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HomeMy WebLinkAbout1989-1291.Union.93-09-01 . CROWN EMP6c.~,:ES DE L'ONTARIO GRIEVANCE B C,OMMISSION-DE SETTLEMENT REGLEMENT BOARD DES GRIEFS OUNDAS STREET WEST, SUITE 2100, TORONTO, ONTARIO. M5G 1~Z8 T~LEPHONE/T/.~L~-PHONE: (4 '~6) 326- 7388 RUE DUNDAS OL/EST, BUREAU 2100, TORONTO {ONTARiO.J. MSG ~Z8 FACSIMILE/TL~L~-CC'PlE : ~4 ~6) 326-13~6 IN THE MATTER OF ~N ARBITRATION Under THE CROWN EMPLOYEES COLLECTIVE BARGAINING ACT Before THE GRIEVANCE SETTLEMENT BOARD BETWEEN OPSEU (Union Grievance) Grlevor T and - The Crown: in Right of ontario (Ministry of Correctional Services' Ministry of Health Management Board of Cabinet) Employer BEFORE: R. Verity Vice-C~airperson' J.C. Laniel Member M.' O'Toole Member FOR THE R. Anand UNION Counsel Scott & Aylen Barristers & Soliciotrs FOR TEE M. Contini EMPLOYER Counsel Mathews, Dinsdale & Clark Barristers & Solicitors HEARING June 20, 1990 October 15, 22, 29, 31, 1990 December 17; 1990 Ja'nuary 31, 1991 February 1, 12, 1990 March 27, 1991 April 9, 15, 18, 1991 May 7, 8, 1991 July 19, 1991 September 5, 1991 March 26, 1992 June 29, 1992 July 2.7, 1992 November 9, 10,' 1992 December 14, 1992 February 8, 9, 1993 'DECISiON The union filed a policy grievance, dated september 5, 1~89, which alleges "that the Ministry of Health and Ministry Correctional Services have violated Article 18.1 by ~ontinuing to allow persons on lieutenant governor's warrants to be housed at Toronto East Detention Centre. These persons are particularly dangerous because "no mandatory ~hemical intervention is allowed." At the hearing, the union requested the following remedy: 1. A declaration that the practice of housing L.G.W.s at Toronto EaSt Detention Centre constitutes an unreasonable. health' and safety'risk, .contrary to the provisions of Article 18.1 of the collective agreement. An order that L.G.W.s be transferred'from Toronto East Detention Centre to a psychiatric hospital within seven daYs of a court sentence declaring an accused 'unfit to stand trial or not guilty by reason of insanity. 3. That the Board remain seized of the matter' in the event that the parties agree .upon an alternate remedy. Article 18.1 of the collective agreement reads as follows: A~C~ 18 H~L~ ~D ~FETY . ~. 18.1 ne EmpL~ shall continue ~ ~ke reasonable provisions for the safety and'health of its e=p[~ees during the hours ~ their e~lo~ent. [t is agre~ that ~th ~he Emplo~r and th~ ~nion shall co-operate to the rut[est extent ~ss~ble in the prevention of accidents and in the ~easo~b[e prb~tion of safety and health of all eap[~ees. An L.G.W."accused is a legal'st&tus, determined by a court of competent jurisdiCtion, for the severely mentally disordered who are charged with the commission of serious criminal offenses, At the time of the filing of the grievance in September 1989, the common practice for an accused found "not guilty by reason of insanity" or "unfit to Stand trial by reason of insanity" was to detain him in the "custody" of a correctional facility until the pleasure of the Lieutenant Governor .of Ontario was known, The 'accused remained in a correctional facility pending the issuance of the initial war~ant of the Lieutenant Governor directing the accused to one of ten regional psychiatric hospitals in Ontario. At ~ome later date, the accused was transferred from the correctional ~acility to a psychiatric hospital. The policy grievance identifies a' particula~ population of inmates as a health and safety risk; namely, accused who have been sentenced in the first step. of the L.G.W. system. The grievance does not relate to those inmates suffering from a major mental illness who do not attain the legal status of L.G.W.~ The substance of the union's case was that accused sentenced under the L.G.W. system remain at Toronto East Detention Centre in 4 Scarborough for extended periods of time varying from 15 dayS' to 208 days (Exhibit 7) prior to transfer to a psychiatric hospital, and that this 'practice violates Article 18.1 'by jeopardizing t~e health and safety of employees. At issue is the appropriateness Of placement of L.G.W.s at Toronto East, given its mandate of secure containment, the adequacy of psychiatric treatment provided to L.G.W.s at Toronto East, and the lack of knowledge and training of ' staff in major psychiatric disorders to enable them to comprehend 'mental illness and to take appropriate measures. The policy grievance focused on the_ union's concern for employee, health and safety by the practice of "warehousing". L.G.W.~s at Toronto East for prolonged periods of time between the dates of court sentence and admission to a psychiatric hospital. The employer con~ends that the circumstances existing at Toronto East do no.t justify the finding of an unreasonable health and safety risk and that, accordingly, the grievance must be dismissed. The arbitration hearing took the form of an exhaustive inquiry over 25 hearing days, including eight days. in final argument. The panel mak%s no attempt to repeat all the evidence and submissions, but sufficiently to indicate the basis of our decisions'. Toronto East is a maximum security detention centre which in September 1989 accommodated some 400 to 440 inmates and a staff of approximately 125 correctional officers. Prior to the filing of the grievance in September 1989, the L.G.W. population at Toronto 5 East was relatively small varying from 0 t~ 5 persons. L.LG.W..s are generally detained in segregation on Unit 2A (a 20 cell facility) in locked cells.containing "hatchways" to limit· direct Physical contact. Unit 2A is also used to accommodate inmates on misconducts, inmates requiring "super-protective custody" and a number of disfunctionally mentally ill inmates. A clipboard is placed on each cell door to document inmate behaviour. The practice in Unit 2A is that no cell door is opened unless two unit officers are present. The distinguishing' feature of Unit 2~ is that medication and meals are passed through~ the hatchways and there are no day rooms or.common areas·on the unit. Essentially, Unit 2A is a 23½ hour per day lock-uP. L.G.W.s are4 fed individually through the hatchways with the use of paper plates, styrofoam cups and plastic spoons. In sum, the physical setting in this unit is both secure and~ barren. At the time the policy grievance was filed, there were two correctional officers assigned to Unit 2A during the day shifts and two staff for the entire second floor .at night. However, in the event of an emergency, a code system was in place at all times in order to obtain the assistance of other officers. We heard evidence from two expert witnesses in the field of forensic psychiatry. Dr, Mark Ben-Aron testified for the union. He is currently·Chief of Service for Metro·Toronto Forensic Service (METFORS) at the ·Clarke Institute of Psychiatry. Dr. Ben-Aron 6 regularly performs psychiatric· assessments of individuals implicated in the criminal justice system', in addition, he provides psychiatric consultation services for certain psychiatric hospitals and for a number of correctional facilities both federal and provincial. The focus of Dr. Ben-Aron·'s evidence was on the welfare of the patient suffering from a major mental illness. ~ In his Words: "L.G.W.s, in my opinion, should be in hospitals, ~not detention centres", and "placing them in a jail setting continues to stigmatize psychiatric illness". Dr. 'Ben-Aron Stressed the need for assessment and treatment of L.G.W.s in hospital with the- advantage of a multi-disciplinary team approach and consistency in staffing including physicians, psychiatrists, psychologists, nursing'staff, and Qccupational 'and rehabilitative therapists. In examination-in-chief, Dr. Ben-Aron advanced a number of opinions to this effect: that L.G.W.s frequently exhibit idiosyncratic and irrational behaviour and, without provocation, can be assaultive; that L.G.W. confinement in a correctional facility can cause "deterioration" leading to more disturbed behaviour and.heightened dangerousness; that without a multi- disciplinary~team approach, the L.G.W. group is less likely to be compliant with medical treatment initiatives offered, resulting in deterioration·and heightened risks of assaultiveness; that in the absence of clinical skills, correctional staff are unable to 7 predict dangerous behaviour, resulting in inCreased risk of assault and increased stress because of skill deficiencies; ~and that L.G.W.s should be in hospitals rather than jails· from both treatment and health and safety perspectives. In Dr. Ben-Aron's words: "Experts will agree on diagnosis but will disagree on the intensity of the illness or the'extent to which the illness m~y· affect individual judgment". The union prapared a case book profile of 13 L.G.W.s at Toronto East (Exhibit 6). Essentially, the profiles contained a number of business records on each L.G~W. and, in most instances, -an initial psychiatric assessment. Dr- Ben-Aron readily acknowledged that he had direct involvement with only one of the individuals profiled~in Exhibit 6. However, he reviewed each profile and made predictions of the likelihood of dangerous or unpredictable behaviou~ in each case study. In examination-in- chief, Dr. Ben-Aron identified 12 of the 13 profiles in Exhibit 6 who, in his opinion, would likely be involved in future dangerous behaviour. In cross-examination, he testified that he made the predictions based on "the diagnosis of mental illness and presence of psychotic state as part of that mental illness and that the person was on at least one occasion previously aggressive or assaultiVe". Howaver, later in cross-examination, Dr. Ben-Aron readily agreed that many of the L.G.W. profiles in Exhibit 6 were either not dangerous 'or that he was unable to make a prediction. In addition, ·he readily acknowledged that medical studies suggest that psychiatrists generally are not. skilled 'in the accurate prediction of dangerousness. He also indicated that "ment'al illness of itself is no indication of any increased dange~ of assault" In Dr. Ben-Aron's words: "the more details you ~an obtain from the patient or other sources, the more likely you are .to be accurate in your predictions" Dr. Ben-Aron candidly acknowledged that he had no personal involvement in 12 of the 13 L.G.W.s profiled. Dr. Russel Fleming, Psychiatrist-In-Chief at Oakridge and Penetanguishene Reg%onal Centre, testified for the employer. Dr. Fleming's expertise is in the psychiatric hospital setting, based on his 30 years experience at Oakridge and Penetanguishene. He described the curr~ent "unique" organization at Oakridge. Oakridge is the only maximum security psychiatric hospital in Ontario and is a 120 bed facility for male patients including 90' L.G.W.s' According to his evidence, the main admission criterion to Oakridge is that "individuals be-a danger to other persons in some form".. Dr. Fleming's evidence was to this effect: that there was "..strictly speaking" no correlation between a not guilty by reason of insanity finding and a suspected high risk .of misbeha~iour; that the L.G.W. status does not indicate dangerousness without regard to individual characteristics; that some L.G.W.s may deteriorate in a correctional facilitY "but they don't necessarily"; that risk to staff in a correctional facility does not increase where an L.G.W. 9 refuses medication, particularly where t~ere is consistency in staffing day after day; that L.G.W.s are "not necessarily" more unpredictable or dangerous than other mentally disordered offenders; that you cannot equate "unpredictability" ~ith "dangerousness"; that assaults by the mental!.y disordered may occur "out of the blue" but normally are precipitated by something someone has done or said; that,.