baillie_mental health and the justice system
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BUILDING BRIDGES:
MENTAL HEALTH AND THE USTICE SYSTEM
Patrick Baillie, Ph.D., LL.B.
Mount Royal UniversityMay 25, 2011
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KEY PRIORITIES
Members of the public want safe communities
Police ofcers want to protect potential
victims, doing so, in part, by catching badguys*
Judges want to give sentences that send amessage about unlawful conduct
* bad guys is based on the notion behind criminal lawthat the person knows what he or she is doing, knows
that it is wrong, and does it anyway
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KEY PRIORITIES
Sta in remand centres, jails and prisonswant to reduce overcrowding and providequality services
Sta in community agencies want to assistoenders in reintegrating to society, whilealso reducing the potential for re-oence
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KEY PRIORITIES
We all want to stop the revolving door thatbrings repeat oenders back into contactwith victims, with police, with the courts,
with custodial facilities, and with communityagencies.
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SOCIETYS FEARS
Man Kills 8 of His Neighbors; John Denver Karaoke Drove Him Crazy
HAT YAI, THAILAND -- 52-year-old WeenusChumkamnerd has been arrested for killingeight of his neighbours for their less-than-stellar karaoke performances to John Denvers
Country Roads.
The Telegraph, March 08, 2008
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SOCIETYS FEARS
CRAZY MAN KILLS SIX
Carpenter Runs Amuck in Lodging House with Shotgun
SAN FRANCISCO, May 7 -- Walter CharleyDavis, a carpenter, in a fit of insanity todayshot and killed a family of six persons withwhom he resided at 414 Pierres Street, in this
city.
New York Times, 1907
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AND THE FEAR PERSISTS
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AND THE FEAR PERSISTS
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VINCENT WEIGUANG LI
Came to Canada in 2001 and became a Canadiancitizen in 2005.
Worked in Winnipeg and Edmonton, as a labourer, ata fast-food restaurant, in newspaper delivery, and
at Wal-Mart. Was described by employers as hardworking and
reliable.
Was married to a woman who sometimes worked as
a waitress.
So, wheres the story?
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HOMICIDE OF A STRANGER BY A PERSONWITH A PSYCHOTIC ILLNESS
Characteristics of these oenders:
Two-thirds had never received treatment with
antipsychotic medication Compared to family homicide oenders, stranger
homicide oenders were:
More likely to be homeless;
More likely to have exhibited antisocialbehaviours; and,
More likely to have fewer negative symptoms.
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WHAT ARE THE ODDS?
Of winning Lotto 6/49 -- 1 : 13,983,816 / draw
Of scoring hole-in-one -- 1 : 12,500 / hole
Of being killed by lightning -- 1 : 5,000,000 / yr
Of being killed in MVA -- 1 : 6,500 / yr Of dying from venomous plant or animal --
1 : 3,441,325 /yr
Of being killed by stranger with psychosis -- 1 :
14,300,000 / yr
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CANADIAN MEDICAL ASSOCIATION 2008RESULTS OF A NATIONAL SURVEY
Almost half of Canadians (46%) think people use theterm mental illness as an excuse for badbehaviour.
One in four Canadians are fearful of being around
people who suer from serious mental illness. Half of Canadians would tell friends or coworkers
that they have a family member with a mentalillness, compared to 72% for a diagnosis of cancer
and 68% for diabetes. Most Canadians (61%) would be unlikely to go to a
family doctor who had a mental illness and 58%would shy away from hiring a lawyer, child-care
worker or financial adviser who had a mental illness.11
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CANADIAN MEDICAL ASSOCIATION 2008RESULTS OF A NATIONAL SURVEY
This years report card shine a harsh, and franklyunflattering light on the attitudes we Canadianshave concerning mental health, said the CMAPresident, Dr. Brian Day, in a press release.
In some ways, mental illness is thefinal frontier of socially-acceptable
discrimination.
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THE ONE-TIME OFFENDER
What makes a person just snap?
Really, are there no warning signs?
These individuals are not predatory and likely noteven opportunistic oenders, but, rather,individuals who in a given set of circumstances, actout.
Those circumstances may include periods of stress,depression, relationship conflict, economic
uncertainty, work transitions, or other contributorsto impaired mental health
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A 2010 STUDY OF WHOS INCARCERATEDJIM COOK AND KATHY MURPHY, CORRECTIONAL SERVICES DIVISION
ALBERTA SOLICITOR GENERAL AND PUBLIC SECURITY
Study looked at every admission to a provincialcorrectional facility between 1979 and 2009.
