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Former inmates not getting health-care support they need upon release

Fiona Kouyoumdjian said research has shown discrimination in the health system exists regarding attending to the medical needs of people who’ve been in prison in this country
Dalhousie University. (Meghan Groff/

Former offenders in Canada aren’t receiving the health-care support they need upon release from federal prisons or provincial jails, a public lecture hosted by Dalhousie University was told Friday.

Simply getting a doctor’s appointment, with a physician accepting new patients, can be challenging, the online-only seminar heard.

Speaker Fiona Kouyoumdjian said research has shown discrimination in the health system exists regarding attending to the medical needs of people who’ve been in prison in this country.

She pointed to an audit study in British Columbia – “an artificial setup” – involving researchers who phoned doctors’ posing as potential new patients seeking
appointments. Some 250 offices were contacted.

Kouyoumdjian said callers either identified themselves as someone “who’s been recently released from prison,” or “a person who’s looking for a family  physician.”

Of those in the first group in B.C., 43 per cent were offered a doctor’s appointment, she said; 84 per cent of phone calls made by the second group resulted in offers of an appointment.

“This is just one indicator of the experiences that people may encounter in the health-care system,” Kouyoumdjian said during the lunch-hour talk presented by
Dalhousie’s Health Law Institute.

She said it “speaks to the fact that people who experience imprisonment, experience discrimination” within the medical system following their release.

Regarding inmates’ mental health, Kouyoumdjian, a medical doctor and an assistant professor in the department of family medicine at McMaster University in Hamilton, Ont., said psychiatric care is an issue for men and women in prison and once they are out.

She said she’s attended to patients inside a correctional facility and seen people “who are very ill from a psychiatric perspective. And I think there’s often a perception that (offenders) are accessing the care they need because they’re in custody, and they’re not at risk of harming themselves or others because they’re in custody.”

“But, certainly, incarceration does not provide the . . . services that hospitalization provides for psychiatric reasons,” said Kouyoumdjian.

She said data on hospital emergency department use show the mental-health needs of former offenders is a concern.

“We can see that from the time when people are in prison to the week after release, we can see a substantial increase in terms of rates of hospitalization. And to a large extent, this is due to things like injury . . . and then if we shift over to psychiatric hospitalization, we also see a substantial increase.”

The Canadian Psychiatric Association has said the treatment of mental illness in Canada’s correctional institutions requires “urgent attention” paid to “an already
disadvantaged population.”

With respect to COVID-19, prisoner-welfare advocates have been calling for quick access to vaccines for people in prison, The Canadian Press reported in December.

People age 50 and older represent one-quarter of the federal prison population, CP said.

“Advocates note people age faster behind bars and are in poorer health than the general public,” the news service reported.

Ottawa recently launched a coronavirus-related pilot project to vaccinate inmates at select federal prisons across the country, including the one in Springhill.

Elderly prisoners and those with pre-existing medical conditions were to be the first to receive their shots, CTV News reported last week. Prison employees and
corrections officers aren’t part of the program, CTV said.

Kouyoumdjian said better co-ordination between officials in correctional centres and those leading community groups will help people who have been in prison once they’re released.

“The best thing we can do during COVID-19, but also routinely, is to create strong relationships between our correctional facilities and community organizations,” she told the seminar. “We have an obligation to do so, and also it sets people on a course to success.”

COVID-19 isn’t the only virus of concern to medical professionals working in the prison system. AIDS experts have said the rates of infection from HIV (human
immunodeficiency virus) and Hepatitis C are significantly higher among those in jail than in the community at large.

Inmates taking part in such high-risk activities as syringe sharing pose threats to the health and safety of other prisoners and of prison personnel.

Kouyoumdjian earned her medical degree at Dal. At McMaster, she heads a research-focused program covering “the health status and health care” of prisoners,
says a McMaster website.

In 2019, Kouyoumdjian was part of a team of researchers that released a study showing about half of Canada’s inmates were abused as children, CBC news
reported in February of that year.

Aside from working at McMaster University, she’s a family doctor in a jail in Ontario.

Dalhousie’s Health Law Institute, at the university’s Schulich School of Law, “seeks to understand, use and adapt law and policy to improve health and well-being
through scholarship, education and public service,” the institute’s website says.

It runs a series of public talks during the school year.

Michael Lightstone is a freelance reporter living in Dartmouth

About the Author: Michael Lightstone

During a general-news career lasting close to 30 years, Michael LIghtstone has covered such things as politics, health matters, courts, labour issues and jazz concerts
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