~contrary to public perception, there "likely isn't any correlation between the unpredictability of psychiatric patients and the prognosis for dangerousness"; and that psychiatrists are "inept" at making predictions of future dangerous behaviour. In particular, Dr. Fleming was unwilling to make predictions of aggressive behaviour and dangerousness in any of the L.G.W.s profiled in Exhibit 6. In Dr. Fleming's words: "psychiatrists regularly disagree on issues of diagnosis and treatment, not to mention the prediction of dangerousness". He candidly acknowledged that he had no direct knowledge of the quality of psychiatric treatment given in correctional facilities. .In Dr. Fleming's opinion, however, correctional facilities can provide effective psychiatric treatment "as far as they are able within their setting". Dr. Fleming testified extensively as.to the quality of care given.by 353 staff at Oakridge in the assessment and treatment of psychiatric patients. Oakridge consists of six wards, and four units; namely, the Forensic Assessment Unit, Social Management Unit, Behaviour Therapy Unit and Rehabilitation unit, A multi- disciplinary team at Oakridge'provides 24 hour coverage seven ~ays a week. Dr. Fleming stressed the need for trained staff who ~re not threatened by the environment, and the need for consistency in staffing· to develop patient' rapport and trust. In cross- examination~ he. acknowledged that "universally patients don't like' being locked up" although "occasionally" the opposite wi%l occur. In addition to Dr. Ben-Aron, the union called a number of· witnesses. Sheran Johnston has been a social worker in the classification department at Toronto East since 1986. She is. president of Local 582 and currently serves as vice-president of OPSEU Region 5 and vice-president of the Ontario Federation of Labour. Ms. Johnston. compiled the profiles of the 13 L.G.W.s in Exhibit 6 from business records at Toronto Easti allegedly as a representative sampling rather than a complete list of behavioural incidents involving L.G.W.s. Her evidence was to this effect:. that L.G.W.s are "more dangerous" than other inmates "because of their unstable mental state"; that it is "unfair and inhumane" to house L.G.W.s in a "harsh environment such as Unit 2A"; that the procedure of "dumping" or '~warehousing" L.G.W.s for prolonged periods of time at Toronto East was an inappropriate method of treating the mentally ill, given the lack of training of' correctional officers in issues of mental health; that it was not the mandate of correctional officers to provide care for the 11 accutely mentally ill; that L.G.W.s pose an unreasonable ~ealth and safety risk to correctional officers at Toronto East by reason of risk of assault and unsettling behaviour such as chanting ~and yelling, kicking cell doors, throwing urine and faeces, flooding cells, and other hygiene concerns; and that in the ~bsence of a multi-discipline approach, the treatment given L.G.W.s at Toronto East was 'inadequate. In cross-examination, Ms. Johnston agreed that the'primary remedy of removal from Toronto East within seven days of sentencing, while "helpful", would'not entirely eliminate the unreasonable health and safety risk posed by L.G.W.s. Arlene Dunn is one of seven full-time registered nurses employed at Toronto East. She has accumulated many years of nursing experience including five years at Queen Street Mental Health Centre. In June 1989, she was designated psychiatric nurse at Toronto East and worked closely with psychiatrist Dr. Leonard Ralley in addition to performing, general nursing duties. Miss Dunn described the behaviour patterns of each~ of the 13 profiles contained in Exhibit 6 as well as Other mentally disordered inmates. According t~ her evidence, L.G.W. behaviour patterns ran · the gamut from assaultive, unpredictable, verbally abusive, noisy and unco-operative to uncommunicative and fairly quiet. She testified that it was not uncommon to hear prolonged screaming and consistent banging of cell doors for hours on end. According to her evidence, many correctional officers at Toronto East were "unable to deal with the mentally ill". In her words: "I don't 12 believe a cOrrectional officer is hired as a psychiatric care giver" She testified that the ~delay in transfer of L.G.W.s to a psychiatric hospital was attribu%able to the shortage of beds in hospitals. She emphasized that medication cannot be forced upo~ an unwilling inmate; 'however, Dr. Ralley did his best to render psychiatric treatment two half days a week (12 to~15 patients each half day) and one full day where some 30 to 40 inmates would be seen. In her words:' "when looking after the mentally ill, there is always some risk' ... you must exercise some caution and judgment". According to Miss Dunn, .20% to 30% .of the inmate 'population at Toronto East suffers from 'some form of mental problem. CorrectiOnal officer Bill Lee is currently secretarY-treasurer of the union local. The thrus't of his evidence was that misconduct reports are hot filed'on inmates who are mentally ill, and that such conduct frequently includes spitting, throwing, food, abusive ranting and raving, and excessive noise for'prolonged periods. In his experience with