temporary basis to work. This type of temporary release is authorized by the warden and may be used to demonstrate an offender’s potential for successful release. Work releases also provide on-the-job training and potential job contacts in the community.

5.70 We found that work releases for women offenders declined by almost 30 percent from the 2014–15 fiscal year. In 2014, Correctional Service Canada built minimum-security units outside the perimeter fences of four of its women’s institutions, at a cost of $27 million, in part to promote work releases for women offenders. Yet the number of work releases still declined.

5.71 Recommendation. Correctional Service Canada should increase the use of employment as well as work releases to support the successful reintegration of women offenders into the community.

The Agency’s response. Agreed. Correctional Service Canada will increase the delivery of the National Employment Skills Program for women offenders, as well as increase the opportunities for vocational certifications, on-the-job training, and work releases, in order to support their successful reintegration to the community.

Improving mental health services

Overall message

5.72 Overall, we found that Correctional Service Canada did not track whether the women offenders it identified as needing mental health treatment actually received it. Furthermore, Correctional Service Canada’s mental health teams were not adequately staffed to provide the required mental health services. We also found some instances where women offenders whom Correctional Service Canada had identified as having serious mental illness were placed in segregation cells, and that Correctional Service Canada used cells in its segregation range to monitor offenders at imminent risk of self-injury or suicide.

5.73 These findings matter because Correctional Service Canada is required to provide essential health care that is consistent with professionally accepted standards, including mental health care and reasonable access to non-essential mental health care. Furthermore, providing effective and timely interventions to address offenders’ mental health needs is a Correctional Service Canada strategic priority.

5.74 According to Correctional Service Canada (CSC) research, women offenders have high rates of serious mental illness (Exhibit 5.3) and substance misuse, and many are at risk of self-injury and suicide. Rates of mental illness among offenders are reportedly three times higher than that of the general population. If untreated, mental illness can lead to disruptive behaviours, misconduct, and higher rates of reoffending.

5.75 CSC offers a range of services to help women offenders identified with mental health issues. Most get care from mental health teams within the five women’s institutions. Two common therapeutic approaches are individual counselling and intensive behavioural therapy (for those with more significant needs). Women offenders identified with serious mental illness may receive 24-hour mental health care at CSC’s psychiatric institution in Saskatoon or at a secure psychiatric hospital in Montréal.

5.76 While in segregation at Grand Valley Institution for Women in Kitchener, Ontario, Ashley Smith, aged 19, died by self-strangulation. In December 2013, the Coroner’s jury found that CSC had contributed to her death through acts or omissions in managing her mental illness and self-harming behaviours. The verdict contained 104 recommendations focusing on the mental health of offenders in the federal corrections system. In response, CSC committed to improve mental health services and restrict its use of segregation, particularly for offenders with mental illness.

Despite timely screening, treatment plans were not completed

5.77 We found that Correctional Service Canada had not confirmed whether its tools correctly identified women offenders with mental health issues or assigned them the appropriate level of care. As well, we found that mental health teams did not complete treatment plans for all the offenders they identified as needing one. The plans that were completed were not completed within 60 days, as required, nor did they contain all of the necessary assessment information.

5.78 Our analysis supporting this finding presents what we examined and discusses the following topics:

• Assessments
• Treatment plans

5.79 This finding matters because many women offenders have a mental illness and need help to manage it. Timely completion of mental health assessments and treatment plans after admission are essential in delivering appropriate mental health services to offenders.

5.80 Our recommendations in this area of examination appear at paragraphs 5.84 and 5.86.

5.81 What we examined. We examined Correctional Service Canada’s tools (such as questionnaires and rating scales) to assess women offenders for mental health issues. We also selected 28 case files to review Correctional Service Canada’s treatment plans for women offenders identified with mental health issues.

5.82 Assessments. Registered nurses briefly assess women offenders for mental health issues within 24 hours of admission. We found that Correctional Service Canada (CSC) screened offenders again within 14 days of admission, as required, using the Computerized Mental Health Intake Screening System. In the 2015–16 fiscal year, this tool referred about 40 percent of women offenders for further assessment. CSC’s preliminary research stressed the need for further study to confirm that this tool’s cut-off points appropriately identified women offenders needing further mental health assessment.

