Four years after the New Brunswick auditor general slammed the province for offering an "unacceptable" lack of access to addiction and mental health treatment inside provincial jails, more than half of her recommendations haven't been implemented.
That includes a recommendation to the Department of Justice and Public Safety to work with health officials "to ensure addiction and mental health counselling and therapy treatment options" are available to people who are incarcerated, according to a followup report published by the auditor general earlier this year.
"There is no programming [in provincial jails], there's nothing," said David Lutz, who has spent more than four decades working as a defence lawyer in the Saint John region.
"They just put you there and after a while, they let you out."
An CBC News investigation previously found several instances of inmates within New Brunswick provincial jails being unable to access prescribed medication, including treatment for mental health issues. In at least one case, a judge wrote a letter to the jail, pleading for a person to be able to access their medication.
In 2018, then-auditor general Kim MacPherson published a report that described a patchwork system with no one responsible for providing treatment in provincial jails.
It detailed a cycle where people frequently lost access to their prescribed medication and emerged from jails, which are for sentences of two years or less, sicker than when they entered.
"I was shocked at what's going on in our New Brunswick correctional facilities," MacPherson said in 2018.
"When I was reading it I was saying, this is the type of stuff you would see in a developing country, not in New Brunswick. It shouldn't be happening."
Listed as priority in government plan
Other recommendations that haven't yet been implemented include adding "a recognized mental health screening tool in the admissions process."
No one from the Department of Justice and Public Safety was made available for an interview about what's being done to address the auditor general's findings.
The previous government formed a committee to address problems with access to addictions and mental health care in jails, but the department didn't answer a question about whether that committee is still operational.
Expanding mental health treatment in correctional facilities is listed as one of the province's priorities in its 2021-25 Inter-Departmental Addiction and Mental Health Action Plan, a department spokesperson noted in an emailed statement sent to CBC News.
"Collaboration is underway with the Department of Health to expand addiction and mental health treatments in correctional facilities," Department of Justice and Public Safety spokesperson Judy Désalliers wrote in an emailed statement.
"A total of six social workers are now in place within the five correctional facilities to provide screening, assessment and services, as well as navigation of services upon return to community."
Access to medication has improved, lawyer says
Access to prescribed medication behind bars seems to have improved over the last few years at the Saint John Regional Correctional Centre, according to Saint John lawyer Charles Bryant.
"If an individual has an active prescription, I understand that they're medicated consistently or they have consistent access to their medication," Bryant said.
"There may be some exceptions here and there but for the most part, I think that has substantially improved. Where we still have a gap is for the mental health treatment, where people do not have active prescriptions."
It means that a person who goes to jail without prescribed medication isn't likely to be able to access any new medication or treatment for mental health issues, Bryant said, and there's similarly little available for those who need access to addiction treatment.
It's problematic because people who are in a mental health crisis can struggle interacting with the courts, Bryant said, and that can see them staying behind bars longer than necessary.
"I have certainly seen individuals who are not medicated and have had difficulty communicating with their lawyers, communicating or interacting with the courts, then get medicated and get stable on their medication," Bryant said.
"And then they're able to engage with the process in a productive way or to gain their liberty that much faster."
MacPherson's report found it costs about $66,000 to house one person in a provincial jail for a year.