the mentally ill, "a problem can happen with no warning and for~ no apparent reason".' According to Mr. Lee,· "someone who is mentally ill is far more dangerous than someone in the general (inmate)'population". ~r. Lee testified that he works in Unit 2A approximately four times a year for two week periods. Correctional Officer Robert Megahy Works in Unit 2A on a r~tational basis. He testified as to the tension created by the unbearable smell of an L.G.W. who refuses to attend to hygiene.and of an incident in March 1990 where he was assaulted by an L.G.W. when he turned his back on the inmate in the admitting departmgnt. As a result, Mr. Megahy suffered a split lip and broken dentures. Megahy's practice was not to submit misconduct reports on L.G.W.s unless it involved~an'actual assault. Correctional officer Greg Hunter has worked, at Toronto East since June 1987. He has chosen to work the' majority of his shifts on Unit 2A, although he considers that L.G.W.s pose a greater risk to health and safety. In his words: "although there are exceptions, I treat them at al.1 times as completely unpredictable". While 'agreeing ~that not all L.G.W.s~ are violent, correctional~ officer Hunter testified that, in his experience, many of them were. He gave evidence of a number of incidents Of aggressive behaviour including the retrieval of a razor from the rectum of an inmate profiled in Exhibit 6. Mr. Hunter testified that he enjoyed working with L.G.W.s.. However, he contended that consistency in staffing on Uni~ 2A and meaningful staff training would assist greatly to reduce the risk. It is significant, we think, that none of the three correctional officers who testified before us had received any training in issues of mental illness or in the proper handling of psychiatrically disturbed inmates. 14 Allan Dvorak, acting senior assistant superinten~dent at Toronto ~East from June to November 1989, was the employer's second witness. He has served as a U.S. marine, a member of the Chicago police force, and at Metro East as a correctional officer from 1978 to 1982, floor supervisor in 1982, shift scheduling manager in 1984, and' shift supervisor in 1987. Mr. Dvorak has extensive experience in all aspects of the institution, including Unit 2A which he visited on a dai.ly basis during "superintendent's rounds" in 1989. He commented on each .0f the L.G.W.s profiled in Exhibit 6 as well as on an additional five L.G.W.s referred to in Exhibit 7.. His evidence was to the effect that Unit 2A was no more dangerous than any other area of the institution and that none of the L.G.W.s at Toronto East posed an unreasonable health 'and safety risk. In his words: "I tre'at the unpredictable as predictable and I would be on my guard". He candidly acknowledged that this approach would not assist in situations of verbal abuse or in situations of' unhygienic behaviour. Like Nurse Dunn, Mrl Dvorak testified that shortage of beds was the cause of delay in the transfer of L.G.W.s to psychiatric hospitals. we do not intend .to repeat the able submissions of counsel, except in summary form. UNION ARGUMENT Counsel for the union contended that in determining whether there has been a violation of Article 18.1, reference should be made to the principles set out in 0PSEU'(W~tts/Kin~) and Ministry of Correctional Services 1367/90, 1368/90 (Kaplan); namely~ (1) that proof of actual injury or harm is not necessary to establish a health and safety risk; and (2) that a health and safety risk will be held to be unreasonable if it is unnecessary or avoidable in the circumstances. Applying the above principles to the case at hand, counsel argued that housing L.G.W.s at Toronto East creates a risk to the health and safety of correctional staff, that this risk is avoidable and, therefore, that it ~is an unreasonable risk within the meaning of.Article 18.1. Relying in large measure on the evidence of Dr. Ben-Aron, it was the position of the union that the risk to health and safety of staff arose from a .number of_ factors. ~yDical Psychiatric Profile of an L.G.W.: .All L.G.W.s suffer from severe mental illness usually accompanied by behavioural · symptoms that make them idiosyncratic, .Potentialiy dangerous and unpredictable, such as paranoia, withdrawal, and verbal and physical assaultiveness. L.G.W.s can only be treated effectively by a multi-disciplinary team approach consisting of clinical professionals having a complete array of treatment resources, including mandatory chemical intervention, none of which is provided in a correctional facility. .In the absence of such treatment, their condition usually deteriorates in a correctional facility. Based on the foregoing, 12 of the 13 L.G.W.s referred to in Exhibit 6 were potentially dangerous, according to Dr. Ben-Aron. Physical Setting: The primary mandate of the correctignal system is to provide a secure setting for the custody and contYol of inmates. This has resulted in the practice of confining L.G.W.s at Toronto East to their cells for 23% hours per day. Such extensive confinement has a deteriorating effect on their mental state making them more dangerous. Training of S~aff: At the time of the grievance, correctional staff received no training in the handling of.mentally ill inmates. Without such training, staff tend to perceive the idiosyncratic. behaviour of L.G.W.s as thr.eatening and stressful with the result that correctiona.1 officers often resort to physical measures to control behaviour. Unfortunately, these measures usually exacerbate the behaviour they are intended to stifle, creating a situation of heightened risk for staff. Lack of training also makes staff less able to deal