Quebec Prisons Face Mental Health Care Crisis: Systemic Deficiencies Leave Inmates Vulnerable
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A growing crisis in Quebec’s provincial prisons reveals a deeply flawed system of mental health care, leaving a important percentage of inmates without adequate support and potentially exacerbating their conditions.Data obtained by Duty shows that despite inmates being five times more likely to suffer from severe mental health disorders then the general population, over 60% of provincial correctional facilities lack a dedicated psychiatrist.
A disproportionate Need
Approximately 15% of the nearly 5,000 individuals housed in Quebec provincial prisons daily grapple with serious mental health disorders like bipolar disorder, schizophrenia, or schizoaffective disorder. These conditions demand ongoing pharmacological treatment and consistent follow-up with a team of healthcare professionals – resources that are demonstrably lacking within the current system. According to Correctional Service Canada, a staggering 7 out of 10 prisoners across the country experience a mental health problem or addiction, further highlighting the urgent need for improved care.
“It’s really more [de cas] than in the community,” explains Dr. Mathieu dufour, a forensic psychiatrist at the Philippe-Pinel Institute. “So, we would expect that ther would be more care for these severe psychiatric disorders in prison.” Dr. Dufour emphasizes that the transition to a provincial establishment is a particularly critical juncture for individuals struggling with mental health, as they may arrive having recently been arrested and potentially having discontinued medication or therapy.
Uneven Access to Care
An investigation by Duty revealed a stark disparity in the availability of mental health professionals across the province’s 16 detention centers. Only five facilities benefit from psychiatric clinic days, and none have access to dedicated psychologists. Furthermore, only one center utilizes a psychoeducator, another employs criminologists, and three rely on community workers. While all establishments have on-call general practitioners and nursing staff, these resources are frequently enough insufficient to address the complex needs of inmates with serious mental illnesses.
Isabelle Fortin, the deputy director responsible for mental health and prison care and services at Santé Québec, acknowledges the recruitment challenges. However, she suggests that professionals beyond psychiatrists – such as nurses and social workers – can adequately address the mental health needs of inmates. This assertion is countered by experts who emphasize the necessity of specialized psychiatric care for severe cases.
In the event of a psychiatric emergency, inmates are typically transported to the nearest hospital, according to communications with integrated health and social services centers (CISSS and CIUSSS).
A Troubled Transition and Systemic gaps
The responsibility for health services in provincial correctional settings shifted from the ministry of Public Safety to the Ministry of Health and Social Services between 2016 and 2022. While this transition aimed to improve service structure, its implementation has been uneven. Santé Québec recognizes “a lot of work to do” to harmonize care and ensure equitable access across the province. “We are aware of the disparity a
“a bit of a black hole.” Nantel represented Joshua Côté-Mashala, a schizophrenic client who stabbed his psychiatrist after being deprived of medication for five months during his detention. the court found that Mr. Côté-Mashala’s fundamental rights had been violated. She also represented Vithushan Aran, a man who fatally stabbed his father while suffering from schizophrenia, arguing that the provincial system fails to facilitate rehabilitation for individuals with mental health disorders.
“We don’t have therapy, we don’t really have support, so the result is ultimately not surprising,” Nantel stated. “The vast majority of people who go thru this system will regain their freedom. We must be able to give them tools so that they can once again become assets for society. It’s a snowball effect: we are making the problem grow. Ultimately, it is indeed society that pays the price.”
If you are struggling with suicidal thoughts or are concerned about a loved one, counselors are available 24/7 at 1 866 APPELLE (1 866 277-3553), by text at 535353, or via chat at suicide.ca.