5.83 Women offenders who are referred for further assessment have face-to-face meetings with members of the CSC mental health team. At this point, a second tool, the Mental Health Needs Scale, helps evaluate the level of mental health services to assign. This scale also helps determine whether services will be provided within the institution through group or individual counselling, or in structured living units inside the institution with higher levels of support and supervision. Offenders assessed with serious mental health needs can also be identified for transfer to a psychiatric institution for specialized care. However, CSC had not determined whether this scale’s ratings were appropriate for women offenders. Also, CSC’s mental health staff indicated that the tool did not help them prioritize offenders for mental health services.

5.84 Recommendation. Correctional Service Canada should ensure that it appropriately identifies women offenders who need mental health services and assigns them to the appropriate level of care.

The Agency’s response. Agreed. Correctional Service Canada (CSC) routinely evaluates and engages community experts to ensure its approach to screening and triage remains consistent with evidence-based practices. Recently, the National Institute for Health and Care Excellence recommended that screening tools need to have 70 percent sensitivity and 70 percent specificity to be clinically useful. Research studies have consistently found that CSC’s screening tools meet these thresholds.

Screening tool thresholds are typically higher for women than men. Given the lack of international research on screening inmates, CSC chose a more conservative approach and used the male threshold, for both genders. CSC is also focusing efforts on improving its approach to triage. Most notably, CSC has begun research to validate the Mental Health Need Scale (MHNS). The MHNS uses the same scale as the Clinical Global Impression scale, which is widely used in research and practice.

In the 2016–17 fiscal year, CSC implemented an electronic health record. As a result, CSC can now monitor the level of care received by offenders in relation to their level of need. CSC can currently monitor this for 40 percent of women receiving treatment and will continue to improve data collection. Early results are promising—all women who were rated as high need received intensive mental health care.

5.85 Treatment plans. Correctional Service Canada (CSC) guidelines require that a treatment plan be completed for each woman offender identified with mental health issues. However, our review of selected offenders’ files found that staff completed treatment plans for only 9 of 27 offenders who needed one—and only 1 was done within the required 60 days. In other words, staff did not complete treatment plans for two thirds of the offenders who needed them. Furthermore, we found that treatment plans did not consistently document how the offenders responded to treatment or define longer-term objectives for treatment, as recommended by CSC’s mental health guidelines.

5.86 Recommendation. Correctional Service Canada should complete mental health treatment plans on time for the women offenders who need one and should include the information required by Correctional Service Canada guidelines.

The Agency’s response. Agreed. Correctional Service Canada recognizes the importance of treatment planning and, in particular, the need to have comprehensive and timely treatment plans for offenders with serious mental illnesses and complex concurrent disorders.

Correctional Service Canada did not have sufficient capacity to address mental health issues

5.87 We found that while Correctional Service Canada (CSC) screened women offenders at intake for mental health issues, it did not know if those with elevated mental health needs went on to receive appropriate and timely care. We also found that CSC’s mental health teams did not have sufficient capacity to deliver mental health services to the high number of women offenders identified with mental illness.

5.88 Our analysis supporting this finding presents what we examined and discusses the following topics:

• Access to mental health services
• Mental health teams
• Psychiatric hospital beds

5.89 This finding matters because Correctional Service Canada is required to provide offenders with essential health care, including mental health services, in accordance with professional standards. Furthermore, treating mental health concerns can support an offender’s successful reintegration into the community.

5.90 Our recommendation in this area of examination appears at paragraph 5.97.

5.91 What we examined. We examined whether women offenders identified with mental health needs had access to appropriate mental health services. We reviewed Correctional Service Canada’s mental health care guidelines, policies, and processes, and examined its capacity to provide mental health services in its institutions.

5.92 Access to mental health services. To plan for appropriate services, Correctional Service Canada (CSC) needs information about the prevalence of mental illness among women offenders. The most recent CSC study found that 67 percent of women in custody met the criteria for a current mental illness, of whom 23 percent had a mental illness that impaired their ability to function. Many had more than one disorder.

5.93 In June 2015, CSC reorganized its delivery of mental health services based on the World Health Organization’s mental health care model. However, using this model, we found that CSC had not yet determined the capacity for beds and staff needed for each level of care (primary, intermediate, and psychiatric hospital). Consequently, CSC could not ensure that it provided appropriate access to mental health services according to professionally accepted standards for the high number of women offenders identified with mental health issues.

