Excerpt from

Report to the Minister of Justice and Solicitor General Public Fatality Inquiry

Into the July 2013 death of Jessie McAdam,
in an administrative segregation cell at Edmonton Institution,

Dated March 15, 2018


Correctional resistance to the reality of administrative segregation and its indisputable impact on the physical and psychological well-being of inmates was evident throughout this Inquiry. There is an obvious complacency within institutional personnel about administrative segregation. There is a perception about administrative segregation that is not founded in reality. For instance, Mr. Kindrachuk testified that inmates in segregation have access to native elders and chaplains, yet there is no evidence that Mr. McAdam visited with native elders or chaplains while in segregation. Mr. Kindrachuk opined that staff often ensures that segregation inmates shower daily, yet Mr. McAdam did not shower daily. Mr. Kindrachuk made reference to daily exercise entitlements, but no one became concerned when Mr. McAdam declined his recreational time.

Ms. Hutchinson opined that segregation might be a relief for some inmates, given that prison is a “scary place” and some inmates might find segregation to be something of a refuge. Ms. Hutchinson adhered to this view, even though it was utterly contradicted by the report of Dr. Knoll – filed as Exhibit 4 in this Inquiry – which evidences a direct connection between segregation and elevated suicide risk. Ms. Hutchinson adhered to this view, even though she was unfamiliar with the scientific research that refuted her position. Her position may have been anecdotal – at best – but it is unclear which inmates formed the basis for her anecdotally informed perceptions that some inmates prefer segregation. It is beyond the purview of this Inquiry report to engage in the sort of comprehensive assessment of the reality of administrative segregation as was undertaken in British Columbia Civil Liberties Association v Canada (Attorney General), 2018 BCSC 62. Suffice to say that there was no recognition by institutional staff that testified at this Inquiry that administrative segregation itself causes harm.

Administrative segregation is spoken of as a placement amongst a host of placement options. Placing an inmate in segregation is not, however, a placement. The description of administrative segregation as a brief emergency placement is imperative in every relevant policy and training session undertaken by correctional staff. The process of withholding intervention until psychological distress is identified is intensely unsatisfactory. Distress should be presumed. The task of institutional staff is to minimize harm on those occasions when an emergency placement in administrative segregation is mandated by an extraordinary event. Commissioner’s Directive 209, which existed at the time of Mr. McAdam’s placement, was extremely vague and left considerable discretion for defining key terms in the hands of institutional personnel. Mr. McAdam’s placement in administrative segregation was based primarily on vague, unsupported, and unproven associations with Security Threat Groups. If the institution is incapable of managing threats of violence that might be visited upon inmates, the placement of the threatened inmate in segregation is not a satisfactory solution to institutional defects. Placement of inmates in segregation must be identified as extraordinary, a decision informed and motivated by pressing and urgent concerns. It is not sufficient to simply opine that an inmate cannot be integrated. From the perspective of institutional culture, an inmate in administrative segregation should represent a pressing problem in need of immediate correction – not as the norm.

In October 2015, Correctional Services Canada issued an amended Commissioner’s Directive for Administrative Segregation. This directive was amended again in August 2017. These directives do not contemplate external inmate advocacy. They are dependent for their effectiveness upon a corporate culture that does not appear to exist within the Edmonton Institution. This is a culture of passivity, a culture that normalizes the exceptional, a culture of adversarial containment rather than a culture focused on rehabilitation and preparation for release. This culture hearkens again for the need of an independent inmate agency. One of the significant tasks of the professional members of an Inmate Advocacy Agency should be to conduct daily visits of inmates in segregation and to attend all segregation review board hearings. Members of the agency should be tasked with advocating for the inmate’s wellness, either for relief of the inmate’s segregation or improvement of segregation conditions, or for access to resourcing for inmates while segregated. It is presumed, for instance, that inmates in administrative segregation do not receive the benefit of programming. The reason for that is unclear. Perhaps inmates in administrative segregation are in the greatest need of programming, through cultural initiatives, or educational opportunities, or other programming options. It is unacceptable to simply assume that all is well because an inmate in not asking for anything.

A sea change to the perception of the impact of administrative segregation is recommended. Such a sea change contemplates independently verifiable and articulable reasons for a placement in administrative segregation. Such a placement should result in the immediate assignment of state-funded legal counsel to the inmate, to ensure that the placement is lawful, and to ensure that the inmate is represented at review hearings. When an inmate is placed in administrative segregation, it is recommended that mental health services be engaged immediately and personally. An inmate in distress may not disclose their distress on the first visit or the second visit. A willingness to provide services and an evident motivation to engage and provide relief would go a long way to fostering an environment where an inmate in need of services could access those services.



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