Needing treatment: a snapshot of provincially incarcerated adult offenders in Nova Scotia with a view towards substance abuse and population health.

• Author: Kitchin, Heather A.
• Position: Canada

Introduction

For the year 2003, Nova Scotia is reported to have the highest increased crime rate of the four Atlantic provinces of Canada (Wallace 2004: 19). In 2003, the rate of violent crime in Nova Scotia was reported to be 1,199 per 100,000--higher than those for Quebec, Ontario, and Alberta, and falling only slightly below that for British Columbia (Wallace 2004: 19). Over the past four years, the Nova Scotia Department of Justice, Correctional Services, has moved towards building larger, more secure facilities to house offenders. Today, the provincial government of Nova Scotia provides housing for a daily maximum of 465 inmates through its five adult correctional facilities, or prisons. Offenders sentenced to a term of less than two years in Nova Scotia fall under provincial jurisdiction. (2)

Over the past several years, the Correctional Service of Canada (CSC) has introduced accredited programming to its federal institutions. The accreditation process draws heavily upon state-of-the-art theory, supported by empirical findings and developed through review of existing scientific literature (Correctional Service of Canada 2002). Proposed rehabilitative programming is thus reviewed by panels of recognized experts who assess a program in relation to specific criteria (see also Bonta and Cormier 1999). If the program is approved, the panel makes a recommendation to the commissioners for accreditation. Substance abuse programming is one of the areas now subject to the accreditation process by CSC, as it is now understood that many inmates are repeat offenders who are challenged by addictions to various substances.

The Ontario Ministry of Community Safety and Correctional Services has also moved into accreditation for programming it delivers to provincially incarcerated adult offenders and is now piloting accredited, high-intensity substance abuse programming with a concomitant focus on criminal thinking. According to Larry Motiuk, Roger Boe, and Mark Nafekh (2003), rehabilitative substance abuse programming administered within correctional settings reduces recidivism, readmissions, and new convictions. Nonetheless, Nova Scotia Corrections is just now considering the importance of accredited substance abuse programming for inmates housed under its authority--a consideration due in part to an initiative of an independent researcher, currently underway. This paper makes the case for the delivery of evidence-based substance abuse programming to adult offenders serving time provincially in Nova Scotia and suggests that substance abuse programming, both within incarcerated populations and more generally, may be well placed within a population health paradigm. The research presented here is the first of its kind to examine substance abuse and crime among provincially incarcerated adult offenders in Nova Scotia and adds to the available literature that addresses crime and substance abuse in Canada.

To date, there is a dearth of published literature that specifically examines provincial corrections systems in Canada. This report (1) situates the case of Nova Scotia within other literature addressing crime and substance abuse in Canada; (2) presents a snapshot of the demographics and programming needs of provincially incarcerated adult offenders in Nova Scotia; (3) speaks to the need for addictions programming for such offenders; and (4) considers how the problem of "warehousing" offenders may be addressed and potentially ameliorated through a population health approach to policy, programming, and treatment. Population health, as defined by Health Canada, offers a viable vehicle through which to situate research initiatives that seek to understand the ways in which crime may be constructed through social and familial environment, upbringing, socio-economic status (SES), inadequate health care, and employment and literacy challenges--all of which may be conceptualized as determinants of health (Health Canada 2001). The purpose of this article is thus to report findings from research conducted with adult offenders incarcerated provincially in Nova Scotia, with a view to exploring links among crime, substance abuse/dependency, and population health.

Methodology

A standardized survey was run with adult offenders incarcerated at the provincial level across Nova Scotia. The purpose of the survey was (a) to explore links between crime, incarceration and substance abuse in Nova Scotia; and (b) to examine the need for responding programming and related treatment services. During preliminary interviews conducted for the research, Corrections administrators and staff had estimated anecdotally the level of substance abuse among provincial inmates in Nova Scotia to be 90 to 95%. One primary goal of running the survey was to determine more empirically whether those estimates were accurate. Data were collected from July 2002 to March 2003.

