By Kevin Ma
Would we put cancer patients in prison? Of course not — it would be inhumane to put people with a treatable, yet frightening, illness behind bars.
So why do we lock up the mentally ill?
Canadians have made it a crime to be mentally ill. This wasn’t intentional — it was the result of a disorganized, under-funded mental health system created by fear and political indifference. While we can’t quickly change the attitudes that put mental illness in jail, we can change the laws that perpetuate them. It’s up to the federal government to change the laws and spend the money needed to break mental illness out of jail.
Mental illness refers to any disorder associated with altered thinking, mood or behaviour that prevents a person from functioning well in society. The Canadian Mental Health Association says one in five Canadians (or about 8,000 of Centretown’s 40,000 residents) will develop a mental illness at some point in their lives.
Howard Sapers, the independent ombudsman for Canada’s prisons, is the latest observer to point out the criminalization of mental illness. He announced in November that the proportion of mentally-ill inmates admitted to federal prisons had more than doubled over the past decade, rising from about seven to 11 per cent. What’s more, he found the level of services available to treat them was “seriously deficient.” This announcement prompted the head of the Canadian Mental Health Association to call our prisons “warehouses for the mentally ill.”
The federal government isn’t the only one at fault, either. Despite a year-old court ruling declaring the practice illegal and unconstitutional, the Ontario government is still jailing people awaiting psychiatric assessment to see if they are fit to stand trial. Six people were imprisoned last month because the Royal Ottawa Hospital, one of the few secure psychiatric wards in the province, didn’t have room for them.
This criminalization of mental illness has a number of causes, says John Gray, head of the Schizophrenia Society of Canada.
One of them is poor co-ordinated health services. Patients usually need additional support from counsellors after release from hospital, but hospitals don’t always do a good job of handing off patients to community groups. This creates a revolving door problem where people bounce back and forth between the community and the hospital. “We don’t want people to have to cut their wrists to get services,” Gray says, but that happens when people can’t get help outside emergency wards.
Money is another factor. One study found that the number of hours the London, Ontario police spent dealing with mentally ill people more than doubled from 1998 to 2001, rising from 5,000 to 10,000 hours. The study directly linked greater contact between the mentally ill and the police to cutbacks in community health services, funding for which was frozen from 1992 to 2004.
“This contact has resulted in the criminalization of behaviours associated to mental illness,” said the Ontario Association of Chiefs of Police in response to the study. “We believe that this is an inherently flawed approach to the treatment of individuals with mental illness.”
Fear and ignorance of mental illness perpetuate this “inherently flawed” approach. The Senate committee on social affairs, science and technology released a report on mental illness last year. It found that people with mental illness were perceived as dangerous and untreatable, even though many respond well to therapy, and were more of a danger to themselves than others. As a result of these fears, landlords refuse to rent to them and employers refuse to hire them. The committee found that people with serious mental disorders had a 90 per cent unemployment rate, higher than that for any other disability.
Lack of federal leadership is a fourth cause. The committee said the federal government was not pushing to include mental health in reforms to health care or in clarifying provincial and federal responsibilities for it. Canada was also the only G8 nation without a national mental health care strategy. There was a reason why the Romanow Commission called the mental health “the orphan child of health-care,” the committee said.
Gray says this is mostly due to our decentralized government. Unlike leaders in the U.K. and Australia, our federal politicians must deal with powerful provincial premiers before making any national initiative. Getting all 10 provinces to agree to anything, let alone something as contentious as health care reform, isn’t a challenge most prime ministers want to take on.
The push to break mental illness out of jail has to come from the top. The federal government should lead by example and change how it treats mental illness for the better.
For one, it should spend the money needed to take care of those they’re directly responsible for: mentally ill prisoners. The Correctional Service of Canada has said it would spend about $29 million on a four-point plan to improve mental health in its prisons. It’s a start, but since that money is only enough to fund a quarter of its plan, it still has far to go.
Federal officials should also create a national strategy for mental health care, one that would promote public awareness and coordinate provincial health services. In November, the federal government said it would create a Canadian Mental Health Commission, which Gray says could become a steering group for such a strategy.
People with mental illnesses deserve the same care and respect we give to those with cancer and other diseases. We should tell our next government to give the mentally ill the attention and funding they need — anything less would be criminal.