Scarce mental health care in BC jails perpetuates addiction and crime

Written By Shannon Waters

People with addiction issues who’ve spent time in provincial prisons paint a bleak picture of what it’s like trying to recover while incarcerated.

“I’ve done a lot of prison time over the years,” said Harry, a 44-year-old Nanaimo resident who asked to be referred to by his first name only.  

Until about four years ago, Harry’s life resembled the so-called “revolving door” of arrest, incarceration and reoffending.

“Every time I got bail, I ended up back in prison,” he said. “I relapsed … I’m in jail for a few weeks or a few months and then I’m back doing what I was doing, getting high and doing crime.”

Harry was what the system calls a prolific offender. He’s been in and out of the system since he was about 15.

 Often when he was released, it was with “absolutely nothing,” Harry said. 

“Here’s a bus ticket and that’s it. There’s no support whatsoever.”

The “number one thing” the province could do to reduce recidivism is better support people leaving corrections, he said. 

Fortunately, Harry finally found those supports in Guthrie House, the one therapeutic mental health and addictions recovery program offered in BC Corrections. 

After finishing his sentence and graduating from Guthrie, Harry spent another year in a therapeutic recovery program in Nanaimo before moving into his own place. 

He’s stayed out of jail ever since.

But Harry’s success is uncommon.

‘A crisis that must be ameliorated’

The lack of available supports for inmates on their return to community is “a crisis that must be ameliorated,” according to an independent, B.C. government-commissioned investigation into the origins of, and solutions to, chronic crime by prolific offenders.

Besides of a shortage of resources available to meet the needs of people after incarceration “most accused with mental illnesses … will not receive the treatment they require while in custody because BC Corrections does not have that capacity or infrastructure,” wrote the report’s co-authors, UBC criminologist Dr. Amanda Butler and retired Vancouver police chief Doug LePard.

Last October, the two released their findings, along with 28 recommendations on how to “interrupt the cycle of offending.”

More than a third of the recommendations called for sweeping improvements in mental health and addiction services for people in jail and following their release, yet little progress has been made implementing them in the eight months since the report was released.

“It is an urgent priority to improve the quality of mental health care for people who are detained.”

Rapid Investigation into Repeat Offending

Of the recommendations geared to people who are incarcerated, probably the most important is for the province to create specialized units “therapeutically designed and dedicated to providing high quality psychiatric care” to those with acute or chronic mental health and/or substance use issues.” 

For inmates with more complex needs who may present a risk to others, the authors recommended “intensive rehabilitation” units based on the low secure model of care used in the United Kingdom.

The yard of an unnamed BC Correctional Centre. [Photo Provincial Health Services Authority]

“It is an urgent priority to improve the quality of mental health care for people who are detained and to decrease the use of segregation,” wrote LePard and Butler.

Neither the Ministry of Mental Health and Addictions nor the Ministry of Public Safety and Solicitor General responded to questions about efforts currently underway to implement recommendations in the report.

Prison services understaffed, no minimum standards of care

While there are some specialized units and programs currently operating in B.C.’s correctional facilities, they are limited, not always accessible, and data on their operations is scarce, Butler told Northern Beat in an interview.

“There’s not a whole lot of publicly available information about what is being offered and this has been a gap that’s not unique to B.C.,” she added.

B.C. doesn’t have basic minimum standards for the delivery of mental health and substance use care within correctional facilities, said Butler.

“We don’t even have basic minimum standards for the delivery of care.”

Amanda Butler

“It’s something I hope that the province will work on.”

Anecdotal information from stakeholders revealed most people in correctional facilities are not having their needs met appropriately, Butler said. 

“There’s just simply not enough staff to meet the needs, particularly in the areas of psychiatry and psychology.”

Addiction key risk factor for incarceration

Massive gaps in mental health and addiction services affect all British Columbians, but they are particularly brutal on those who are incarcerated. 

A recent B.C. study revealed three-quarters of people in BC Corrections in 2017 had some kind of mental health need and/or substance use disorder, up from 61 per cent in 2009. 

That same data used in another study indicated addiction was a key risk factor for incarceration. The study found 71 per cent of people with substance use disorder were back in jail within three years of release, compared to 44 per cent of people with no disorder returning to jail in the same timeframe. 

Among ‘outdated’ treatment offerings, Guthrie stands out

For most of Harry’s time in corrections facilities, addiction treatment was limited, he said, and a lot of the programming offered was “outdated.”

Harry described a culture of stigma around seeking treatment among his fellow inmates, some of whom warned him against enrolling in support programs.

Eventually, during his last stint in jail four years ago, Harry applied for a transfer from a provincial facility on the mainland to the Nanaimo Correctional Centre in order to voluntarily participate in the Guthrie House therapeutic program

Delivered by Connective, formerly the John Howard Society, in cooperation with Nanaimo Corrections, Guthrie House is separate from the rest of the correctional facilities. The program offers participants a secured community atmosphere of “work, treatment, counselling and around-the-clock behavioural modelling to address the root causes of addiction.” 

