According to the United Nations, one in six older adults experienced abuse globally in 2017.[i] With lockdowns and reduced care, violence against older persons is on the rise.[ii] Physical distancing can take a heavy toll on mental health, and the risks are higher for older persons who may live alone and be less virtually connected.[iii] Today, on World Elder Abuse Awareness Day, the global community is spreading awareness about the impact of COVID-19 on older adults’ mental and physical wellbeing.
More than 1.8 million Canadians over the age of 60 lived with a mental health condition in 2016.[iv] Depression is the most common mental health condition for this demographic, affecting 15 per cent of older adults living in community and up to 44 per cent of those living in long-term care homes.[v] Anxiety affects at least five to 10 per cent of those aged 65 and over, making older adults the most likely age group to be hospitalized for anxiety disorders.[vi] Men aged 80 years and older have the highest suicide rate of any age group in Canada.[vii]
Substance use conditions, including complications from the use of prescribed medications, are common for older adults.[viii] Harmful drug-drug interactions can occur when older adults are exposed to drug combinations. Mixing alcohol with medication causes the greatest risk and range of harms to older adults.[ix] Older adults with problematic substance use experience higher rates of hospitalization and mortality as a result of falls and accidents.[x] They may also experience abuse, homelessness, social isolation and crime, increasing their likelihood of interacting with the justice system.[xi]
Proper diagnosis and treatment of mental health and substance use conditions is the best way to minimize symptoms and improve an older adult’s quality of life. However, the stigma surrounding many mental health and substance use conditions may prevent people from seeking the help they need.[xii] This stigma contributes to the barriers people encounter when seeking the treatment and social supports they need, which may increase their likelihood of interacting with the justice system. Conversely, for many in need, the justice system provides an opportunity to access substance use treatment and support for the first time.
Older adults with mental health issues, problematic substance use or age-related conditions such as dementia often encounter challenges working through the criminal justice process, accessing necessary services in custody and finding housing upon release. As Ontario experiences an increase in its population aged 65 and older, all areas of the criminal justice system are interacting with older adults at a more frequent rate and struggling to adapt to the needs of this vulnerable population.
In response, the Provincial Human Services and Justice Coordinating Committee (HSJCC) released Older Adults and the Justice System: A navigational guidebook for caregivers and service providers to help caregivers and service providers of this demographic interact with police, courts, corrections and probation/parole personnel.
The guidebook outlines different age-related conditions and examines how mental health issues, substance use issues, developmental disabilities, physical health conditions and social determinants of health can create complex challenges for older adults at various points in the criminal justice system. The resource contains detailed summaries of the criminal and mental health law systems and outlines best practices for engaging with police and the courts. It also looks at challenges and available services in correctional facilities, including supportive housing options.
This guidebook was prepared by the Provincial HSJCC, with support from the Canadian Mental Health Association, Ontario Division. Project guidance and expertise was provided by the Older Adults and the Justice System Project Advisory Committee, which includes representation from the Ministries of Health, Attorney General and Solicitor General, as well as agencies in the community mental health, addictions, social services and criminal justice sectors.
About the Provincial Human Services and Justice Coordinating Committee
The Human Services and Justice Coordinating Committee (HSJCC) Network was established in response to a recognized need in the province to co-ordinate resources and services and plan more effectively for people who are in conflict with the law. Priority consideration is made for people with a serious mental illness, developmental disability, acquired brain injury, substance use issue, and/or fetal alcohol spectrum disorder. The HSJCCs are a co-operative effort of the Ministries of the Attorney General, Children, Community and Social Services, Health, and the Solicitor General. The Provincial HSJCC functions as a planning body, supporting the efforts of the full HSJCC Network.
[i] United Nations (UN). (2020). Policy Brief: The Impact of COVID-19 on Older Persons. Retrieved from https://www.un.org/sites/un2.un.org/files/un_policy_brief_on_covid-19_and_older_persons_1_may_2020.pdf.
[ii] World Health Organization (WHO). (2020, March 18). Mental health and psychosocial considerations during the COVID-19 outbreak. Retrieved from https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf.
[iii] WHO, ibid.
[iv] Mental Health Commission of Canada. (2018). What we do: Seniors. Retrieved from https://www.mentalhealthcommission.ca/English/what-we-do/seniors.
[v] Canadian Coalition for Seniors’ Mental Health (CCSMH). (2006). National guidelines for seniors’ mental health: The assessment & treatment of depression. Toronto, ON: CCSMH; Canadian Institute for Health Information (CIHI). (2010). Depression among seniors in residential care. Ottawa, ON: CIHI.
[vi] Bryant, C., et al. (2008). The prevalence of anxiety in older adults: Methodological issues and a review of the literature. Journal of Affective Disorders, 109(3), 233-250; Mood Disorders Society of Canada (MDSC). (2009). Quick facts: Mental illness and addiction in Canada (3rd Ed.). Guelph, ON: MDSC.
[vii] MDSC, ibid.
[viii] MacCourt, P., et al. (2011). Guidelines for comprehensive mental health services for older adults in Canada. Ottawa, ON: Mental Health Commission of Canada.
[ix] Flint, A., et al. (Eds.). (2018). Substance use in Canada – Improving quality of life: Substance use and aging. Ottawa, ON: Canadian Centre on Substance Use and Addiction.
[x] Flint, ibid.
[xi] Flint, ibid.
[xii] Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625.