5.94 For women offenders identified with treatment needs, we found that CSC did not track whether they received appropriate mental health services in a timely manner. For example, CSC did not have complete data on how many women with elevated mental health needs had been admitted to one of its structured living units, where they could access therapeutic programs and counselling. At the time of our audit, CSC was transitioning to electronic health records to capture this information.

5.95 Mental health teams. Teams of mental health care professionals provided mental health services in all five women’s institutions. The size and mix of teams varied by institution, and included psychologists, nurses, social workers, occupational therapists, and behavioural counsellors. None of the five women’s institutions had a full-time psychiatrist on staff. Instead, local psychiatrists were typically hired on contract to provide services one half day per week. We found ongoing shortages of mental health care staff at each of the women’s institutions, with 5 of 24 psychologist positions and 6 of 7 social worker positions vacant. Correctional Service Canada (CSC) did not have a recruitment and retention strategy to fully staff these positions.

5.96 Psychiatric hospital beds. Correctional Service Canada (CSC) had up to 20 psychiatric care beds available for women offenders at its psychiatric care institution in Saskatoon. We found that these beds operated at near or full capacity from the 2015–16 to the 2016–17 fiscal year. In 2014, CSC identified the need to secure additional psychiatric care beds by partnering with provincial psychiatric hospitals. But at the time of our audit, CSC did not have active agreements in four of its five regions. CSC had one long-standing agreement in place with a secure psychiatric hospital in Montréal. Women offenders held in custody outside of Saskatchewan or Quebec had to travel long distances, far from community support, for psychiatric care.

5.97 Recommendation. Correctional Service Canada should determine the capacity of mental health services needed to treat women offenders identified with mental illness, according to professionally accepted standards, and address any service-level gaps in a timely manner.

The Agency’s response. Agreed. Correctional Service Canada (CSC) has been working since the 2015–16 fiscal year to refine its model of mental health care delivery to ensure the services provided to women meet their clinical needs and incorporate international best practices. This work has been guided by the World Health Organization’s Mental Health Policy and Service Guidance package and an external expert report.

While CSC began implementation of its refined model of mental health care in 2015–16, it recognizes that, like all health systems, resources are limited, and it must continue to work to ensure efficient and effective service delivery that meets women’s mental health needs.

To this end, CSC is now finalizing, in collaboration with community experts, its first ever comprehensive prevalence study for women offenders. This research will enable CSC to identify any mental health service capacity gaps for women. CSC will use this research, together with external expertise, to inform any necessary modifications to CSC’s refined model of care specific to women offenders.

Some women offenders with serious mental illness were placed in segregation

5.98 Although Correctional Service Canada (CSC) reduced its use of segregation from the 2014–15 to the 2016–17 fiscal years, we found that some offenders who were identified with a serious mental illness had been placed in segregation. We also found that CSC used cells located in the segregation range to monitor offenders identified at risk of self-injury or suicide. This type of placement involved little oversight.

5.99 Our analysis supporting this finding presents what we examined and discusses the following topics:

• Segregation
• Enhanced observation

5.100 This finding matters because CSC committed to restrict its use of segregation in response to the verdict of the Coroner’s inquest into Ashley Smith’s death. CSC also acknowledged that long periods in segregation are not conducive to healthy living or to meeting the goals of corrections.

5.101 Our recommendation in this area of examination appears at paragraph 5.107.

5.102 What we examined. We examined Correctional Service Canada records over the 2014 and 2016 calendar years on the use of segregation and enhanced observation of women offenders in custody. We also reviewed case files for 18 women offenders identified with serious mental illness with significant impairment.

5.103 Segregation. In 2016, 188 women offenders were admitted to segregation for an average of seven days per placement (Exhibit 5.4). Half of the offenders were Indigenous and many had multiple placements. The number of offenders segregated declined by 18 percent from 230 offenders in 2014. However, we found no change in the proportion of segregated offenders (20 percent) who remained segregated for longer than 15 consecutive days.