An initial analysis of the program, done one year after it began in 2008, revealed a 44 per cent reduction in recidivism. The Solicitor General’s office would not provide more recent data on program outcomes.

Guthrie was life-changing for Harry.

“This is the longest I’ve ever been out of prison,” he said.

After living with a learning disability all his life, Harry learned how to read and write while in the program. 

Critically, after leaving Guthrie, Harry wasn’t released unsupported into the community. Thanks to his relationship with Connective in the Guthrie program, he was accepted into a residential therapeutic recovery community run by the organization in Nanaimo, where he lived with supports for another year.

“This is the longest I’ve ever been out of prison.”


According to the prolific offender report by LePard and Butler, B.C. needs to better support people when they are released, providing housing for those transitioning back into community living, as well as for people awaiting trial in the community instead of being held in remand. 

Another “critical need” noted by report investigators was to connect people with treatment and support services post-release, an area where Harry benefitted from Connective staff facilitating access to services and helping guide his transition to independent living. 

These days, when Harry goes back to jail, it’s by choice.

“I go in every Sunday to go put on the [Alcoholics Anonymous] meetings with my other friends and that was a goal that I wanted to achieve while I was incarcerated,” he said.

The importance of building community

Mo Korchinski provides support to people recently released from correctional facilities, a situation she is deeply familiar with.

Korchinski is the founder and executive director of Unlocking the Gates Services Society, a Maple Ridge-based organization that helps people from provincial and federal correctional facilities to reintegrate back into society.

Like Harry, Korchinski said she spent many years in provincial prisons.

“I’ve been out for 17 years,” she told Northern Beat. “I was in addiction for 28 years.”

A stay at the Alouette Correctional Centre for Women changed Korchinski’s life. She described a warden who was focused on the care and recovery of inmates in a facility that offered art therapy, activities and a sense of community.

“People just want to be a part of [community] and have dignity and self worth and have hope.”

Mo Korchinski

“It was just amazing,” she said. “Segregation wasn’t used as much … if there was a problem, they just got some people to sit down and talked about it or you had to clean windows on your unit. It was just a way different way of doing it.”

Alouette Correctional Centre for Women [Photo BC Government]

A sense of community is essential to supporting people in recovery, Korchinski says.

“People just want to be a part of [community] and have dignity and self worth and have hope.”

Correctional facilities and homeless camps often foster a sense of community among residents, she said.

“But how do we build that community out everywhere, so people actually feel like they’re a part? I think that’s one thing we don’t do a very good job about. We’re very negative towards anybody who’s an addict or has mental health issues,” Korchinski said. 

Getting to the root cause of addiction

Michelle LaBoucane works with people “from their first interaction with the RCMP all the way through to reintegration back into community.” 

The justice services director with the John Howard Society Okanagan and Kootenay branch, LaBoucane said the main question for each person they help is, “how can we support these individuals in community so that they aren’t causing havoc in the community anymore?

“I would love to see funding for community-based programs that get to the root cause of the individual’s behaviour,” she told Northern Beat in an interview. “It’s one of those really awkward and hard things to do. Like why are they committing a crime?”

“How can we support these individuals … [so] they aren’t causing havoc in the community?”

Michelle LaBoucane

Harry credited the sense of community in Guthrie with helping him process the trauma that contributed to his addiction. 

“It took me a very, very long time to talk about my trauma,” he said. “But I did it because I’d seen my other friends doing it and it made me feel okay, like hey, this is a safe place to share this stuff.”

Health services in correctional facilities: many unknowns

The Provincial Health Services Authority has overseen healthcare delivery in provincial correctional facilities since October 2017 and has a $35.7 million annual budget.

Officials would not reveal how much of the budget is directed toward mental health and substance use services, the quality and depth of those services, nor how many people are participating.

According to the health authority website, about 70 per cent of all provincial inmates receive some type of health care services during their stay, including mental health and substance use supports, withdrawal management, treatment by an addiction physician or nurse practitioner, and therapy with counsellors.

“All services are voluntary and clients can access as many services as they choose,” a PHSA representative said in an emailed statement.

Despite repeated requests, provincial health authority officials would not grant an interview for this story. 

Ninety-three per cent of BC inmates were released back into community without a discharge plan.

BC Auditor General report

Limited data on the health authority’s website indicates in 2022, about 40 per cent of all BC Corrections inmates were on opioid agonist therapy (OAT), a prescribed opioid substitution medication for individuals addicted to opioids.

Upon their release, people receiving OAT in provincial corrections can receive referrals to a community OAT provider or to other services such as recovery and residential treatment, according to the health authority.

However, a recent report by the BC Auditor General showed the Provincial Health Services Authority is falling far short of that. 

