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Many people leaving Canadian jails and prisons face very significant obstacles to developing a normal life. Despite the criminal justice system’s official goal of assisting rehabilitation, those leaving the system tend to face serious problems and may get very little help in dealing with them, increasing the chances of further criminal behaviour.
Three recent reports address one aspect of the challenge – health. Many people who come into the criminal justice system already have significant physical or mental health issues, including addictions of various kinds. The Correctional Investigator has drawn annually attention to the problematic nature of health care in federal prisons, and the situation appears to be worse in provincial jails.
Access to primary care
One recent study showed that primary care physicians in British Columbia were only half as likely to take on new patients with a criminal record, even though this group tends to have higher medical needs. In a telephone study of 250 physicians, about 85% offered an appointment to someone without a criminal record, compared to 42% of those with a record. This was the case for both male and female prospective patients. Yet people leaving jail tend to have higher than average health care needs.
Health and related needs
The range of health issues for released prisoners is apparent in a project supported by John Howard Canada and undertaken by researchers at the University of British Columbia and Simon Fraser University with the aim of providing workshops and support for issues identified by men leaving federal prisons. The men involved determined topics for workshops and did much of the actual workshop planning. Most of them were over 50, unemployed, and had spent at least 20 years locked up.
Sixteen workshops were eventually run, including nutrition, spiritual health, opioids and naloxone, Hepatitis C (common in jails), mental health, diabetes, and HIV. A few workshops covered related issues such as use of cell phones, since many long term prisoners have never used one, and acquiring identification, since many long term prisoners no longer have health cards or drivers licenses, which can make it impossible to do things such as opening a bank account. Moreover, if released prisoners have no fixed address, which is often the case, they may have difficulty getting these documents.
This project was a very practical effort to assist men leaving jail. However the federal prison system releases several thousand people each year, so the issue remains of how to provide such services on a much larger scale.
Many deaths post release
Finally, a recent piece in the Globe and Mail by Marcus Gee showed the consequences of lack of support for released prisoners. The article cites an Ontario study that found that 10% of all overdose deaths were people who had been released from jail in the previous year, and another study finding that released prisoners were more than 50 times as likely to die from an overdose as were other people. The vast majority of those who died were young or fairly young men – that is, below age 50. Gee also cites a BC study finding that about 2/3 of those dying from an overdose in that province had been in jail at some point. Of those who died in this way, nearly 1 in 5 died within 30 days of release, and 25% within a year of release.
Addiction issues are not easy to treat and many other health issues are also complex. But these reports show how high the cost can be when we fail to provide for the real health and other needs of the people we incarcerate, many of whom are among the most disadvantaged in our society.