5.104 We also found that out of 18 women offenders identified with a serious mental illness with significant impairment, 7 were placed in segregation at some point during 2016. Two of these placements lasted longer than 15 consecutive days. Correctional Service Canada (CSC) has acknowledged that segregation for those with serious mental illness should be limited. In August 2017, CSC updated its segregation policy to prohibit the segregation of offenders with serious mental illness with significant impairment. These offenders will now be monitored under CSC’s new mental health policy for enhanced observation.

5.105 Enhanced observation. We found that Correctional Service Canada (CSC) also used cells in its segregation range to monitor offenders who were at imminent risk of self-injury or suicide. These offenders were placed under what CSC refers to as enhanced observation—an alternative form of isolation in cells in the segregation range. In 2016, about 64 offenders were placed in enhanced observation a total of 141 times for monitoring by mental health staff. The average length of stay for offenders with one placement was 42 hours. While under enhanced observation, the offender is placed in a cell located in the segregation range. These cells were also used for segregation placements. However, in the view of mental health experts, it is not clinically appropriate to use cells in the segregation range to monitor offenders who are at risk of self-injury or suicide. In addition, access to on-site health care (for clinical treatment and support) 24 hours a day, seven days a week was not available at any of the five women’s institutions.

5.106 Despite strict legal requirements for admission into and review of placement in segregation, CSC’s policy for enhanced observation did not prescribe time frames for the required reviews of an offender’s placement. CSC recognized that its oversight of offenders under enhanced observation should be improved. In August 2017, CSC updated its policy to require clinical reviews by health care professionals for prolonged placements.

5.107 Recommendation. Correctional Service Canada should ensure that women offenders with serious mental illness with significant impairment are not placed in segregation. It should improve its oversight of offenders being monitored for self-injury or suicide under enhanced observation, as well as its oversight of offenders identified with serious mental illness with significant impairment. The use of cells on the segregation range to monitor women offenders at risk of self-injury or suicide should be discontinued.

The Agency’s response. Agreed. Correctional Service Canada has promulgated the revised Commissioner’s Directives 709—Administrative Segregation and 843—Management of Inmate Self-Injurious and Suicidal Behaviour to restrict the use of segregation for specific groups of inmates not admissible to administrative segregation as well as additional groups that are not admissible unless exceptional circumstances are identified.

The revised version of Commissioner’s Directive 843—Management of Inmate Self-Injurious and Suicidal Behaviour, promulgated on 1 August 2017, includes enhanced oversight and review mechanisms for inmates placed under enhanced observation. This includes reviews by the Interdisciplinary Mental Health Team; the Chief, Mental Health Services; and the regional and national complex mental health committees. Reviews are intended to reduce the time inmates spend in enhanced observation while taking into consideration risks to safety and strategies for mitigating these risks. Correctional Service Canada will also develop a plan to relocate the observation cells to areas outside of segregation ranges at all sites.

Releasing offenders into the community

Three quarters of offenders remained incarcerated past their parole eligibility

Overall message

5.108 Overall, we found that Correctional Service Canada did not prepare women offenders for parole hearings in a timely manner. Only one quarter of offenders released on parole were released when they were first eligible. The majority remained in custody four months after the date when they were first eligible.

5.109 This finding matters because time spent in custody past the first parole eligibility date reduces an offender’s time to benefit from a structured and gradual release into the community.

5.110 Our analysis supporting this finding presents what we examined and discusses the following topics:

• Offenders released on parole
• Delayed or waived parole hearings
• Custody costs

5.111 Before an offender’s parole eligibility date, Correctional Service Canada (CSC) assesses the offenders’ risk of reoffending and engagement in addressing key factors related to their crime, such as participating in and completing their correctional programs. CSC provides its assessment to the Parole Board of Canada, along with a recommendation as to whether an offender should be granted parole. The Parole Board decides whether to grant parole and sets the conditions of release.

5.112 If a parole review is delayed or cancelled, an offender will have less time to benefit from supervision in the community before her sentence ends, which can hinder her safe reintegration. Parole supervision has been consistently shown to contribute to an offender’s successful reintegration. As well, it is much more expensive to keep an offender in custody than to supervise her in the community.