Instrument

Survey questions were developed with the dual purpose of approximating rates of substance abuse among provincially incarcerated offenders in Nova Scotia and assessing what types of programming or treatment services were most desired by surveyed inmates. These two research goals were stated overtly in the consent form used for the research and were explained verbally to all respondents. Demographic and background information collected through the survey includes age, gender, educational level, estimated number of prior sentences to custody, number of prior arrests for offences involving substances, length of sentence, prior federal sentences, prior youth sentences, and current crime(s) of record.

The survey was designed to be self-administered, consisting of 25 questions in total, with several questions containing sub-questions. Some questions solicited a yes or no answer, with seven questions inviting qualitative responses to provide context or specificity to the answers. In one case, for example, respondents were first asked to disclose whether they had problems with drugs or alcohol and were then asked to identify exactly what substances with which they had problems. Questions regarding gambling habits and possible links to crime were also included in the survey but are being analysed separately. The final question on the survey provided enough space for an open-ended, qualitative response, through which respondents were able to provide any feedback they desired with respect to substances, crime, and programming. Three inmates followed their comments with a personal letter to the principal investigator, noting their history with crime and substance abuse and indicating their hope that substance abuse programming would be forthcoming in the provincial correctional system in Nova Scotia.

Sample

The total sample consisted of 168 respondents, drawn from all five provincial adult correctional facilities in Nova Scotia: Dartmouth (Central Nova Scotia Correctional Facility [CNSCF]), where 90 of 164 offenders made available to the research completed the survey, an overall response rate (RR) of 54.9% (82 of 153 males [53.6% RR] and 8 of 11 females [72.7% RR]); Amherst (Cumberland Correctional Facility [CCF]), where 16 of 25 available offenders completed the survey, an RR of 64%; Antigonish (Antigonish Correctional Facility [ACF]), where 6 of 11 available offenders completed the survey, an RR of 54.5%; Sydney (Cape Breton Correctional Facility [CBCF]), where 49 of 80 available offenders completed the survey, an RR of 61.3%; and Yarmouth (Southwest Nova Scotia Correctional Facility [SWNSCF]), where 7 of 9 available offenders completed the survey, an RR of 78%. Both sentenced and remanded offenders held under provincial custody were invited to participate in the research. Federal inmates remanded temporarily to the provincial facility or those held on federal parole violations were excluded from the study. Offenders hot made available to the research were those offenders considered by classification officers to be a security risk, those in administrative segregation, those serving intermittent sentences (this applied to all but CCF, which was surveyed on a Saturday, when intermittent sentences were being served), and those away from the facility due to day passes or court appearances.

Procedures

Survey participation was on a voluntary basis. Respondents at all facilities were recruited first by a letter of invitation circulated prior to the actual survey days. Subsequently, at CNSCF, the researcher and research assistants personally entered dayrooms to request participation in the research. At the other sites, interested offenders were brought to a secondary site, where the research was explained by the researchers and the survey was completed by those interested. At these sites, Corrections staff had full control over the way in which the research was presented to the inmates. Assumedly, if potential respondents were given the impression by Corrections staff that the research was unimportant, they may have chosen not to come forward to complete the survey. At CBCF, a complete wing of fourteen offenders failed to come to the meeting room to complete the survey when invited by the Corrections worker.

Consent forms were signed or marked and witnessed by respondents, prior to their completing the survey. Given the length and content of the survey and the time required for explaining the consent form, efforts were made to have the survey completed by six offenders in each session. This plan proved difficult because several residents, due to challenged literacy, required full assistance in completing the survey. Of the 168 respondents, 19 required full assistance with completing the survey. In these cases, the survey was read aloud to the respondents and answers were recorded by one of the researchers. To capture qualitative responses, questions were read and answers were written verbatim and were then read back to respondents for confirmation.

Prior to beginning the survey at each...