Suicide risk ‘ebbs and flows,’ inquest hears
Psychiatrist says death of accused rapist in detention may have been impulsive
The suicide of an accused serial rapist at the Ottawa-Carleton Detention Centre may have been “impulsive,” a forensic psychiatrist told an inquest looking into the man’s death.
Yousef Hussein, 27, was found hanging in his cell on April 12, 2016. He was one of three inmates in the jail to kill himself by hanging while in segregation at the jail within a 10-month period.
Hussein had been placed on suicide watch in segregation on April 8, 2016. He remained there over the weekend, and was taken off suicide watch on April 11 at 3 p.m. Almost exactly 12 hours later, he was found lifeless in his cell. He was declared dead in hospital about 45 minutes later.
Dr. Derek Pallandi, who is a consultant at a number of Ontario corrections facilities and holds a staff position at the Centre for Addiction and Mental Health in Toronto, spoke to the inquest on Friday.
Hussein lacked many of the factors that underline suicide risk — he did not have a pre-existing diagnosis of mental illness, a criminal record or a history of substance abuse or self-harm, said Pallandi. However, Hussein felt isolated as a result of spending time in segregation. And he was upset about a forced transfer to another jail in Lindsay, Ont., and feared he would be deported.
Screening tools for suicide risk ranked Hussein’s risk from a high of seven or eight out of 10 to zero out of 10 only hours before his death. It’s not uncommon to see these kinds of variations, said Pallandi. This was not a case where standard protocols were ignored. Rather, Hussein’s actions may have been difficult to predict.
“It’s not a like a solid block of concrete. It ebbs and flows,” he said of suicide risk. “It’s more difficult to predict something that moves. It’s like weather prediction. There’s climate, but weather changes from day to day. Those changes can happen quickly.”
Pallandi later added that it is commonly reported after the fact that a suicidal person appeared more energetic with a better outlook just before they died. The renewed energy could be an “investment” in suicide, or it could be to distract others from their intent.
Inquests are mandatory for all prisoners who die while in custody. Hussein died at a time when there was significant media attention on numerous lockdowns and overcrowding at the detention centre, as well as long waits for trial. Hussein had already spent almost two years in jail at the time of his death, and was anticipating another year there before he got his day in court.
This inquest is narrowly focused in preventing deaths under similar circumstances. The five-person jury cannot make findings of legal responsibility, but may make recommendations.
Pallandi estimated that inmates die by suicide at five to eight times the rate of the general population. Theoretically, it would be possible to almost eliminate suicides in correctional facilities by restricting liberty, he said. But that’s not workable because inmates would consider that intolerable.
“Many of these fellows have a strong sense of right and wrong and their own liberty,” said Pallandi.
Detention centres are more complicated than prisons because of the volume of people coming and going. Pallandi addressed some changes that might help reduce suicides, including standardizing or regulating the wait times for mental health treatment by having a health-care supervisor such as a nurse managing the triage system and using technology.
Telemedicine makes it easier for patients to consult with medical professionals, and it might also help recruit psychiatrists to work with inmates. Electronic health records might also be helpful, said Pallandi. As it stands, a lot of medical record-keeping in correctional facilities is done using a pen-andpaper system.
It should also be easier for inmates to get visitors, he said. As it stands, there are significant obstacles even to using a telephone.
The inquest, which was originally scheduled to last five days, heard it last witnesses on Friday. The jury is to begin its deliberations on Monday.