“There are a lot of inmates sitting in the remand centre right now on regular units who have several risk factors for suicide”
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Warning: this story deals with suicide. If you need help, the AHS Mental Health Help Line can be reached at 1-877-303-2642. The Canada Suicide Prevention Service can be contacted at 1-833-456-4566.
A psychiatrist with two decades of experience treating inmates at the Edmonton Remand Centre told court it is “remarkable” more people in correctional facilities don’t die by suicide given the plethora of risk factors facing the population.
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Dr. Curtis Woods made the comment Monday during a fatality inquiry into the death of Timothy “T.J.” McConnell, who died in the provincial lockup after repeatedly asking for help with mental health and addictions issues.
Woods — one of three forensic psychiatrists who offer weekly clinics at the provincial jail in northwest Edmonton — was questioned by lawyers for the inquiry, Alberta Health Services, and McConnell’s mother, Lana Greene, who claims negligent medical care led to her son’s death.
Fatality inquiries are held whenever an inmate in Alberta dies in custody. Their purpose is not to assign blame but to clarify the circumstances of a death and make recommendations aimed at preventing similar fatalities, said Justice Olugbenga Shoyele, the Alberta court of justice justice presiding over the hearing .
McConnell was jailed on Sept. 4, 2020, for allegedly stealing airsoft guns in Grande Prairie. He was found dead in his cell on Jan. 11, 2021. Woods reviewed McConnell’s file but never met the 23-year-old, who refused to attend an appointment weeks before his death for reasons that remain unexplained.
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According to Woods, four psychiatrists offered weekly clinics at the remand when McConnell was in custody. There is also an on-site mental health team and separate clinics for opioid dependency, pain management and other issues.
Woods said psychiatrists might review 40 files during a clinic and see 10-15 patients. Overall, he described those working in the system as “extremely competent people who are very busy, with limited resources.”
When asked by Chris Wiebe, Greene’s lawyer, whether they were “too busy,” Woods declined to answer.
Wiebe walked Woods through a variety of written requests from McConnell, asking for treatment for drug addiction and mental health issues.
On one form, McConnell said he had overdosed 16 times and worried he would die when released.
“I’m scared I’m gonna lose my life when I get outside, back around even more pressure to use,” he wrote.
McConnell asked to be prescribed Suboxone, saying he was “functioning in society” and staying off drugs when on the medication.
The opioid clinic is responsible for Suboxone prescriptions, Woods said.
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On another occasion, McConnell asked for mental health medication he claimed he was prescribed in the community. A health-care worker told him to follow up with his family doctor after his release because the remand centre had no record of him having been prescribed the drug in the past year.
Woods said such medications are often “diverted” by inmates for non-prescribed use, but stressed he had no reason to believe that was happening in McConnell’s case.
Wiebe also questioned Woods on a corrections admission form, filled out by another staffer, which failed to mention McConnell’s repeated hospitalizations for overdoses, drug-induced psychosis and a flesh-eating disease associated with IV drug use.
“Did he leave out important information that would be helpful?” Wiebe asked of the form’s author.
“Based on that, I would say yes,” Woods replied.
COVID conditions
While not referencing McConnell’s case specifically, Woods said it is not unusual for “floridly psychotic” people to wind up in remand.
“You’re getting people in there that are sicker than (in) a psychiatric facility,” he said. “But you can’t certify them, it’s not a hospital.”
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During the height of the COVID-19 pandemic, caring for inmates was even more difficult, Woods said.
“Getting to units and getting people brought down, there was far less access at that time,” he said. “To physically see people, to get to a unit to see them … was quite ridiculous at times.”
Woods also discussed the culture among inmates around mental health. He said inmates whose mental illnesses are out of control can be labelled a “bug” and ostracized.
“People don’t want people like that on their units,” he said. “You get labelled with stuff and it affects your placement.”
“It’s a whole different world entirely … a lot of it’s unfathomable to a reasonable mind, what goes on in jails.”
Being deemed a risk of suicide can also be undesirable because inmates are removed from their cells and placed in a strait-jacket-like uniform called a “baby doll,” Woods said.
“There are a lot of inmates sitting in the remand centre right now on regular units who have several risk factors for suicide,” he said, adding he’s been “surprised” how few suicides there are in institutions given the risk factors.
Woods stressed the jail is “not the Ritz-Carlton” but he nonetheless has “a lot of respect” for the staff who work there.
The Edmonton Remand Centre is the largest correctional facility in Canada, with room for 1,952 inmates.
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