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A novel approach: Doing what works

Years ago, when my criminology degree was fresh, I did a volunteer stint as a court worker for the Ottawa Elizabeth Fry Society. My job, one morning a week, was to show up at First Appearance Court, keep an eye out for women who looked like they needed some help, and try to match them up with the appropriate community resources.

I remember one woman who was obviously at the mercy of a major mental illness. She didn’t have a lawyer – or anybody else – with her. She was immersed in her own reality, which seemed radically different from the ‘real’ reality. She was agitated, disoriented, paranoid and incapable of carrying on a cogent conversation.

The prosecutor, the duty counsel and the judge all shared quite a few laughs at this woman’s expense. I can’t remember exactly what was said, but it was clear that her mental illness – and their comments on it – were a source of great amusement to them. This took place in full public view, in a courtroom full of people, including the woman herself, and me. (I am ashamed to admit that I did not stand up and ask those men to stop mocking her. As an Elizabeth Fry volunteer, and as a human being, I should have. But I was intimidated, so I sat in appalled and complicit silence.)

If you’ve ever been up on charges, you probably already know how confusing it is. They talk their own language in court – a language not designed for the purposes of clearly communicating what’s going on to the defendant. In fact, I think it’s designed to obscure what’s going on, and to require the defendant to have a paid representative who will translate what’s going on into English. Unfortunately this translation is often half-assed and provided on-the-fly, after-the-fact, and while multi-tasking. If you’re poor, and your crime is on the mundane side, you can expect to be very poorly represented; you get what you pay for in the criminal justice system. After it’s all over, you’re lucky if duty counsel even takes a minute to explain to you What Just Happened.

I was reminded of that mentally ill woman when I attended the session on Mental Health Court at the Mental Health Symposium. She would have been the ideal candidate for this innovative program, which unfortunately didn’t exist at the time.

Ottawa became home to Ontario’s first Mental Health Court in 1994, and Canada’s first Mental Health Youth Court, in 2008. The adult court sits three times a week and the youth court sits once a month. It’s not enough, but courtroom real estate is at a premium.

Mental Health Courts emerged because some people working in the system recognized that our courts and jails had become dumping grounds for people with unmet mental health and social needs. People with serious mental illnesses (particularly in combination with fetal alcohol spectrum disorder, developmental disabilities, addictions, homelessness and other concurrent disorders) were a huge drain on the system’s resources, and yet the system was failing them. The criminal justice system is an expensive and ineffective way to house people.

People weren’t just slipping through the cracks, they were getting permanently wedged into them. This is what happens when you effectively criminalize mental illness, poverty, and other health and social problems that are, at their core, not criminal in nature.

The Mental Health Courts work by trying to divert people with major mental illnesses away from the criminal justice system and towards the health care system. They try to get everybody who has been identified as having a major mental illness into a special courtroom which has a dedicated Crown attorney, judge, clerk and duty counsel. Participation is voluntary. If a defendant refuses, they are processed back through the regular court system.

Rather than approaching each case in the traditionally adversarial way (prosecution versus defense, or the people versus the accused), everybody in the courtroom works collaboratively from a case management perspective, and the individual’s legal problems are considered in the context of all their problems – health, financial, housing, social, etc. Case workers help clients link to appropriate community-based resources in an effort to ensure that their basic needs are met, because it’s unreasonable to expect people with major mental illnesses to be able to function well in society when their basic needs are not being met.

The goals of Mental Health Courts include reducing pressure on the regular court system, improving access to mental health treatment, improving access to other community services, making court more user-friendly, slowing the revolving door phenomenon, reducing recidivism, and ultimately benefiting society by reducing crime.

By all accounts, it’s working.

7 comments to A novel approach: Doing what works

  • This post was surprisingly moving. I suppose it’s strange to get a lump in your throat reading about the court system, but I’m just so amazed and impressed to hear that someone out there is actually trying to help people, not just blame them. It’s beautiful.

  • Since we ran the story you link to at the end, Heather Perkins-McVey has been made a judge, sitting in Ottawa.

    My only reservation about the whole thing is that people diverted to mental-health court end up in the hands of a team of people who work together quite a bit. (This happens to some extent to anyone who’s represented by duty counsel, but by definition the accused in mental-health court are less able than usual to advocate on their own behalf.) That could lead to some awkward conflicts of interest, since the lawyers and judges are still working within the boundaries of a system that remains formerly adversarial.

    But still, it does seem to work.

  • As you know, I’m not big on tv, but one of my all time favorite tv shows was This is Wonderland which was a court show based in Toronto. It addressed the issues of poverty, addiction and mental illness really wonderfully, and it began with a lead defender having a mental breakdown. In fact, many of the lawyers grappled with mental illness themselves through it.

    Of course it failed.

  • Oh, so “A novel approach” isn’t a reference to NaNoWriMo?

    @DavidReevely: really? She was a neighbour of mine back in the west end. Funny how one learns where people are now.

    – RG>

  • Gillian

    I think you’re underemployed. You write such interesting posts and you are such a great advocate for the disadvantaged. Someone should realize that they need you on their team, (even if they have to construct a desk where you lie flat and the desk moves for you, for the next few months.)

  • grace

    This post and the last are the reason some of us just sit back and listen. And nod in agreement.

    My first new friend here in my new city is a pharmacist. One of only two one who would agree to take on the meth program newly relocated to where the clients actually live. Bringing the facilities to those who need them most, imagine! She LOVES her job.

    As an aside, you told me that I would find like minds even in a big ‘C’ conservative town. I’m happy to say that you were right.

  • I feel that way too Lynn. So often our mistakes, as a society, get so irredeemably institutionalized that we can’t fix them. We’re just stuck doing things the way we’ve always done them, even if they never worked, simply because that’s how we’ve always done them. I love seeing evidence, like this, that we can sweep everything aside and find new and better ways to do things.

    David, I’m not sure I understand your concern here. Can you give an example of an awkward conflict of interest?

    Mudmama, interesting that only 12% of Canadians would knowingly hire a lawyer with a mental illness.

    Grouchy, damn, I blew that headline!

    Gillian, thank you very much. I would love to get a job that involves writing, particularly about people who are marginalized. It’s where my head and heart and talents all intersect.

    Grace, I’m happy I was right too, but I have to say I’m impressed that you’re finding them so quickly!