Relying on data from a small sample size of 92 randomly selected Indigenous inmates, the provincial auditor assessed whether they had been given adequate access to mental health and addictions care while incarcerated in BC Corrections facilities. His findings indicated only 40 per cent of individuals in jail had care plans, almost 20 per cent had no access to health care services in jail at all and 93 per cent of people were released back into community without a discharge plan.

Housing is the biggest barrier

The province has been scaling up specialized community transition teams, which help people newly-released from jail connect to the mental health, primary care and addiction services they need. The teams include people with lived experience and serve all 10 provincial correctional facilities.

But even transition teams struggle to find places for their clients to live, Butler said. “Time and time again, their biggest barrier is trying to get people into housing.”

In 2022, almost 900 people were connected with a community transition team upon their release from jail, nearly double the number of people who received services in 2019, based on data provided by the provincial health authority.

While the teams can provide critical transition support for people returning to community with sometimes little more than the clothes they were arrested in, participants can only access the services for three months after their release.

“We just need that support. You just can’t keep throwing people out with nothing.”

Mo Korchinski

Unlocking the Gates helps around 1,500 people every year and Korchinski wonders why the province isn’t investing more in grassroots organizations like hers, which fill a range of gaps. 

“We don’t just deal with people coming out, we prevent crime, we prevent homelessness, we prevent overdoses … We cover everything and we have to fight for funding every year,” she said.

Sometimes it seems like the people making policy aren’t listening to those working on the front lines, she said.

“I sit on all these committees and they keep asking people with lived experience, ‘How do we fix this, what’s the first step?’” Korchinski said. 

“We all know what would help somebody change their life. We just need that support. We need those resources. You just can’t keep throwing people out with nothing,” Krochinski said.

‘People need support the day they get out’ 

Even fairly simple policy interventions could go a long way to delivering the support people need, Krochinski said.

“Why don’t we have walk-in mental health clinics?” she asked.

In fact, Butler and LePard’s report recommends the province create crisis response and stabilization centres offering “high-quality mental health and substance use care that accepts walk-ins, as well as people being transported by ambulance, fire and police.”

Report authors also recommend high-level interventions to prevent crime by meeting people’s basic needs.

“We have to have the basic social determinants of health needs met.”

Amanda Butler

“Long-term reductions in crime require that the provincial government invest significantly in addressing the systems-level issues that contribute to offending including systemic racism, poverty, inadequate health services, food insecurity, and housing unaffordability,” the report reads.

“We have this narrow idea that public safety is law enforcement and courts, but public safety is also housing, access to food,” Butler said. “If we invest in our communities and actually create the social structures, people are less likely to be involved in crimes.”

“Not much of a chance that they’re gonna stay clean in a homeless shelter.”

Mo Korchinski

Korchinski says finding suitable accommodations for people coming out of correctional facilities is the number one issue for her organization. 

“Sending somebody to a homeless shelter who just got out of corrections puts them at a higher risk of overdosing, [and] women [at a] higher risk of being victimized,” Korchinski said.

“Not much of a chance that they’re gonna stay clean in a homeless shelter,” she said. “It’s not a place for somebody to turn their life around.”

On top of that, most treatment centres in B.C. won’t take anyone straight out of jail, which is another huge barrier, Krochinski added. “They want them on the street [clean] for 30 days.” 

Which leads to another problem – there are waitlists for services across the board, even for drug and alcohol counselling.

“People need support the day they get out,” she said.

Getting released in Prince George, the only provincial correctional facility in northern B.C., brings additional challenges.

“It’s minus 50 and they release them, while their bus doesn’t leave for four days. So they have to hang out on the street and then they end up doing crime,” Korchinski said.

“It’s super sad up there. It’s not like down here in Vancouver where people can live outside all year round.”

“If we … create the social structures, people are less likely to be involved in crimes.”

Amanda Butler

Unlocking the Gates helps bridge that gap, picking people up on their release and driving them home to their communities. 

Korchinski says having a community to return to for support is crucial to former inmates being able to continue their recovery and stay out of jail.

A holistic approach is the most effective way to help people stay in treatment and prevent crime, according to Butler.

“We speak about corrections, we speak about health care, we speak about housing but all of these things intersect,” Butler said. “You can have an incredible mental health program lined up for somebody but if they don’t have a house, that program is not going to be their priority. We have to have the basic social determinants of health needs met.”

‘Seismic shift’ to meet basic needs

For Butler, one of the biggest barriers to addressing B.C.’s situation is the tendency of politicians to latch onto short-term policy solutions rather than grappling with the long-term solutions required. Leaders need to accept that positive impacts may not be realized within the next re-election cycle, she said. 

“When you’re working on these seismic shifts related to poverty reduction, housing affordability, continuum of care, there isn’t a silver bullet for it and it’s costly in the beginning.” 

The ultimate return on investment is clear, Butler said. 

“But the initial investment — when things have gotten as bad as they are — inevitably will be substantial to get us back to a place where ideally everyone has their basic needs met. 

“We’re not even close to that, at the moment, in the province.”