A week before she died, Teresa Michelle Gratton wrote her husband a panicked letter.

Scrawling in frantic capital letters, she begged him to get her out of the maximum security jail where she was being held indefinitely as an immigration detainee.

“PLEASE GET ME OUT OF HERE I DON’T BELONG HERE!! HELP ME! HELP ME! PLEASE!!!!!! … I don’t see how they can continue to keep me locked up like a criminal. I have no charges. I had already paid my time for my crime. I’ll leave Canada if that’s what it comes to, but let me out until that’s what’s desided (sic) if it comes to that.”

Gratton, a grandmother who celebrated her 50th birthday behind bars, never made it out of jail. She died this past Oct. 30, a few days after her husband received the letter.

She was “found in medical distress” inside the maximum security Vanier Centre for Women in Milton, according to a brief news release from the Canada Border Services Agency, which did not disclose Gratton’s name, the cause of her death or any other information. She was immediately taken to hospital and died shortly after, the agency said. They did not say whether she died at hospital or en route.

She had been in immigration detention for a month.

Herb Gratton, Teresa’s partner of 32 years, can’t talk about his wife for long before he succumbs to heaving sobs, often excusing himself and retreating to his bedroom, where he can be heard weeping from behind the closed door.

“She was as much me as I am,” he says. “They took away everything I have. Thirty-two years of being with that woman and they took that from me.”

Herb, 58, grew up in West Lorne, Ont. His parents separated when he was 13 and he moved with his mother to Nashville, Tenn. That’s where he met Teresa, whom he called Michelle, in 1985.

“I looked at her and I fell in love,” he says. “It took her a little bit longer but I knew right away.”

After dating for five or six months they moved in together and started a family, raising three sons — now 24, 27 and 30 years old — and working together at a chain restaurant.

Their eldest sons, Matthew and Stan, have children of their own now and Jacob’s fiancée is expecting in the spring. All are Canadian citizens.

“As any couple, me and her had our ups and downs, but we worked through it,” Herb says. “We were great together. She was my soulmate and I was hers. We knew we would spend the rest of our lives together. Or at least we thought we would.”

The weeks since his wife died have been the worst of his life, Herb says. Compounding the sadness and confusion is that he still doesn’t know what happened. “I’m just at an impasse,” he said. “I can’t really grieve my wife.”

The provincial coroner’s office is investigating the death, but it has not determined if there will be an inquest.

Teresa Gratton’s lawyer, meanwhile, is unequivocal in his condemnation of the system that incarcerated her.

“I think her death was entirely avoidable,” said Joo Eun Kim, an immigration lawyer with Legal Aid Ontario who was assigned to Gratton’s case after she had already been detained by the Canada Border Services Agency for nearly two weeks.

“She should not have been detained in the first place and she should not have been detained in a maximum security jail,” he said. “I feel like we as a society let her down.”

A U.S. citizen and permanent resident of Canada since 2011, Gratton was not serving a criminal sentence. She was detained by border services after she served 24 days in jail for trying to steal food and clothing from a Walmart near her home in London, Ont.

But border services was trying to deport her for convictions from 2013, when she pleaded guilty to multiple counts of fraud under $5,000 and was sentenced to nine months of house arrest. Permanent residents can be deported for “serious criminality” if they are sentenced to “a term of imprisonment of more than six months” or convicted of an offence with a maximum sentence of 10 years or more. In such cases, they have no right to appeal.

Border services interpreted Gratton’s house arrest as a “term of imprisonment” and was hoping to quickly deport her.

Incidentally, 19 days after Gratton was detained, the Supreme Court of Canada ruled it was unreasonable for immigration officials to equate conditional sentences, such as house arrest, with jail sentences. Gratton’s admissibility hearing was scheduled for Nov. 8, when, even if she had still been ordered deported, she likely would have been released pending an appeal.

So why was Gratton, who suffered from chronic pain and was addicted to prescription opioids, detained in the first place? And why was she detained in a maximum security jail?

The Canada Border Services Agency has the power to jail non-citizens, for an indefinite length of time, if they are deemed a danger to the public, if they are deemed a flight risk — meaning the government fears they will not show up for deportation — or if their identity is in doubt.

Gratton was considered a flight risk because border services said she missed a meeting with immigration officials and because she had a conviction for failing to appear in court. Herb Gratton says they were never informed of the immigration meeting and points to his wife’s compliance with her house arrest and probation to counter the claim that she was unreliable.

Kim said Gratton would have “every reason” to appear for her hearing. “That’s her chance to stay in Canada.”

The Star requested interviews with Public Safety Minister Ralph Goodale, whose ministry oversees the Canada Border Services Agency, with border services president John Ossowski and with Immigration and Refugee Board chair Mario Dion. All declined our requests.