5.113 Our recommendation in this area of examination appears at paragraph 5.121.

5.114 What we examined. We examined whether Correctional Service Canada (CSC) prepared women offenders for parole hearings in a timely manner. We reviewed CSC case files from the 2014–15 to the 2016–17 fiscal years for women offenders released from institutions and compared their dates of release with the dates when they were first eligible. We also examined the reasons parole hearings were delayed.

5.115 Offenders released on parole. For the 2016–17 fiscal year, we found that 73 percent of offenders first released from custody (299 of 411) were granted parole, a 15-percent increase from the previous three fiscal years. However, only one quarter of women offenders (74 of 299) were released on parole at their first eligibility date. The majority were released on parole later in their sentences, about four months after they were first eligible. Fewer Indigenous women offenders were released on parole than non-Indigenous women offenders (64 percent versus 77 percent).

5.116 On the other hand, we found that Correctional Service Canada (CSC) increased its use of section 84 (of the Corrections and Conditional Release Act) release plans, where Indigenous organizations or communities are part of the reintegration process. In the 2016–17 fiscal year, CSC released 58 Indigenous women offenders under section 84, compared with 36 offenders three years earlier. We noted that Indigenous offenders with a section 84 release plan were more likely to be granted parole.

5.117 Delayed or waived parole hearings. We found that more than half of women offenders either waived or postponed their parole hearings. Offenders did this for a variety of reasons, such as not completing their correctional programs by their hearing dates. However, many offenders postponed their parole hearings even after successfully completing their correctional programs.

5.118 We found that many offenders eligible for parole remained in custody an additional six months after they had completed their correctional programs. This sometimes occurred so that the offender could participate in other social and therapeutic programs within the institution. We noted that many of these extra interventions did not specifically address the offenders’ risks of reoffending upon release and could have been provided through community residential facilities. As well, social and therapeutic programs were often more effective when taken under supervision in the community rather than in custody.

5.119 Almost half of the women offenders assessed with a low risk of reoffending delayed or waived their parole hearings. As a result, low-risk offenders remained in custody an average of eight months after their first parole eligibility date, and some were released only at their mandatory release date. Yet CSC research showed that many low-risk offenders can be safely managed in the community until the end of their sentences.

5.120 Custody costs. We found that the cost for each woman offender in custody was about $190,000 annually, whereas the cost for community supervision was $31,000 annually. While there are fixed costs for correctional institutions that do not depend on the number of offenders in the institutions, Correctional Service Canada could still have saved about $4 million in custody costs if the 225 women offenders released on parole in the 2016–17 fiscal year were prepared for and released by their first parole eligibility date.

5.121 Recommendation. Correctional Service Canada should ensure that women offenders—particularly those assessed with a low risk of reoffending and who have successfully completed their correctional programs—are prepared for their parole hearings by the earliest parole eligibility date, to support their successful reintegration into the community.

The Agency’s response. Agreed. Correctional Service Canada’s policy framework emphasizes timely case preparation to ensure that offenders are prepared for their parole hearings at the earliest possible date. Performance results obtained for women offenders in the 2016–17 fiscal year showed the lowest median percentage of sentences served prior to first release (35.9 percent in 2016–17 and 47.7 percent in 2015–16). As well, in 2016–17 more women offenders had completed a correctional program before day parole eligibility (62.7 percent in 2016–17 and 46.2 percent in 2015–16). Accordingly, a recent review (16 July 2017) of Correctional Service Canada’s reporting platforms revealed that very few women offenders (six) who had been assessed as having high reintegration potential (or low risk) were past their full parole eligibility date without a Parole Board of Canada decision.

Correctional Service Canada will enhance its focus on timely case preparation for low-risk women offenders who have successfully completed their correctional programs through regular monitoring and oversight at the local and national levels.

Conclusion

5.122 We concluded that while Correctional Service Canada provided women offenders with correctional programs, it did not do so in a manner that adequately supported their timely and successful reintegration into the community. Correctional Service Canada had not implemented an initial security classification or appropriate program referral tools for women offenders. It had also not assessed the effectiveness of correctional programs in addressing the risk factors related to reoffending, such as substance misuse. As well, Correctional Service Canada had not determined the type or level of resources needed for women offenders with mental health issues and did not have a system in place to monitor their access to treatment. Despite a reduction in the use of segregation over the past three fiscal years, Correctional Service Canada continued to place some women offenders with serious mental illness in segregation.