with inmates who are unco-operative with treatment or otherwise disruptive which, in turn, leads to an increased risk of assault and stress for staff. Staffing Practices: The medical evidence indicates that consistency of staff observations of and interaction with L.G.w.s is important to secure their co-operation to treatment. However, there is no consistency in the staffing of the unit where L.G.W.s are housed. As a result, Staff are less able to deal with 17 treatment refusals and this, in turn, increases the risk of staff safety. Correctional staff have no access to the information in the medical or corporate files of. inmates. Without ~uch information, they may inadvertently trigger assaultive or other disruptive behaviour. Presuming the above factor, s make L.G.W.s a risk to the 'health and safety of staff, counsel turned to an assessment of whether the risk wes avoidable. This involves a balancing of interests of the staff, the L.G.W.s and the institution. The interests of the L.G.W.s and the staff clearly, favour treatment in a hospital setting. Moreover, given that the mandate of the institution is secure containment, which is quite different from assessment and treatment, the institutional interest is not really opposed to the other interests. Considering that all three interests are aligned against the housing of L.G.W.s in a correctional setting, and that the reasons for the Unavoidability of so housing. L.G.W.s are within the knowledge of the employer, counsel argued that the onus is on the employer to prove'that the risk from L.G.W.s is unavoidable. Mr. Anand argued that the employer failed to adduce any such evidence and that what evidence there was from the union's witnesses regarding a bed space problem in hospitals was speculative. Accordingly, the Board was urged to draw the appropriate adverse inference from the above failure and find that such evidence, if adduced by the employer, would have supported the case that the housing of L.G.W.s at Toronto East is avoidable and therefore constitutes an unreasonable health and safety risk to staff. The union contended that in addition to a declaration that the employer had violated Article 18.1, the appropriate remedy for avoiding the risk was an order requiring that L.G.W.s 'be transferred from Toronto East to a psychiatric hospital· within seven days from the date of sentence by a'court. The union also requested that the Board remain seized to afford the parties an opportunity tO investigate and implement, if necessary, an alternative solution based in part on legislative changes to·the. Criminal Code which came into force on~ February 4, 1992. In support, the union cited the following authorities: oPSEU (Union Grievance) and Ministry of Correctional Services 0311/88 (Watters); · 'OPSEU (Leeanan) and Ministry of Correctional Services 1268/88 (Roberts)·; OPSEU (Un$°n Grievance) and Ministry of Community and Social Services 1190/89 (Stewart); OPSEU .(Watts/King) and Ministry of Correctional'Services, supra~ Fleming v.· Reid by his litiqation quardian, the Public Trustee; Fleming v. Gallaqher (a.k.a. Gallacher) by his litiqation quardian, the Public Trustee, (199i) 40.R. (3d) 74 (Ont. C. of A.); Ontario Public Service Employees Union and Anderson et al. v. The Oueen in Right of Ontario as re~resented by the Ministry of Natural Resources and the Crown EmQloyees Grievance Settlement Board, (1990) 75 0.R. (2d) 212 (Ont.. Div. Ct.); OPSEU (Joseph ~rlek et al) and Minist.r¥ of Correctional 19 Services 1466/87 (Dissanayake); OPSEU (Allan Dvorak, et al.) and Ministry of Correctional Services 113/83 (Saltmani; Khan v. St. Thomas Psychiatric Hospital and.~Komer; Adv0cac¥ Resource Centre, for the HandicaDDed, amicus curiae, (19'92) 7 0.R. (3d) 30'3 (Ont. C '~of A.); Re Steinber~ Inc. and Commercial Workers Union, Local 486 (t984), 16 L.A.C. (3d) 171 (Fraser); Re Weltand District ~ASSociation for Retarded Inc. and Canadian Union of Public Employees, Local 2276 (1982), 5 L.A.C. (3d) 315 (Devlin); Levesque et al. v. Comeau et al., (1970) 16 D.L'R. (3d) 425 (S.C.C.); Attorney-General for Ontario v. Bear Island Foundation et al.; Ports et al. v. Attorney-General for Ontario, (1984) 49 O.R. (2d) 353 (Ont. Div. Ct.); and Re The Crown in Right of Ontario (Ministry of Government Services) and Ontario Public Ser~vice EmDloyees Union (Kimmel/Leaf) (1991), 21 L.A.C. (4th) 129 (Kaplan). EMPLOYER ARGUMENT Counsel for the Employer contended that the risk of violence by inmates is inherent in the occupation of correctional staff. It was therefore conceded that the housing of L.G.W.s at Toronto East does pose a risk to the health and safety of staff. However, it was submitted that this risk is not significantly higher than the risk posed by other inmates. Accordingly, the employer contended that the risk is not "unreasonable" within the meaning of Article 18.1. 