Registed Nurses' Association of Ontario

Transforming Ontario's Correctional Services: Starting, But Not Stopping, with Segregation

Transforming Ontario's Correctional Services: Starting, But Not Stopping, with Segregation

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses (RN), nurse practitioners (NP), and nursing students in all roles and sectors across Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contributions to shaping the health system, and influenced decisions that affect nurses and the public they serve.

RNAO appreciates the opportunity to provide feedback to the Ministry of Community Safety and Correctional Services (MCSCS) in response to the Segregation Review. RNAO staff and representatives from our Ontario Correctional Nurses' Interest Group (OCNIG) and the Mental Health Nursing Interest Group (MHNIG) found a briefing on the Segregation Review by MCSCS staff on January 5, 2016 to be helpful as context. Responses to the questions provided by MCSCS have been incorporated in the sections below followed by RNAO's recommendations.


  • RNAO reiterates that a foundational aspect of a comprehensive Mental Health Strategy for Correctional Services is that our provincial facilities comply with international human rights law. To be consistent with United Nations (UN) standards, the UN Committee on Torture clearly stated that Canada must:
  • strengthen its efforts to adopt effective measures to improve material conditions in prisons, reduce the current overcrowding, properly meet the basic needs of all persons deprived of their liberty and eliminate drugs;
  • increase the capacity of treatment centres for prisoners with intermediate and acute mental health issues;
  • limit the use of solitary confinement as a measure of last resort for as short a time as possible under strict supervision and with a possibility of judicial review; and
  • abolish the use of solitary confinement for persons with serious or acute mental illness.
  • To comply with the UN Committee on Torture prohibition on segregation for people with "serious or acute mental illness,” ensure timely and appropriate mental health screening by qualified health professionals upon admission to provincial correctional facilities. As lack of privacy is a disincentive to disclosure, ensure screenings and assessments are done with adequate privacy protections.
  • As recommended by the Ashley Smith inquest, abolish indefinite solitary confinement. Inmates without serious or acute mental illness must not be placed in segregation for more than 15 days at a time. There must be a wait period of at least five consecutive days between each placement in segregation. Ensure that an inmate is not placed in seclusion for more than 60 days in a calendar year. If an inmate is transferred to a different institution, the calculation of consecutive days must continue and not be considered a break from segregation or seclusion.
  • Implement the recommendations by the Office of the Provincial Advocate for Children and Youth arising from their systemic review of secure isolation in Ontario youth justice facilities.
  • Implement justice-related recommendations of the Truth and Reconciliation Commission of Canada. Top priority must be given to:
  • recommendation #30 that calls on all levels of government to eliminate the overrepresentation of Aboriginal people in custody over the next decade accompanied by detailed annual monitoring and reporting of progress; and
  • recommendation #31 that calls on all levels of government to provide stable and sufficient funding to implement and evaluate community sanctions that will provide realistic alternatives to imprisonment for Aboriginal people and respond to underlying causes of offending.
  • Implement recommendations on moving towards decriminalization of mental health issues prepared by the John Howard Society of Ontario.
  • Implement recommendations from numerous coroners' inquests in a systematic and transparent fashion, including providing access to 24/7 nursing services. RNAO urges for a focus on improving access to registered nurses and nurse practitioners specifically.
  • Increase capacity of primary care, mental health, and other required health services by strengthening recruitment and retention of correctional nursing workforce by addressing compensation disparities with other sectors.
  • Transition governance of health services from the Ministry of Community Safety and Correctional Services to the Ministry of Health and Long-Term Care. Ensure transparency and improvements in health equity through ongoing evaluation by Health Quality Ontario.
  • Increase transparency and accountability for health and human rights for inmates in segregation and the general population within the provincial system equivalent to the federal Office of the Correctional Investigator of Canada.

See the full submission below.

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