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Research:
Wendy L. Wobeser, Jason Datema, Benoit Bechard, and Peter Ford
Causes of death among people in custody in Ontario, 1990–1999
CMAJ 2002; 167: 1109-1113 [Abstract] [Full text] [PDF]
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[Read eLetter] Causes of death among people in custody
Marc S. Daigle   (26 November 2002)

Causes of death among people in custody 26 November 2002
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Marc S. Daigle,
Professor
University of Quebec at Trois-Rivières

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Re: Causes of death among people in custody

marc_daigle{at}uqtr.ca Marc S. Daigle

Dear Editor,

I would like to add some comments on the November 12 paper by Wobeser, Datema, Bechard and Ford: Causes of death among people in custody in Ontario, 1990-1999.

With regard to the comparisons done between the federal and provincial correctional systems, it is up to Correctional Service of Canada to explain their own statistics. Nevertheless, I should mention that, at least for the Province of Quebec, the rate of suicide seems to be higher in provincial prisons than in federal penitentiaries. In fact, a special Coroner Inquiry held in Quebec (David, 1997) showed that the rate was 339.8 per 100 000 for Quebec prisons between 1992 and 1996. For the same period, Ontario prisons had a much lower rate (44,3) but the range was large for Canadian prisons (from 0 to 339.8), the mean being 101.2. For a comparable period (1993-1994), the rate in Canadian penitentiaries was 185 per 100 000 but had known large variations (246 in 1982-83 and 88 in 1989-90). All this shows that we have to be very cautious in analysing these relatively small numbers of events which, effectively, have to be estimated by 100 000.

Beyond that, it is nevertheless true that the rates of violent deaths are high for incarcerated people, mainly for males. As did Wobeser and all, these rates have to be compared with the rates in equivalent populations, that is males aged, roughly, between 25 and 40. But we have to go one step further and compare incarcerated delinquents with…non- incarcerated delinquents. This is not an easy job but Pritchard, Cox and Dawson (1997), for example, showed that the rate of violent deaths in probationers was 10 times higher than in the general population. For those aged 35-54, the rates was 35 times higher! Other researches (Lidberg, Wiklund & Jakobsson 1989; Forsman & Holmberg 1998) also tend to show that these are mainly characteristics of the delinquents, not of the correctional systems. But this is not to say that institutions have no responsibilities in the problem. On the contrary, having these delinquents available for care, they should maximize this opportunity to help them.

Commenting on the paper of Wobeser et al, Fruehwald and Frottier mention that interventions taking places behind bars are not well documented. For ourselves (Daigle and Côté, 2001), we tried, in a pilot study, to investigate this question. More particularly, our study showed that, in Quebec prisons, 75% of those being in suicidal “urgency” were detected at intake, at least informally. As compared with the 24% rate observed in an American hospital by Malone, Szanto, Corbitt, and Mann (1995), this is not a too bad report for non medical staff mainly implied in security activities.

Finally, maybe we could close this debate by stating, again, that correctional facilities are not the best place to treat people. Diversion programs, as the ones being implemented now in Quebec (see for example PECH) and elsewhere, are much better alternatives, at least for those have serious mental health problems.

Marc Daigle, Ph. D.

Center for Research and Intervention on Suicide and Euthanasia Philippe-Pinel Research Center University of Québec at Trois-Rivières C.P. 500, Trois-Rivières, Québec, G9A 5H7

Phone: 819-376-5011 # 3509 Fax: 819-376-5195 Email : marc_daigle@uqtr.ca

References

Daigle, M., & Côté, G. (2001). Suicide et troubles mentaux chez des hommes incarcérés : faut-il en appeler à une prise en charge communautaire? Criminologie, 34(2), 103-122.

David, A.-M. (1997). Rapport d'enquête de la Coroner sur la mort de 12 détenus du SCQ. Québec: Bureau du Coroner en chef.

Forsman, A., & Holmberg, G. (1998). Interaction between criminality and psychiatric disorder sharply increases risk of early death. XXIIIrd International Congress on Law and Mental Health.

Lidberg, L., Wiklund, N., & Jakobsson, S. W. (1989). Mortality among criminals with suspected mental disturbance. Scandinavian Journal of Social Medicine, 17(1), 59-65.

Malone K.M., Szanto K., Corbitt E.M., & Mann J.J. (1995). Clinical assessment versus research methods in the assessment of suicidal behavior. American Journal of Psychiatry, 152(11), 1601-1607.

PECH. Programme d'encadrement clinique et d'hébergement (2000). Rapport annuel 2001-2002. Québec: Programme d'encadrement clinique et d'hébergement. Pritchard, C., Cox, M., & Dawson, A. (1997). Suicide and "violent "death in a six-year cohort of male probationers compared with pattern of mortality in the general population: evidence of accumulative socio- psychiatric vulnerability. Journal of the Royal Society of Health, 117(3), 180-185.