British Columbia’s Provincial Health Services Authority must “do better,” the auditor general said, after his office found it was not consistently providing services to Indigenous inmates with mental health and addictions diagnoses.
Michael Pickup told a news conference Thursday his office looked at 92 sample files from people jailed in eight of the province’s 10 institutions between 2019 and 2021 and found inconsistent assessments, care plans and supports programs upon their release.
“These are real people behind these numbers,” Pickup said, after his office delivered a report to the B.C. legislature showing the audit found “full care plans” were completed for fewer than half of those inmates.
The audit found gaps in monitoring and oversight of access to care, due in part to limitations in the provincial authority’s health information system.
Pickup said the system cannot generate detailed reports, making it difficult for staff to assess whether they’re providing required services to everyone who needs them.
The good news, he said, is most clients whose files it reviewed had health screenings within the standard 48 hours of entering the correctional system.
The audit found 93 per cent of clients whose files it reviewed were screened within two days of entering the correctional system, and 63 per cent received services for all or some of their needs within 72 hours, while nine per cent declined help.
However, Pickup said the authority did not always complete comprehensive assessments or detailed care plans beyond the initial screening phase.
While the audit found about 80 per cent of clients received some ongoing services, close to 20 per cent had no care plan and received no services while in custody.
It was concerning to find the authority was not reviewing Indigenous client files nearly as often as required by their own policies, Pickup added.
“On average, just one-third of the client files had received proper review. This means the (health services authority) was missing opportunities to detect and correct errors in client assessments, programming, and discharge planning,” he said.
Pickup also emphasized the lack of planning around discharge, saying the health authority generally was not connecting people with health services and other community resources outside the correctional centres ahead of their release.
The audit found just seven per cent of the files had complete discharge plans, although there had been some planning for a little over half of those.
Pickup said the authority has agreed with the four recommendations made in the audit, which are aimed at enhancing internal reporting and oversight of mental health and substance use services.
The auditor general did not confirm whether the gaps in services had resulted in any specific health outcomes, but if the required care isn’t provided, he said, “the logical next question would be, what is the risk of not doing these things?”
Pickup underscored the importance of providing a “continuum” of care in minimizing health risks, from initial screening to planning for discharge.
When asked whether non-Indigenous inmates face similar gaps in mental health and substance use services, Pickup said he couldn’t make that assumption, but the audit does raise “fair questions that people may want to ask” the health services authority.
A statement from Pickup’s office said it undertook the audit because colonialism and discrimination have caused socioeconomic inequalities leading to an overrepresentation of Indigenous people in the provincial justice system, and 90 per cent of those in custody had a diagnosed mental health or substance use disorder.
The Provincial Health Services Authority website says its Correctional Health Services program includes primary care, mental health and addictions services, opioid antagonist treatments, and post-discharge supports.
Brenna Owen, The Canadian Press
This report by The Canadian Press was first published Feb. 9, 2023.