CAT/C/CAN/CO/7 17. The State party should: (a) Establish an independent and effective mechanism for addressing complaints of torture and ill-treatment in all places of deprivation of liberty; (b) Provide the Committee with detailed statistical data, disaggregated by sex, age, ethnic origin or nationality and place of detention, on complaints of torture and ill-treatment, as well as information on investigations, disciplinary and criminal proceedings, convictions and the criminal or disciplinary sanctions applied. Deaths in custody 18. The Committee regrets the death of Michael Ryan, who died of a drug overdose while in police custody in Saskatoon on 26 February 2016. In addition, it takes note with concern of the findings of the final report, dated 15 February 2017, of the Office of the Correctional Investigator on its investigation into the death of Matthew Ryan Hines, who died unexpectedly in federal custody following a series of incidents related to the use of force at the Dorchester Penitentiary on 26 May 2015. In its final report, the Office of the Correctional Investigator stated that while the family had initially been informed by the Correctional Service of Canada that Mr. Hines had died of a seizure, it was not clear on what basis or on whose authority such a claim could have been substantiated. The family had, until not long beforehand, been led to believe that Mr. Hines’s death could not have been prevented. The Committee notes that the Correctional Service of Canada agreed with all the recommendations included in the final report of the Office of the Correctional Investigator and that a number of initiatives to prevent deaths in custody associated with the use of force have been implemented, including enhanced training for staff, improved responses to medical emergencies and the implementation of a new model on the use of force (arts. 2, 11 and 16). 19. The State party should: (a) Ensure that all instances of death in custody are promptly and impartially investigated by an independent entity; (b) Provide the Committee with detailed information regarding cases of death in custody; (c) Ensure the implementation of the recommendations included in the final report of the Office of the Correctional Investigator into the death of Mr. Hines, as well as the recommendations of the Coroner’s inquest jury on the death of Mr. Ryan. Inspection of detention centres 20. While taking note of the existing prison monitoring bodies, including the Office of the Correctional Investigator and the Canadian Human Rights Commission, the Committee observes with concern the absence of independent oversight bodies to inspect other places of deprivation of liberty, in particular psychiatric institutions. It also notes with concern that during the period under review several non-governmental organizations were denied access to Leclerc Institution, a provincial detention centre in Laval, Quebec, following the transfer of female prisoners from Maison Tanguay prison in February 2016. The Committee appreciates the information provided by the delegation regarding the consultations held with territorial and provincial governments and within the federal Government in the framework of the review process of the potential accession of Canada to the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. It also welcomes the assurances of the delegation that civil society and indigenous groups will be consulted as soon as the federal, provincial and territorial government consultations are finished, but remains concerned that no fixed time frame was specified for the completion of the overall process (arts. 2, 11 and 16). 21. The State party should: (a) Ensure an effective and independent monitoring and reporting system for mental health institutions; 5

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