MENTAL HEALTH AND JUSTICE

The mentally ill shouldn’t languish in jail cells without proper care, but they do. “There should be a better way to deal with that situation than we have right now, unfortunately,” says Dr. Joe Ferencz, an expert in forensic psychiatry at St. Joseph’s Healthcare. On average, about 30 per cent of the roughly 7,500 people in provincial custody on any given day are identified for a mental-health alert, the Ministry of Community Safety and Correctional Services notes. Those alerts aren’t always triggered by a clinical diagnosis, but are sometimes based on self-reporting and observations of staff, ministry spokesperson Andrew Morrison said. Jail can be part of a vicious cycle for inmates with mental illnesses, says Erin Boudreau, manager of policy and community engagement for the Schizophrenia Society of Ontario. “They may be returned to the community and more at risk of being put back into the court process.” Jaime Stephenson, president of the Hamilton Criminal Lawyers’ Association, says it’s tricky to help clients who don’t have a formal diagnosis or won’t acknowledge they have a problem. “The difficulty is that once the person is an adult and they meet the threshold for being capable of participating in their own defence … family and counsel cannot force an assessment or treatment.” Judges can order psychiatric assessments to decide whether defendants are fit to stand trial. A person can eventually be deemed not criminally responsible. Ferencz believes a better mutual understanding must be forged between the justice and health-care systems. St. Joe’s hopes to launch a pilot project that aims to fill a gap between care and corrections. The pilot would involve a small number of special beds at the West 5th hospital for patients from detention who require more urgent psychiatric treatment than others. The plan awaits funding and approvals, said Dr. Peter Cook, chief of psychiatry. “But we’re pretty much ready to go,” waiting for funding and final approvals.” Morrison said more than 200 mental health professionals provide support to inmates in Ontario jails. The ministry is following recommendations made by the Independent Review of Corrections and the provincial ombudsman, he added. That includes “exploring options to shift oversight and provision of health-care services … to the Ministry of Health and Long-Term Care.”