ARCHIVED - Building Bridges: Mental Health and the Justice System Symposium

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Calgary, Alberta
May 25, 2011

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Thank you for that warm welcome. It's a pleasure to be with you all here today at this Building Bridges symposium.

The great English Mathematician and Physicist Sir Isaac Newton once noted that people in general often build too many walls and not enough bridges.

That might be true in some cases. Today, however, I'm delighted to see so many of you come together to discuss ways we can work together to bridge the gaps that still exist in approaches to working with those with mental illnesses - in particular, those who have come into contact with the criminal justice system.

Let me extend a very warm welcome to each of you as well as my deepest appreciation for the work you do and for taking part in these discussions.

I am looking forward to hearing your ideas and the results of your meetings.

I especially want to extend my appreciation to the organizers for their hard work in bringing you all here.  Thank you very much for a job well done.

Today, we know that approximately 29 percent of female and 13 percent of male offenders have been identified at admission to the federal corrections system as presenting with mental health problems.

We also know that mental health problems are now two to three times more common in Canadian institutions than in the general population.

In many ways, the presence of so many people with mental illnesses in our corrections system today can be traced all the way back to the wave of provincial deinstitutionalization that occurred in Canada during the 1970s and 1980s.

Looking back, this was done with the best of intentions. People with serious mental illnesses, the reasoning went, could be more humanely and better treated in the community thanks to the emergence of new drugs, and enhanced community supports.

People with serious mental illness could have a chance to lead constructive lives in the community while hospital beds could be reserved for only the most serious cases to ensure they receive proper treatment.

Of course, hindsight is 20/20 and as we now know, the shift from institution to community has been far from perfect.

Deinstitutionalization was eventually coupled with statutory, judicial, and practical expansions of the ability of the mentally ill to refuse treatment, and to reject committal to care.

We are left today with a situation where young people over the age of 18 who are at greater risk of becoming involved with the justice system no longer have a place to turn for help, can refuse to accept treatment, and are often not even identified as needing help until someone calls the police.

The result is that large numbers of people with mental illnesses ultimately find themselves inside correctional institutions - in many cases, federal prisons.

What, then, can we do to change this?

How can we move forward together to help ensure that people with serious mental illnesses don't end up where they were 150 years ago - in our prisons?

I believe that the lessons of the last 30 years serve to highlight the scope of the challenges we face. But they also serve to show us a way forward. This is what I would like to briefly talk about now.

As all of you are aware, the Government of Canada established the Mental Health Commission of Canada to develop a national mental health strategy.

This is an important step forward and I want to join with all of you in applauding the work of the Commission thus far. Already, the efforts of former Senator Kirby and his colleagues are producing some valuable insights. However, much remains to be done.

The Commission’s framework document, for example, points out that governments need to find ways to coordinate their activities not only within the health sector, but across the different ministries, departments, and agencies that are involved in the funding, organization, and delivery of services and supports that influence mental health.

It also points out that new and innovative forms of government coordination need to be explored to ensure that mental health priorities are addressed across governments.

The Commission’s Advisory Committee on Mental Health and the Law is today partnering with the Winnipeg branch of the Canadian Mental Health Association and the Public Interest Law Centre of Legal Aid Manitoba, to assess how mental health and the law currently impacts the rights of people with mental health problems.

The Advisory Committee’s Police Project is also developing comprehensive guidelines for police training and education programs across Canada with the aim of improving interactions between the police and individuals with mental health problems or illnesses.

An important aside: as Minister responsible for federal corrections, I must also turn my attention to the rights and obligations of those who work in our correctional institutions.  How do mental health issues impact on the operations and management of federal correctional institutions? None of you will be surprised to hear that the effects are profound.

Better coordination, partnerships, and cooperation will be vital to our success. And we are making progress both through the work of the Mental Health Commission of Canada as well as through the work of many of the partners with us here today.  

Our provincial and territorial partners, for example, are increasingly investing in new models of service delivery such as mental health courts and integrated response teams.

As the Compendium, developed following the 2009 meeting of the 2009 Federal Provincial Territorial Ministers Responsible for justice, notes, today there are over 200 initiatives underway to help establish a fuller continuum of care for people with mental illnesses by a range of government departments and agencies as well as community and not-for-profit organizations. This is a very promising trend.

At the Federal level, the Correctional Service of Canada is making progress in implementing its Mental Health Strategy at both the institutional and community levels.

CSC continues to develop proposals for Intermediate Mental Health Care Units. These would provide care for offenders whose mental health problems are not so severe as to require in-patient care in a psychiatric facility but who need structured support and care beyond what can be offered through the organization’s Primary Mental Health Care services.

As an interim step, CSC is piloting a 30-bed Intermediate Mental Health Care Unit in Kingston Penitentiary and a 10-bed Complex Needs Unit in the Regional Treatment Centre/Pacific Institution Complex. 

CSC has implemented a mental health screening system at intake and federal institutions have enhanced the multi-disciplinary teams of mental health professionals providing basic mental health services and supports for offenders.

CSC also offers clinical discharge planning and mental health services to support offenders with mental disorders who are released into the community.

The Correctional Service of Canada can and will continue the positive changes already underway to improve the intake, treatment and subsequent release into the community of offenders with mental illnesses.

However, it is here that I want to make an important observation about the limits of the federal correctional system: preventing crime before it happens and addressing it appropriately when it does, means that we must have a proper understanding of the scope and depth of the mental health challenges we face as a country.  While I expect this process to take time, we must stop relying on prisons to act as a parallel health care system to provide care for the mentally ill after a crime has been committed.

That’s why our government established the Mental Health Commission of Canada -- to recommend appropriate, optimal solutions to what appear sometimes to be intractable problems. 

And that’s why we will be talking about mental health and justice—again and again—until together we find appropriate solutions to one of the greatest challenges facing Canadian society today.

How we treat our mentally ill goes to the very heart of what this country is all about and the twin values of justice and compassion which all of us as Canadians cherish.

We need to find answers. We need to find solutions. And together I know that’s just what we can do.

I look forward to hearing from you and to working with you over the coming months. Thank you.

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