Laws concerning prisoners and the psychiatric treatment of prisoners are neither clear, comprehensive nor readily accessible to those affected. Several factors which contribute to this state of «lawlessness» are examined. While the enacte-ment of the Canadian Charter of Rights and Freedoms has probably increased prisoners' rights to treatment, this right has not as yet been tested before the courts, nor has it's meaning been clearly defined. Prisoners' rights to refuse treatment are discussed, as well as the differing criteria for involuntary treatment laid out by the provincial mental health acts. Finally, the legal liability of health care professionals who treat, or fail to treat, accused or convicted offenders is addressed.
While severe mental disorders have consistently been shown to be more prevalent among inmates of penal institutions than among the general population, the provision of mental health within jails, prisons and penitentiaries has always been, and continues to be, problematic. The present investigation was designed to examine the impact on patients of one organizational model of mental health care for penitentiary inmates. Ninety-nine men who were transferred from a penitentiary to a maximum security hospital for varying periods of time were followed for three years after discharge. Relapse and criminal recidivism were documented from official files. Interviews were conducted at the end of the follow-up period in order to examine subject's level of social functionning and mental state. Specific conclusions are drawn about the way in which mental health care was provided and the benefit which accrued to the patients.
The penitentiary psychiatrist, in France, as in Québec and elsewhere is confronted daily with multiple dilemmas of a moral, ethical and practical nature. He/she is obliged to practice within the constraints of laws, policies and regulations which are not necessarily sensitive to the needs of the mentally disordered inmate. The distinction in French law between the “mad” and the “bad”, and the role of the psychiatrist in placing the accused in one or other of these categories is described, as is the penal system, and one regional treatment center for prison inmates. Problems related to the prescription and distribution of medications are presented in order to illustrate the constraints and ethical dilemmas inherent in psychiatric practice within a penal institution.
The probation officer in a correctional milieu is confronted more and more by a clientele with various psycho-social pro b -lems, one of them psychiatric. By means of a case study, the authors examined the role of the probation officer in pre-sen-tence evaluation and post-sentence intervention vis-à-vis offenders and referrals to community resources
The first objective of the probation officer is to help in some way resolve the social conflict engendered by the offence and keep this in mind when dealing with the offender social services.
Working in the health service of the Montreal Prevention Centre, the author presents the observations he made while there. The constant increase in psychiatric cases since 1976, in both number and severity, according to the author, is the result of deinstitutionalization by the Department of Social Affairs. The clientele, suffering from a psychic pathology, expresses its suffering and hopelessness in delinquent activity. Given the limits on intervention in this type of milieu, the ambiguity of the laws and restricted facilities, prison is not appropriate for the psychiatric offender. Victim of the power struggle between the government departments and social organizations, he bears the stigma of the table imposed on wards of the court.