baillie_mental health and the justice system

8/2/2019 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

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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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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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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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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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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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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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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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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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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: [email protected]

[email protected]

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