The peer report on services provided by Dr. David Craig may have concluded he meets the standard of care for psychiatrists working in Canada’s prisons, but that standard is not good enough, says a defence lawyer.
Mark Gruchy, president of the provincial division of the Canadian Mental Health Association, said the standard of care must be raised and the report’s recommendations should be heeded.
“People aren’t getting the care they deserve as human beings,” Gruchy said
Ex-inmate says treatment of prisoners is ‘utterly disgusting’
“The best way to respond to this is not to focus on Dr. Craig so much, but to focus on the fact the report very clearly establishes there is a disconnect and severe variance, serious variance between the provision of psychiatric services within prison facilities and those outside. … The public’s expectation of how prisoners are to be treated by our society has rose to such a level that they are not going to tolerate anything other than the implementation of the recovery model (of treatment) and the proper and thorough implementation of mental-health services in the prison.”
Current and former inmates routinely complain that Craig pulls them off drugs that have been prescribed by other doctors once they arrive in prison.
In the spring of 2011, citizens’ representative Barry Fleming wrote a report saying that Craig should be removed from the prison system, because inmates were not being treated fairly.
The government dismissed Fleming’s report, saying he doesn’t have the expertise to make that call. Instead, Ontario forensic psychiatrist Philip Klassen was hired to do a peer review of Craig’s service.
Klassen interviewed Craig and other health-care workers in the prison. He also talked to Fleming and reviewed a random selection of 18 inmates’ charts, although he did not speak to any current or former inmates.
Klassen made a series of recommendations, which the government has accepted. He recommended that the psychiatric services should be less variable, and operate based on guidelines. He also called for a team approach to psychiatric care, with more mental-health services, and bringing in other psychiatrists to shoulder part of the load in the prison system.
It’s those recommendations, said Gruchy, that the government should use to revamp mental-health services in the province’s prison system.
He noted comments by Craig in the report which suggest he is crying out for help to provide services.
And Gruchy noted that Craig admitted he’s not well versed with the recovery model.
The recovery model, Klassen noted, is supported by the Mental Health Commission of Canada, is used widely in outpatient treatment, and is “a model where the patient or client is supported and facilitated by care providers, with respect to goal setting and goal attainment. This places the patient at the centre of the process.”
Gruchy said he hopes more pyschiatrists and services are added to the system.
To simply accept the report as verifying Craig fits the standard of care is overlooking the moral problem that exists, Gruchy said.
“Mental health concerns need to be treated with dignity and respect,” he said.
The report recommends the practice of 20-minute consultations, and states five-minute followup visits should be re-evaluated.
Gruchy said 20 minutes isn’t enough time for the prisoners to feel comfortable and open up.
Craig sees 25-30 patients a day.
“You got a very vulnerable patient group is what you have,” Gruchy said. “The challenge posed for anybody dealing with a psychiatric context are enormous. Now you have a vulnerable, particularly difficult population in the communication area, and you got one man trying to deal with 150-odd people.
“Therefore I am really heartened (Craig) said he could use help and he would like to operate in a collaborative team. And I think if anything (will) come out of this which is positive, and truly forward-looking, is we get more psychiatrists, more professionals in the penitentiary to assist Dr. Craig in his work, and to spread some new ideas and to get the recovery model on track.”
Changes in mental health services clearly have not penetrated prison walls, Gruchy said. He said staff interviewed didn’t appear to be able to give the proportion of prisoners who are dealing with mental health issues.
And Gruchy said prisoners should have been consulted in the peer review.
Ex-inmate Doug Squires told The Telegram Tuesday he won’t stop speaking out about what he sees as poor psychiatric services in the Pen.
Squires insists that when he got his own medical records, they didn’t reflect what his actual state of mind was.
When Craig took him off his anti-depressant medication, Squires said, his file noted ‘Doug is doing great, well groomed.’
“That wasn’t true one bit,” Squires said. “How can you come up with an opinion without talking to inmates? Why didn’t (Klassen) talk to the inmates?”
Squires said the way prisoners are treated is “utterly disgusting.”
“I can guarantee you the population of Newfoundland and Lab-rador’s prisons don’t think (Craig) should be there,” he said.
“He runs pretty much the place down there. The warden don’t.”