20 In support of that submission, Counsel relied primarily on a number of admissions by Dr. Ben-Aron in cross-examination together with statements made by Dr. Fleming in his testimony. These arg.as follows: Tv~ical Psychiatric Profile of L.G.W.: Dr. Ben-Aron admitted that the following are generally accepted principles in forensic psychiatry: (1) prediction of dangerousness is not only difficult, but essentially unreliable in the sense that psychiatrists will be wrong more often than they are right; (2) reliable prediction is not pOSsible without the gathering o£ exhaustive information about the patient and this can take weeks; (3) reliable predictions of dangerOUsness cannot be made on the basis of mental illness alone; and (4) mentally, ill inmates are not necessarily more dangerous than the general population of inmates. Counsel argued that the effect of the foregoing admissions was to undermine seriously Dr. Ben-Aron's evidence-in-chief that L.G.W.s in general are potentially dangerous, as well as the specific predictions of dangerousness he made with regard to 12 of the 13 L.G.W.s referred to in Exhibit 6. In his evidence, Dr. Fleming supported the above principles. In addition, he offered the following opinions: (1) dangerousness and unpredictability cannot be equated in the sense that a patient can be unpredictable .without being dangerous; (2') there is no 21 correlation between mental illness and dangerousness; the mentally ill actually commit assaults at a rate lower than the general population; (3) the information in Exhibit 6 is too limite~ to permit any reliable prediction of dangerousness from any of ~he L.G.W.s referred to therein; (4) confinement in a correctional facility will not necessarily cause the mental condition of L.G.W~s to deteriorate in the sense that some L-.G.W.s do very well in such a setting; and (5) treatment refusal 'by 'an L.G.W. will not necessarily lead to a heightened risk of 'dangerousness, and may even be followed by improvement. ~,, Counsel for the employer sought to minimize the health and. safety risks posed by L.G.W.s by reference to the following additional factors: No Evidence of Significant Assaultive Behaviour: Counsel stated that during the period covered by the. evidence, namely September 1988 to July 1990, four assaults on staff were committed by four of a total of eigh'teen L.G.w.s. Only two of'the incidents occurred prior to the filing of the grievance On September 5, 1989. None of the incidents of assault resulted in any 10ss of time or serious injury. Further, .only one of the four incidents was confirmed by viva voce evidence. The only proof for the remaining assaults were the documents in Exhibit 6 which, in the opinion of Mr. Contini, are purely hearsay and therefore could not be subjected to cross-examination. Thus, the alleged seriousness of these incidents could not be effectively scrutinized with the result that no weight should be accorded to Exhibit 6. The cumulative effect of~the foregoing was to establish that there~was no significant assaultive behaviour by L.G.W.s at Toronto EaS~ at the'relevant time. .Adequacy of Treatment: During the period covered by the grievance, L.G.W.s were seen regularly by psychiatrist Dr. Leonard Ralley. Although. Dr. Ralley had a heavy'patient case load, the focus of his treatment was on the control of behaviour in the short term and the prevention of deterioration. Given this limited focus, Dr. Ralley's case load did not prevent him from providing- effective treatment. Indeed, Dr. Ben-Aron was of the view in cross-examination that five or six of. the L.G.W.s in Exhibit 6 appeared to be receiving safe and effective care at Toronto East. ~ Training of Staff: 'Counsel conceded that staff received no training on issues of mental health, but argued that this was not needed to ensure the safe handling of L.G.W.s on Unit 2A. In support of this argument, Mr. Contini relied upon the testimony of Dr. Fleming, Ms. Johnston and Miss Dunn about the importance of common sense, patience and empathy' in dealing with L.G.W.s. Counsel also noted that any stress caused by the handling of L.G.W.s has not resultedin any significant absenteeism or turnover of staff at Toronto East. Accordingly, he argued that the lack of training presents no serious stress problems to staff. 23 Physical SettinQ: There are usually only one to three L.G.W.s at Metro East at any one time. Ironically, at the time of the filing of the grievance, there' were no L.G.W.s at Toronto E%st. The total inmate population is' normally around 400 to 450. Considering that the L.G.W.s are a small fraction of the total inmate population, it is difficult to conclude that they constitute a serious health and safety risk, particularly on the evidence that they are locked in cells for 23½ hours per day. In the alternative, presuming that the presence Of L.G.W.s at Toronto East gives rise to an unreasonable health and safety risk, counsel argued that the grievance cannot succeed unless the primary remedy sought by the.union will effectively avoid th~ risk. That remedy is the removal of L.G.W.s from Toronto East within seven days of sentencing by a court. Even if the remedy were granted, counsel noted that L.G.W.s will still be detained at Toronto East prior to a Court sentence. Such detention can be for lengthy periods of time. Dr. Ben-Aron conceded that offenders who attract the label of L.G.W. present the same risks before and after the L.G.W. status attaches. Accordingly,'counsel argued that the above remedy would not be effective in avoiding the risk and therefore should not be granted. Counsel objected to the arbitrary nature of the remedy sought in the absence of any consideration for individual circumstances of L.G.W.s. Mr. Contini maintained that this remedy was' 24 inappropriate, as L.G.W.s are not a uniform group but a collection of individuals suffering from different problems. To be effective, Mr. Contini contended that any re'medy must allow for th, ese differences and the remedy proposed does not do so. '~ Counsel also.argued that the employer had the exclusive right under s.18(1)(a) of the Crown Employees Collective Bargaining Ack to determine its organization~ and that the granting of this remedy would directly encroach upon that right.' -He therefore submitted that the remedy was beyond the jurisdiction of this Board. Mr. Contini noted that the proposed.remedy was to operate as of the date of the court sentence rather than the date of the issuance of the warrant. 