A total of over 250,000 admissions werestudied.
For 125,000 individuals, only 1 admission was
recorded during the study period.
For 38,000 individuals, more than 5 admissions
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PERSONS ADMITTED TO ADULT CUSTODY INALBERTA
Percentages
1admission
2-3admissions
4-5admissions
6ormoreadmissions
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AVERAGE AGE AT FIRST ADMISSION
0
8
15
23
30
1admission Alladmissions Chronic(6ormoreadmissions)
Age(inyears)
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CHRONIC OFFENDERS (CO) WHO ARE THEY?
Vancouver Police Department (2008) monitored 379CO, including 27 super chronics
The average CO being monitored has 39convictions.
Top 10% of group has average of 77 convictionseach.
Six oenders have over 100 convictions each.
Their oending often directly supports their
drug addiction.
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CHRONIC OFFENDERS (CO) WHO ARE THEY?
VPD Chronic Oender demographics:
84% were born in Canada;
70% were Caucasian;
Average age was 35 years; and,
Oence record frequently covers 20 years ormore.
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CHRONIC OFFENDERS (CO) WHO ARE THEY?
VPD data shows:
78% of CO were noted to have substance abuseissues;
25% of CO were noted to have some form of
mental disorder
A number of chronic oenders have someindications of anti-social personality disorder.
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CHRONIC OFFENDERS (CO) WHO ARE THEY?
Oence categories in VPD data:
54% property oences
18% non-compliance oences;
8% violent oences;
8% drug oences; and,
12% other oences.
Compare to Cook and Murphy:
61% of super CO had index property oences,57% had index non-compliance oences, and20% had index Mischief /Disturbance oences.
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RISK FACTORS THE USUAL SUSPECTS
Who is most at risk for recidivism?
Early onset
Male
Substance abuse problems
Childhood or adolescent maladjustment
Mental health problems
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RISK FACTORS THE USUAL SUSPECTS
In summary, CO are likely to:
Have early onset of problems;
Have a history of substance abuse;
Have a history of mental health problems;
Have antisocial personality traits; and,
Oend out of perceived necessity, often related tosubstance abuse.
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THE MENTAL HEALTH OF POLICE OFFICERS(SCORES FROM MMPI-2-RF)
30
40
50
60
70
RCd RC1 RC2 RC3 RC4 RC6 RC7 RC8 RC9
Lawenforcement(n=674)
CPS(n=66)
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NEW YORK POLICE DEPARTMENT 2004SURVEY OF 1500 OFFICERS / 574 PARTICIPANTS
29% of police ofcers found to have one DSMdiagnosis, with another 4% having two ormore DSM diagnoses.
Two-thirds of those diagnosed werediagnosed with an anxiety disorder; one-third were diagnosed with clinicaldepression.
Source: G. Kapalka et al., 16th Conference of theInternational Society of Environmental Epidemiology
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RCMP - 2009
PTSD is the third most common medical condition inthe RCMP.
I didnt really talk about it because I knew it was my
own personal experience. I didnt feel that I wouldbenefit in any way by talking about it because Ifelt ... it was just part of the job and you wereexpected to do this. You brought it home with youand you carried it around everyday. You tried not
to. ... I especially noticed it when, after hours, mymind became filled with thoughts of what hadhappened, what I had seen. ... It seemed like toomuch time that I spent thinking about things.
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PRISONS AND MENTAL ILLNESS
Bureau of Justice Statistics (2006):24% of inmates in state prisons had a recently
diagnosed mental illness;
14% of inmates in federal prisons had a recently
diagnosed mental illness;56% of inmates in state prisons reported recent
symptoms of a mental health problem;
45% of inmates in federal prisons reported recentsymptoms of a mental health problem; and,
State prisoners with a history of mental healthproblems were twice as likely as other prisonersto have been injured in a fight since admission.
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PRISONS AND MENTAL ILLNESS
Over one-third of all inmates in federalpenitentiaries have a mental health problemrequiring treatment.
Providing mental health services in provincial jails is
hampered by the short length of average sentences(~ 39 days). Providing mental health services infederal penitentiaries is hampered by limitedresources.
Without access to treatment services, mentally illoenders serve longer into their sentences, leavinglittle time for supervised community reintegration,which may actually increase the risk of re-oence.
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PRISONS AND MENTAL ILLNESS
The plight of oenders with mentaldisorders in prisons has become a majorfocus and priority of my Ofce. We knowthat the prevalence of oenders withsignificant mental health issues uponadmission has doubled in the past fiveyears.
