Mr. Speaker, with respect to Bill C-83, I will focus mainly on administrative segregation because it is one of the key measures that should have been greatly improved. Unfortunately, we are not seeing this improvement.

There are two rulings on the use of administrative segregation that, in essence, have profoundly challenged the use of this technique because of the psychological and psychiatric effects it can have on people. For example, a number of studies show that administrative segregation could trigger or aggravate certain psychiatric symptoms such as hallucinations, panic attacks, paranoia, depression, impulsiveness, hypersensitivity to external stimuli, self-harm, insomnia and problems with thinking, concentration and memory. The use of administrative segregation increases the risk of suicidal thoughts and suicide.

In light of all that, the government should have engaged in a profound re-evaluation of the circumstances justifying the use of administrative segregation as well as the guidelines for the duration and supervision of this practice, among other things. Unfortunately, there are no options.

Segregation is also used in the health system. It is one measure used to restrain patients. Clearly, I am not referring to the same clients. Nevertheless, there are many linkages that can be drawn. The health system previously used many restraint measures on a regular basis. For example, a lap belt was used for seniors with dementia and the bed rails were raised so they would not fall out of bed. That was how things were done.

Quebec's health system has seriously questioned the circumstances that justify the use of restraints. There have been questions about how health institutions should determine whether their protocols for the use of restraints are effective.

Several documents were written about this, and I will be referring to a document put out by the Government of Quebec called Cadre de référence pour l'élaboration des protocoles d'application des mesures de contrôle, which deals with restraint, isolation and chemical substances. Chapter 4 is extremely interesting and so I hope that members will look into it, especially at committee. It talks about the ethical and clinical principles that health institutions should use to establish their protocols for the use of restraint. The first principle is this:

Control measures are only used as safety measures when immediate threats are identified

The protocol should state that control measures must be used in a therapeutic context only and must under no circumstances be used to punish, intimidate or correct a person, to modify a behaviour, or to deal with organizational constraints. If a control measure is used, it must be used with the sole object of preventing the person from imminently causing harm to themselves or others.

These ethical principles make many interesting points, especially where they say that restraint measures, such as segregation, must never be used to deal with organizational constraints. In other words, if segregation can be avoided by doubling staff numbers, that would be the ethical thing to do, rather than placing people in segregation just because it is the easiest option and money is tight.

This is also a very important principle from a legal perspective. Administrative segregation should not be used as a substitute for increasing staff numbers due to a lack of means. If segregation can be avoided by increasing staff, whether that means more security guards or other professionals, then increasing staff is the better option.

Another ethical principle is that control measures should be used only as a last resort. That seems logical.

I will continue after question period.

Christine Moore

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