'Under the practice in existence at the time of the grievance, the usual order by the court at the time of sentencing was to remit the offender to the custody of TO~onto East until the pleasure 'of the Lieutenant Governor was known. Under the procedure contemplated by recent legislative amendments, Toronto East may still be ordered by a court to retain custody of an offender from the date of sentencing until final disposition. Having regard to the foregoing, counsel submi{ted that if the above remedy were to be granted, it would force the employer to breach court' orders, and for that reason the remedy would be inappropriate. The employer made reference to the following authorities: 25 OPSEU (G. Walker, et al) and Ministry of the Solicitor General 863/85 (Kirkwood); OPSEU (Union Grievance) and Ministry of Correcti6nal Services 69/84, 70/84 (Samuels); Douqlas L19¥d~ ComDlainant, v. The Crown. in Right of· Ontario (Ministry'~ of Community and Social Services), Respondent, [1988] OLRB Rep. January 50, and OPSEU (Allan Dvorak, et al.) 'and Ministry of Correctional Services, supra. The issue before us is whether, on the particular facts of this grievance, by housing L.G.W.s at Toronto East Detention Centre for extended periods of time, the employe~ has failed "to make reasonable provisions for the safety and health of its employees.. during the hours of their employment", contrary to the provisions Of Article 18.1 'of the collective agreement. There is, of course, a body of arbitral jurisprudence which has evolved under Article 18.1. We would adopt the rationale of Vice-Chairperson Kaplan in the Watts/Kinq decision, supra, where in a case involving a health and safety risk to correctional officers at the Niagara Detention Centre, the panel stated at pp. 26-27: ...To be sure, risk is part of the job. However, unnecessary risk is not. The employer has an obligation to take reasonable precautions for the safety and health of its empLoyees. Like other panets of this Board, we are of the view that "reasonable" d~ea not ~an "every." And we are also of the view that what is reasonable will depend greatly on the facts of each case, and must involve a balancing Of interests of the employees and the employer. In the instant case, the fact that no employee has been attacked or ~njured whi Le conducting a patrol is neither hera nor there in the same way that the concerns raised in the StockweLL case (176~i/87, ~/iLson) had not taken place. It is obvious that the potential for injury exists. In our view, it is not unreasonable in a case where the union has demonstrated some degree of risk to the safety and health of employees to require the employer to explain, if not justify, the necessity and reasonableness of that employer-imposed risk .... In the instant grievance, we had the benefit of .hearing lengthy testimony' from two distinguished Ontario f0reqsic psychiatrists. The thrust, of Dr. Ben-Aron's evidence was the welfare of the patient and his concern that placing L.G.W.s in'jail "continues to stigmatiZe psychiatric illness". Dr. Fleming testified as to the multi-disciplinary team approach at Oakridge. According to his evidence, contrary to public perception, there "likely isn't" any correlation between a major mental disorder and the ~propensity for dangerousness. Dr. Fleming went on to state that "psychiatrists are inept" in predicting future p~ognosis for dangerousness for patients suffering from a'major mental illness. However, both psychiatrists stressed the need for consistency in staffing and the4 advantages of a trained multi-disciplinary team approach. Essentially, there was little disagreement between the approaches of the two psychiatrists, although Dr. Fleming adopted a more cautious approach in his Unwillingness to comment on the "dangerousness" of any of the 13 L.G.W.s profiled in Exhibit 6. We found the evidence of both Drs. Ben-Aron and Fleming informative and helpful on a complex and difficult set of issues. On the evidence, we must conclude that it is difficult, if not impossible, for psychiatrists to predict future dangerous conduct of L.G.W.s with any degree of certainty. .We also find on the evidence that correctional facilities and psychiatric hospitalS are in identical positions on the issue of consent to treatment. 27 Patient. consent to treatment was first introduced into Ontario in the 1978 ~ental Health Act and in subsequent amendments to that Act. Dr. Fleming has no direct knowledge of psychiatric treatment provided in correctional facilities. Although Dr. Ben-Aron has experience in both federal and provincial correctional facilities, he has had limited exposure to the treatment given at Toronto East. Unfortunately, the Board heard no evidence of a medical or psychiatric nature from any .psychiatrist involved in the delivery of Psychiatric treatment at Toronto East. We do know, however, that at the time of the filing of the grievance in September 1989, Dr. Leonard Ralley was providing, psychiatric services one full ~day and two half days'a week at the institution. In our view, evidence from Dr. Ralley regarding the quality of the psychiatric treatment at Toronto East would have been helpful. As a result of the failure to call Dr. Ralley, or any of his successors, the Board is left with some uncertainty as to the ~quality of psychiatric treatment given L.G.W.s at Toronto East. The focus of Article 18.1, however, is not on the welfare of the inmate or patient. It is important to recognize that the mandate of a correctional facility is secure'containment as opposed to the mandate of a psychiatric hospital which.is assessment and treatment. 