"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things."

~ Niccolo Machiavelli, historian and writer

Friday, October 31, 2008

Mental Health Courts ~ The Good, The Bad and The Ugly

The custodial response to people with mental health problems is an historic one. To incarcerate people merely because we have failed to develop appropriate supports has always been shameful. In 2007, this is totally unacceptable.”
~
Archie Kaiser, Professor, Faculty of Law and Department of Psychiatry, Dalhousie University
Canadian statistics show that 12 per cent of men in federal institutions in 2007 had a mental disorder, up from seven per cent in 1997. The rate of mentally ill women in prisons was even higher, at 21 per cent, compared with 13 per cent in 1997.

In a similar vein, American research has found that more than 16 per cent of adults in jail have a mental illness, roughly 20 per cent of young people in the juvenile system have a serious mental health problem and 40 per cent of Americans with a mental health problem will butt up against the U.S. justice system at some time in their life.

Viewing such statistics and depending on your point of view (perspective, as they say, is everything) the concept of a "mental health court" can look like a very good or a very bad idea. But no matter your point of view, such courts (part of the Progressive Conservative government's crime-reduction strategy) will soon be a reality in Nova Scotia.

The plan is to have the system running by April 1, 2009. After visiting different court models in New Brunswick, Ontario, and Newfoundland and Labrador, the Nova Scotia Department of Justice ultimately opted for a referral system that would see offenders treated by a team of trained court staff, including social workers and a probation officer. The Nova Scotia court model is to allow family, friends and justice officials to refer such offenders for help through the mental health court, with candidates first having to undergo an assessment, be found fit to stand trial and be willing to accept responsibility for their actions.

As in the regular court system, sanctions at the end of the day could range from an absolute discharge all the way up to incarceration. However, the bottom line of the mental health court is said to be to get the person out of the criminal justice system.

In general, the concept appears to be supported by the police. According to Halifax police Chief Frank Beazley
"You go from the courtroom to the social services, who then get you through the housing people who get you through the doctors — whatever you need to deal with that individual," he said. "It's a much superior approach."

Beazley said his officers will deal with 1,100 to 1,200 calls this year related to incidents involving people with mental illnesses.

"Those are the ones that are coded either mental health or suicide, attempted suicide, but there's many calls we go to that get coded theft or robbery where there's a mental health issue also," he said.
But not only the police are in agreement. Noting that people should not be criminalized because of their mental illness, the executive director of the Canadian Mental Health Association’s Nova Scotia branch has also said the theory behind a specialized mental health court is "an excellent one."

That theory being that by connecting people with mental illness who have committed low-level crimes with community-based treatment, we can make better use of our jails and tax dollars, increase public safety, and make our communities healthier.

And the research does look promising. Participants in one American mental health court program received more mental health services and spent fewer days in jail than they might otherwise have if they had been sentenced in the criminal court and fewer days in jail than they spent related to a prior arrest.

Despite this, concerns remain in some circles about mental health courts, which are really still in their infancy in Canada. Some fear that such courts simply generate more stigma and forced treatment of persons with mental illnesses.

Still, recalling the case of the mentally ill Nova Scotian woman who was ordered into the care of the provincial Health Department by the court after it failed to find her a suitable place to live while awaiting the outcome of numerous charges, one can't help but think that something must be done. Something has to change. Only time will tell whether mental health courts are at least part of the answer here in Nova Scotia.

The issue of how the courts deal with accused with mental health issues is also currently being examined in New Brunswick.

Update: For a fuller, more depresing view of the extent of the mental health crisis within the justice system, check out this interesting Globe and Mail story.

**You can view the relevant legislation, the Mental Health Court Act, here.

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