The agencies sent written statements, but did not address most of the specific questions about Gratton’s incarceration and death, citing privacy laws.

Gratton is at least the 16th person to die in immigration detention since 2000, and the fourth in the past two years. Her death raises many questions about how Canada treats the people it wants to deport, particularly people like Gratton, who are poor and suffer from chronic health problems.

“As a country, we should not be OK with this,” said Kim, who believes Gratton would be alive today had she not been detained in a maximum security jail. “There is a significant problem with our immigration detention system and it seriously needs an overhaul urgently.”

An ongoing Star investigation, as well as several high-profile court challenges from earlier this year, has revealed persistent problems with Canada’s immigration detention system, which has been criticized by human rights organizations and described as Kafkaesque by a Superior Court judge.

According to the Canada Border Services Agency’s own policies, Gratton, who had never been charged with or convicted of a violent offence and was not considered a danger to the public, should have been eligible to be detained at the Toronto Immigration Holding Centre, a far less restrictive facility dedicated to immigration detainees.

Instead, she was sent to a maximum security jail, where frequent lockdowns and regular strip searches are routine, and treated as harshly as sentenced criminals and those awaiting trial.

Gratton’s detention was twice reviewed by the quasi-judicial Immigration and Refugee Board — after her first 48 hours in detention and again after her first week. As is often the case for immigration detainees, she did not have a lawyer at either hearing.

Detention review hearings — which have been widely criticized for being procedurally unfair and stacked against detainees — do not review the conditions or location of detention. The decision to send Gratton to a maximum security jail was made by a border services officer and not subject to any oversight.

Border services did not explain why Gratton was ineligible for the immigration holding centre.

The Star has previously reported that immigration detainees who have any criminal record, even for minor property offences, have been barred from the immigration holding centre due to stipulations in an insurance contract held by a private company that provides services at the facility.

The Public Safety Ministry says it wants to “sharply reduce” the use of criminal jails for immigration detainees and is upgrading the immigration holding centre so that it can hold “higher-risk” detainees by next summer.

It’s unclear why border services considered Gratton to be “higher risk.”

“She posed no risk to anyone,” Kim said.

It’s also unclear why Gratton was transferred from the Elgin-Middlesex Detention Centre in London, where her family lives and where she served her short criminal sentence, to the Vanier Centre for Women in Milton, 150 kilometres away.

The likeliest explanation is that it was more convenient for immigration officials, who already travel to the Milton jail for detention review hearings.

Herb Gratton first heard of his wife’s transfer two days after it happened when she called him from Milton on a social worker’s phone.

Gratton doesn’t own a car and travelling to Milton posed a significant expense. His only income comes from a monthly cheque from the Ontario Disability Support Program. He suffered a serious back injury in 2004 and hasn’t been able to work since.

Teresa Gratton suffered from chronic pain due to fibromyalgia and osteoarthritis. She was dependent on prescription painkillers — the opioid hydromorphone — but she was not an illicit drug user, according to her husband. She was also diagnosed with anxiety and depression, he said.

Her family doesn’t believe she received appropriate medical or mental health care in jail, particularly after she was transferred to Vanier. They say her pain medication was initially withheld and then her dosage dramatically reduced, which led to incredibly painful withdrawal symptoms. She described the agony of withdrawal in each of her near-daily letters home. Kim says she also told him that jail staff was threatening to cut off her pain medication.

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“It was never made clear to me why they were threatening to do that,” he said. “But the last time I spoke to her, she told me they told her they were indeed going to take her medications away.”

Gratton’s family believes she died as a direct result of her withdrawal symptoms, but opioid addiction experts say that is unlikely.

“But the discomfort of opiate withdrawal is so great that people will do almost anything to get rid of it,” said Dr. David Juurlink, the head of clinical pharmacology and toxicology at Sunnybrook Hospital. “It really is hell.”

The symptoms include intense abdominal and muscle pains, severe diarrhea, vomiting, insomnia, depression and suicidal ideation.

Juurlink and Dr. Meldon Kahan, an addictions specialist at Women’s College Hospital, said they could not comment on Gratton’s case directly. But after hearing about her circumstances they said the likeliest causes of death for someone in her position would be a fatal overdose, potentially from illicit opiates inside the prison, which could have been laced with fentanyl; or suicide, if her withdrawal symptoms became intolerable.

“Even if it turns out she died of suicide or of an overdose from taking illicit opiates, it was still inappropriate medical management,” Kahan said.

A spokesperson for Ontario’s Ministry of Community Safety and Correctional Services said it would be “inappropriate for the ministry to publicly address any individual case,” but the ministry follows an “evidence-based approach” to treating substance abuse and addiction in its jails.