28 The 13 L.G.W. profiles in Exhibit 6 contained employer business records including incident.reports, A.I.S. cards, and psychiatric assessm'ent reports. Although the employer objecte~ to Exhibit 6 as "hearsay", we are satisfied that it constitu'tes business records which are admissible under s.35(2) of the Ontario Evidence Act, R.S.O. 1990, c.E.23. Dr. Ben-Aron.ackn0wledged that he had limited knowledge of the variables in each of the profiles presented; however, he was able to identify basic characteristics of the L.G.W. populations. These characteristics are said to include a major mental illness, the need for a multi-disciplinary ~team apProach provided in a psychiatric hospital, the possibility of deterioration without these ~amenities, the effects of- deterioration in the sense of conflict with other inmates and staff,, and idiosyncratic behaviour which may be both unpredictable and aggressive. On the evidence, there Were relatively few incidents of physical assaults upon staff causing bodily injury either~during a reasonable period of time before or after, the filing of the grievance. Indeed, the relatively few incidents of physical assaults came as a surprise to Dr'. ~Ben-Aron. In his words: "I would say it doesn't add up; I would expect more".· It maY well be that the small number of physical assaults is directly related to the maximum security setting on Unit 2A, including the requirement of a 23% hour lock-up in the cells. 29 On the exhaustive evidence and submissions before us and in balancing the interests of both the employees and the employer, we are persuaded to strike the balance in favour of employee health and safety at Toronto East. After careful and · sustaihed reflection, we find that there was an unreasonable health and safety 'risk to employees at Toronto East Detention Centre on September 5, 1989, and that the risk ~could have been avoided. The avoidable risk isrthe total absence of staff training on issues of mental illness at this institution and the lack of consistency of staffing on Unit 2A. The evidence established that, at the relevant time, there was no staff training in the nature of. the causes and manifestations of major mental illness and the range of appropriate actions that should be taken by staff. ~In the absence of ·training, it is understandable that correctional officers would feel ill-equipped to deal effectively with idiosyncratic behaviour such as threatening, constant verbal abuse, persistent 'chanting and banging o~f cell doors~ smearing of fasces, refusal to shower and other hygienic related problems. It is inevitable that, in the absence of training, these types of behaviour are viewed by staff as threatening and stressful. In making that finding, we accept the evidence of Dr. Ben-Aron, Ms. Johnston and the three correctional officers who testified at the hearing. We also accept.the evidence of Toronto East psychiatric nurse Arlene Dunn that the environment on Unit 2A is "quite frightening" to some correctional officers and that her aduice as 30 to the proper handling of L·.G.W.s is not always accepted. With resPect to the matter of staffing, Dr. Ben-Aaron and Dr.~ Fleming emphasized the importance of consistency· in securing the co- operation of L.G.W.'s with treatment and thus reducing the risk, of assault and stress for staff. The evidence regarding staffing practices, however, established that there was little, if any, consistency in the staffing of correctional officers on Unit 2A. · In our view, greater consistency in the staffing of correctional officers who work on Unit 2A, together with more meaningful training for ·such officers on the issues of major mental illness would be ~n effective method to alleviate misunderstanding and to reduce, if not eliminate, the avoidable risk to staff with respect to L.G.W.'s. By way of remedy, there shall be a declaration that as of the date of the filing of this grievance, the Ministry of Correctional Services has violated the health and safetY provisions of Article 18.1 of the collective agreement. We have been advised by the parties that as a result of the judgment of the Supreme Court of· Canada in Reqina v. Swain (1991, / 63~ C.C.C. (3d) 193, there have been extensive legislative amendments to the Canadian Criminal Code as of February 4, 1992 which affect the operation of the Lieutenant Governor's Board of Review in Ontario. There was no evidence.before us as to the effect of these-legislative changes and the procedural changes which were subsequently introduced at Toronto East in September of 31 1992. The Board is in serious doubt as to whether we have the jurisdiction t'o grant the seven day transfer remedy Sought by the union or the appropriateness of such a remedy. It appears to us that a court having made an initial L.G.W. sentencing, order or the Lieutenant Governor's Board of Review retains jurisdiction until the L.G.W. 'is transferred from Toronto East to a named psychiatric hospital. Accordingly, we remit to the parties the issue of' remedy in light of the legislative changes on February 4, 1992 and the subsequent procedural, changes at Toronto .East. together with the- findings and declarations of'this award. In the event that the parties cannot'agree upon an appropriate.remedy, the issue may be brought'before the Board for final determination. In that event, · the. parties shall have the right to introduce evidence as to the nature and effect of legislative changes~and the circumstances at Toronto East as a result of amendments to the Criminal Code of Canada and any other relevant legislation. DATED at Brantford, Ontario, this 1st day of September, 1993. .... : ..... M. O'TOOLZ - M~MB~R