Assigning Responsibility for Mental Health Services in a Prison:A Case Study

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Public Policy and Administration


Kevin J. Fandl


The proportion of Canadian prisoners with mental illnesses is rising. Prison administrators are legally responsible for funding and providing access to mental health services for prisoners. Models of service delivery are organized differently in prisons across Canada, and limited scholarly research exists on the efficacy of different approaches to delivering prison mental health care services. The purpose of this case study was to explore the organization and delivery of mental health services in a provincial prison (APP) in Canada. The research question considered how to organize the delivery of these services to meet the needs of prisoners with mental illnesses. The right to health, which holds that services should be available, accessible, appropriate, and of good quality (AAAQ), was applied as the conceptual framework. Data were collected from public documents, observations of the medical clinic and a meeting of a multidisciplinary committee, and individual interviews and focus groups. A total of 31 participants from APP, the provincial health care system, and community-based organizations participated in this study. The data were inductively coded and subjected to pattern matching with emerging themes from multiple sources. Findings indicated that the provincial health care system, not prison administrators, should be responsible for the oversight and management of prison mental health services. Collaboration between the systems is needed in program design and delivering these services. Application of the AAAQ framework against mental health services revealed that the services did not satisfy the right to health and need enhancement. These findings suggest that policy makers could use the AAAQ framework to design and deliver mental health services equivalent to services in the community for the benefit of prisoners.

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