“During admission to provincial custody, inmates who have been identified with substance use disorder, including opioid addiction, are assessed for withdrawal,” the statement reads.

All inmates have access to a “variety” of health-care supports, including opioid substitution therapy, such as methadone or suboxone, the ministry said.

Before she was detained, Gratton took 38 milligrams of hydromorphone each day, according to a doctor’s prescription provided by her husband.

In her letters from jail, she wrote that she was receiving only two doses of six milligrams per day.

Such a dramatic reduction, doctors said, would lead to severe withdrawal symptoms. If the jail doctor felt Gratton should have been on a lower dose, they said, her dose should have been reduced much more gradually.

Canadian guidelines recommend tapering opioids by 5 to 10 per cent every two to four weeks, Kahan said, adding that even this can be too quick.

“I think there’s a common assumption in jails — well, in fact, everywhere — that opiate withdrawal is uncomfortable but it’s not dangerous,” he said. “That is actually untrue. It’s dangerous precisely because people will lose their tolerance and they’ll relapse to an opiate which will kill them. Or they’ll attempt suicide.”

Although they had already been together for 18 years and had three kids, Herb and Teresa decided to throw themselves a wedding in Nashville in 2003.

“She wanted to make it official,” Herb says.

Not long after the wedding, they started to talk about moving to Canada. Herb is a member of the Caldwell First Nation, based in Leamington, and the band was in the process of reaching a land claim settlement and setting up a reserve. There was also a spate of gun violence near their home in Nashville, which had unsettled the family.

“I wanted my children to know their other side, that they had options with their citizenship,” Herb explained. Teresa loved the idea.

They moved first to Blenheim, near Chatham-Kent, and then later to London, which was more convenient for doctor’s appointments.

Herb said they tried for years to get his wife citizenship, but it always seemed to be delayed.

The family’s financial situation started to deteriorate after his back injury. Teresa had occasional work cleaning houses, but they fell into credit card debt and were barely making ends meet.

The 2013 fraud convictions relate mainly to allegations that Teresa forged cheques — for amounts ranging from $100 to $250 — for a man whose house she was cleaning.

Herb said his wife didn’t believe she was guilty — in court, her lawyer said that while she forged the signature, she believed he owed her the money — but they didn’t have the financial means to fight the charges. He says their legal aid lawyer told them pleading guilty to a nine-month conditional sentence — avoiding jail time — would not jeopardize her immigration status.

“She figured the easiest way out was to take a plea on part of it,” Herb says. “At the time, they told us there was nothing that could get her kicked out.”

Immigration lawyer Kim said it’s common for people in Teresa’s position to get incorrect advice on the effect a criminal conviction would have on their immigration status. “I’m not surprised if that happened in her case,” he said.

A series of personal crises led to more trouble with the law. Teresa’s father died in March 2016, then her mother’s house was destroyed in a fire. This past January, she and Herb were evicted.

Forced out of their apartment, they moved in with their son and his fiancée’s family in Sarnia for a few months. The relocation precipitated another criminal conviction when Teresa asked her doctor for an early release of her hydromorphone to take to Sarnia. Her doctor refused, so Teresa forged her signature and later pleaded guilty to the offence.

“Several things contributed to her making rash decisions, doing things completely out of character,” Herb said. “At 40-something years old you don’t just decide you’re going to start stealing. She definitely needed help.”

Throughout her recent struggles, Teresa was still the glue that kept the family together, according to her husband and sons.

“She was the person we all ran to,” said Stan Gratton, her middle son. “If you ever needed something, any kind of advice or just love, you’d go to her.”

She wrote Herb almost daily, filling single-spaced pages with a schoolteacher’s tidy cursive (“I was always jealous of her handwriting,” he says). In her letters she describes the torture of withdrawal and the daily anguish of life behind bars, but she also gushes lovingly, encourages Herb to say his prayers and concludes each one the same way. “Love you always forever & a day.”

The letters broke Herb’s heart.

“That was my wife and I could not help her,” he said, choking back tears.

Herb says he’ll never forget the phone call the day she died. He says the news was delivered curtly, bordering on callous.

“No compassion, no anything,” he said. “It was the worst moment I’ve ever had in my life. I lost my best friend, my wife of 32 years, the greatest person I’ve ever known … and there was no condolences. Just, ‘Your wife died.’”

Since then, everything has been bewildering. He still doesn’t understand why Teresa was detained in the first place or what he’s supposed to do now.

But he wants someone to answer for what happened.

“They have to be accountable somehow,” he said. “Somebody’s going to have to say, ‘I’m sorry’ or something. I hope I can get that much at least.”

Brendan Kennedy can be reached at bkennedy@thestar.ca or 416-869-4192.