Unlike staff at a psychiatric facility, guards have difficulty responding instantly to emergencies - such as a recent case in which a schizophrenic became hysteric in the belief that his cell was crawling with mice and snakes. "Staff knew how terrified he was," Ms. Gauthier recalls. "The look in their eyes was compassion. But they had to force him back in his cell."
On a 50-man range reserved for the most severe cases, offenders float quietly between their cells and a narrow corridor with tables bolted to the floor. Like a herd of deer, they appear docile, yet leery; most are heavily medicated.
"I used to say that I had never seen anyone as sick as I had seen in hospital forensic units, but I can't say that any longer," Ms. Gauthier remarks. "A psychiatric facility has different equipment, a different model. Correctional centres were never set up to be mental-health centres."
Guards and nursing staff on the mental-health ranges appear genuinely caring, referring to inmates by name and keeping elaborate charts of any change in behaviour that may point toward a suicide attempt or sudden attack. However, they are not always trained in the finer points of mental illness.
"A schizophrenic may think that a guard is the devil and start calling him really foul names," Ms. Gauthier says. "If he were a healthy person, he would be up for misconduct. One of the challenges is to understand that this is a symptom of an illness."
Graham Glancy, a forensic psychiatrist who works three days a week at Maplehurst, sounds like a battlefield medic as he describes what it's like to process patients in 20-minute intervals all day long: "Basically, it's a matter of medication and management - and trying to drop one little pearl of wisdom on them."
Some offenders are violent or hallucinate wildly, but exercise their right to refuse treatment. Staff can try to persuade local hospitals to medicate them involuntarily, Dr. Glancy explains, but getting them there requires diplomacy. "You have to be very careful about it. I can only send one or two at a time, or the hospital can get swamped."
On another range, 50 inmates with brain damage or subnormal intelligence gaze warily at strangers. All they have in common is the fact that, in prison, they're highly vulnerable. Some are chronic bedwetters. Others are old, scraggly and demented. Some are hulking men, but behave like school kids.
"The developmentally delayed are the forgotten population," Ms. Gauthier says. "... It is like putting four-year-olds in custody. They cry all day for their mommies. Social workers give them colouring books and crayons."
She recalls an inmate who arrived clinging desperately to a Beanie Baby, which prison rules didn't allow in his cell. "He had never been separated from it. He finally let us take a picture of it so he could hold that."
How did Canada's prison system turn into a holding tank for mentally damaged individuals?
Many officials trace it to the deinstitutionalization of psychiatric patients over the past 30 years. Patients wound up on the street when neighbourhoods shunned them and social-service agencies failed to provide adequate housing or care. In many cases, their mental state deteriorated, and they turned to crime, everything from the mundane to murder.
"We see people who ... felt there was no other way," says Mr. Small, the assistant deputy minister. "We also see people with mental-health issues who couldn't even form the intent to commit a crime."
Treating mentally damaged offenders can be close to impossible in provincial jails, where inmates are on short court remands or serve sentences of less than two years. Longer federal sentences allow time for treatment, but it's rarely available.
"There are waiting lists for almost every program at every institution," says Mr. Sapers, the federal investigator. "Although a program may be advertised as being available at a particular institution, it very likely isn't. This is where it all falls apart."Report Typo/Error
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