Howard Sapers
Ofce of the Correctional Investigator, 2009
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PRISONS AND MENTAL ILLNESS
While the precise numbers and definitionsmight be in some dispute, it is increasinglyclear that we are confronted with a verysizable, vulnerable and distressedpopulation. Federal prisons are housing thelargest psychiatric populations in thecountry.
Howard Sapers
Ofce of the Correctional Investigator, 2009
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PRISONS AND MENTAL ILLNESS
Recommendations from the 2009 Annual Report ofthe Ofce of the Correctional Investigator:
CSC should bolster recruitment of clinical mental
health professionals;* CSC should immediately implement intermediate
mental health care units; and,
Clinical management plans should be developed,
involving interdisciplinary teams.
* 20% vacancy rate in CSC psychology positions in 2010
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Results from the MHCC National Trajectory Project
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Results from the MHCC National Trajectory Project Dr. Anne Crocker (Lead Investigator)
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Please note:
The information presented in the following
four slides is drawn exclusively from theQuebec sample and may not be indicativeof results from the Ontario and British
Columbia samples.
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MENTAL HEALTH COURTS / DIVERSION
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MENTAL HEALTH COURTS / DIVERSIONPROGRAMS
By 2010, there were over 250 mental health courtsin the United States.
Multiple studies show lower rates of recidivism afterparticipation in a mental health court.
Participants in mental health courts spend less timein jail than the same participants previouslyprocessed in traditional courts.
Reduced rates of homelessness, less hospitalization,and reduced rates of substance abuse have also
been found. e.g., Schneider, R.D. Mental health courts and diversion
programs: A global survey. Int J Law & Psych 2010.
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MENTAL HEALTH COURTS SCHNEIDER 2010
It is clear that the problems we are facing withinthe criminal justice system would not be nearly sopressing had the civil mental health system beenoperating in a more potent manner. Most of theaccused who come through the court house doors
have extensive civil mental health histories. So, thecivil mental health system had carriage of thematter, but either the individual escaped itsclutches, or they were released prematurely, or theyfell through some legislative gap. We should be
reinvesting in mainstream civil mental health careand perhaps encouraging less the expansion of thecourts role as a principal dispenser of mental
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PROGRAM GUIDELINES FOR JUSTICE AND
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PROGRAM GUIDELINES FOR JUSTICE ANDMENTAL HEALTH LIAISONS
In 2006, the Human Resources Committee of theCanadian Association of Chiefs of Police endorsed a
set of guidelines to assist police services in thedevelopment of programs and services related topolice interactions with persons with mental illness.
Put simply, the guidelines describe the people andthe connections that must exist for bettercommunication between elements of the justicesystem.
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PROGRAM GUIDELINES FOR JUSTICE AND
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PROGRAM GUIDELINES FOR JUSTICE ANDMENTAL HEALTH LIAISONS
Each organization should foster a culture in whichmental illness is viewed as a medical disability not amoral failure, and in which persons with mental
illness are treated with the same degree of respectas other members of society.
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THE CONSENSUS PROJECT
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THE CONSENSUS PROJECTA PROJECT OF THE COUNCIL OF STATE GOVERNMENTS
The single most significant commondenominator shared among communitiesthat have successfully improved the criminal
justice and mental health systems responseto people with mental illness is that eachstarted with some degree of cooperationbetween at least two key stakeholdersone
from the criminal justice system and theother from the mental health
system.
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SOME FINAL RECOMMENDATIONS
Better collaboration must occur between Ministriesof Justice, Health, Corrections, Education,Employment, Childrens Services, and SocialServices;
Mental Health Commission of Canada (MHCC) must,in the National Strategy, include attention toassessment and treatment in forensic populations;
MHCC Opening Minds campaign must addressmyths about dangerousness and mental illness andmust pay attention to immigrant populations and
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SOME FINAL RECOMMENDATIONS
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SOME FINAL RECOMMENDATIONS
MHCC Knowledge Exchange must providestrategies for intervention and treatmentwith oenders, with reluctant clients, andwith families; and,
MHCC Partners Program must advocate fornecessary legislative changes.
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QUESTIONS?
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QUESTIONS?
Dr. Patrick Baillie 3500 26th Avenue NE
Calgary, Alberta
CANADA T1Y 6J4
phone: (403) 943-5662
e-mail: courtdoc@hotmail.comor
Patrick.Baillie@albertahealthservices.ca
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