Editorial: Criminalization and Mental Illness
Network, Winter 2005
History has a tendency to repeat itself. Centuries ago, individuals with mental illness were feared as being possessed by the devil. Later they were placed in institutions and chained like criminals. Mental health and criminal behaviour continue to intersect. Today, unfortunately, we find too many cases of the mentally ill languishing in prisons for lack of assessment space in psychiatric hospitals. Worse, large numbers of criminal offenders suffer from mental illness. This prompts the question of whether mental illness led to their crimes in the first place. It also points out the problem of inadequate mental health services in our society.
Many of us recall seeing the famous Jack Nicholson movie One FlewOver the Cuckoo’s Nest, which portrayed psychiatric hospitals in the poorest light. At about the same time, the deinstitutionalization movement became prominent. Advocates, including the Canadian Mental Health Association, argued that it was better to treat the mentally ill in the community, where they could maintain their connection with families and loved ones, strengthening their resolve to benefit from treatment.
While many still agree with this approach, the results have not all been rosy. Community treatment programs and facilities have not replaced the “institutions” in adequate numbers, due to chronic underfunding. The result in many cases, rather than a choice between a psychiatric institution and community treatment, is no treatment at all. For many people, this lack of support has led to increased contact with police and the criminal justice system, often for minor offences. Deinstitutionalization has in fact become criminalization.
Ontario has had a number of tragic experiences as a result of the lack of assessment capacity in psychiatric hospitals. Courts will frequently order psychiatric evaluations of offenders to determine whether they should be subjected to the criminal justice system in the first place. When beds are not available, they are placed on waiting lists for psychiatric assessment and then confined to local or regional prisons. While in prison, a number have been killed or assaulted by other prisoners.
In November 2004, an Ottawa judge ruled the practice unconstitutional and illegal. The province has decided to not appeal this decision and has promised to fix the problem. How this will be done and how long it will take is not clear, but at least those who are thought by the court to be mentally ill will not be kept with other criminal offenders, prior to a finding of guilt.
The solutions are neither simple nor obvious. Investment will be required in program development, enhancement and research. Clearly action is required to identify those suffering from mental illness at the first possible event involving contact with a criminal justice official and then streaming them into diversion programs. This is secondary prevention and far better than offering them “treatment” in penitentiary.
Willie Gibbs, BA, MSW, is president of the Canadian Criminal Justice Association. He began his career in corrections as an institutional parole officer with the Correctional Service of Canada (CSC) and rose through the ranks to become Senior Deputy Commissioner of CSC and then chair of the National Parole Board. In the latter part of his career, he also served as chair of the National Joint Committee of the Canadian Chiefs of Police and Senior Federal Correctional Officials, and international vice-president of the Association of Paroling Authorities, International. His new book, The Cons and the Pros, is based on his journey in prisons and parole.
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