Jury calls on prison system to meet cultural needs of Inuit inmates

Inquest into suicide of murderer Mark Jeffrey while in prison concludes with jury offering 19 recommendations

Mark Jeffrey, 34, an Inuk man who had been convicted of the 2002 murder of 13-year-old Jennifer Naglingniq, died by suicide while in segregation at the Beaver Creek Institution in Gravenhurst, Ont. in 2015. An inquest concluded Wednesday that looked at the circumstances of his death and offered recommendations to avoid similar deaths in the future. Pictured here is the outside of Jeffrey’s cell door. (Photo courtesy of the Office of the Chief Coroner of Ontario)

By Madalyn Howitt

The coroner’s inquest looking into the circumstances surrounding the 2015 suicide of Inuk inmate Mark Jeffrey at the Beaver Creek Institution in Ontario concluded Wednesday, with the jury submitting 19 detailed recommendations that call on Canada’s correctional system to do more to meet the unique cultural needs of Inuit in custody.

Jeffrey, a 34-year-old from Iqaluit, died by suicide while in custody at the medium-security federal institution in Gravenhurst, Ont., where he had been serving a life sentence for the 2002 murder of 13-year-old Jennifer Naglingniq. Correctional officers found him unresponsive after he hanged himself in his cell in segregation.

“Mr. Jeffrey committed a terrible act that ended the life of another and caused unimaginable harm to the family of the victim and to the community,” said coroner’s counsel Kate Forget of the Indigenous Justice Department, in her closing statements.

She and co-counsel Ashley Jacobs led the inquest. When it was over, they asked the jury to consider Jeffrey’s death within the broader social and historical context of colonial policies and systems that are imposed on Indigenous people.

“Each of us is more than the worst thing we’ve ever done, and Mr. Jeffrey’s life reveals the truth of that statement,” said Forget.

The jury was charged with considering ways that correctional institutions can better support Indigenous inmates, in particular Inuit inmates like Jeffrey, to avoid deaths under similar circumstances in the future.

After listening to each counsel’s comprehensive closing statements, the four members of the jury submitted their final recommendations.

Some key recommendations include:

  1. Correctional Service Canada (CSC) should make the Anijaarniq Strategy, a holistic Inuit strategy to better understand the needs of Inuit in federal custody, publicly available and ensure CSC staff know how to implement it properly.
  2. CSC should explore ways to better understand and meaningfully address barriers to recruiting Inuit elders.
  3. With mental health practitioners, including Indigenous health practitioners, CSC should identify whether suicide prevention tools should be updated to take into account Indigenous social realities.
  4. Orientation training should be provided to Inuit elders and Inuit liaison officers … [including] how to review entries to the inmate management system to ensure that events and interactions are accurately reflected.
  5. Conflict resolution, healing circles and elders should be considered before an increase to security classification and or a transfer recommendation is made.

Other recommendations include CSC conducting a feasibility study of establishing an Inuit Centre of Excellence closer to Ottawa, where access to Inuit services is more readily available, addressing the delays in payment to Indigenous support workers on contract who provide services to CSC and giving closer consideration to Inuit inmates who have established community and cultural connections at an Inuit Centre of Excellence like BCI when the possibility of a transfer emerges.

The jury’s recommendations come at the end of an eight-day inquest that saw witnesses deliver at times emotional testimonies and reflect on what they’ve learned in the six years since Jeffrey’s death.

Jeffrey’s suicide on June 29, 2015, came after he spent 74 days in segregation, which is a type of isolation unit that federal law abolished in 2019. Jeffrey had been placed in segregation after he was caught consuming Gabapentin, a prescription drug sometimes used to treat anxiety that he had purchased from another inmate.

“How the system responded is not an example of a system failure. The system responded exactly as it was designed to do,” Forget said in her closing submissions.

Witnesses testified throughout the inquest that numerous factors, including shortcomings in how the institution provided Inuit-specific supports to Jeffrey, likely contributed to his death.

Parole officer Roy Singh and counsellor Jim Salmon each said in their testimonies that Jeffrey had become a “champion” for the Inuit population at Beaver Creek, even being elected chairperson of the Inuit group and the carving shed. Elder Wes Whetung and Indigenous liaison officer Noah Noah shared that Jeffrey’s acceptance into Waseskun, a healing centre for Indigenous inmates, was a “monumental achievement” and demonstrated that Jeffrey was committed to his healing.

Yet when Jeffrey was placed in segregation after consuming drugs, the opportunities to stay in minimum security or attend Waseskun disappeared, meaningful access to Inuit cultural supports were scant, and when an incompatible inmate arrived at Beaver Creek during this time, it prompted staff to begin the process of transferring Jeffrey to an entirely new institution rather than consider alternatives.

This kickstarted a convoluted process of multiple segregation review meetings, submissions of transfer requests and difficulties determining where Jeffrey would be placed after being released from segregation, which caused his stay in isolation to drag on for two and a half months.

Journals that were found in his cell showed Jeffrey felt “broken” and “tired spiritually.” Psychiatrist Derek Pallandi testified that feelings of isolation and of regressing in his healing plan could have been factors in Jeffrey’s suicide.

“He lost hope in a system that he felt was labeling him and stereotyping him,” Forget said. “He lost hope in a system that marginalized the voices of his Indigenous supports who spoke on his behalf.”

Dr. Steven Bodley, who presided over the inquest, said the jury arrived at recommendations that he thinks will be helpful.

“[The verdict] recognizes the principles of listening to our [Indigenous] communities and to truly incorporating their input into the decision-making process. This is essential as we move along the path of truth telling and reconciliation,” he said.

Following the closing of the inquest, the jury’s recommendations will be made available to the public.

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