Time to “Decriminalize” Mental Health

Introduction

The Canadian criminal justice system is adversarial by nature; it is broken, and disproportionately affects those with mental health problems. The criminalization of mental health problems is subtle yet highly pervasive given that over 40 percent of people with mental health issues have been arrested in their lifetime and this becomes more problematic because it is estimated that almost half of all Canadians will have at least one serious mental health problem by the time they are aged 40, according to a report released by the John Howard Society of Ontario (JHS). According to this 2021 report, “The criminalization of mental illness refers to inadvertently making acts associated with symptoms of mental disorders illegal or punishing behaviors that can arise from mental health or substance use issues.” The majority of incarcerated people with mental illnesses enter the criminal justice system for reasons that they cannot control. Canada has inadvertently criminalized mental illnesses and as Justice David Paciocco summed up when appealing to the Ontario Court of Appeal, mentally sick people are “often sick, always in need.”

How We Got Here

If we are to come up with effective intervention measures in the future, we need to understand our history. Over 300 years ago, mentally sick people would be categorized among those possessed by evil spirits or partakers of witchcraft, and thus they would be burnt at the stake. 200 years ago, they would be locked at home or imprisoned, and a century later, they would be committed to an asylum. The discovery of antipsychotic drugs 70 years ago was the much-awaited light at the end of the tunnel, as it allowed the clinical management of such problems. Therefore, thousands of those held in asylums were released back into society, but there were few resources to support such large numbers of individuals. Two decades ago, the government cut funding to social programs as part of curbing its spending, which means such individuals are on their own. This brings us to date whereby the chronic underfunding of support agencies implies that those with mental health problems are unlikely to get help or shelter. Additionally, self-medication is rampant, which leads to overdosing and an increased risk of being arrested for minor offenses. The cycle then repeats itself for the next foreseeable future with the affected people getting in and out of incarceration.

A Complex Situation

In this confusion, police officers have unwittingly become front-line triage workers dealing with the mentally ill in Canadian society. However, police officers are not trained to diagnose and treat mental illnesses; their work is to investigate, arrest, and charge those involved in criminal activities and misdemeanors. Writing for the Toronto Star in 2017, Michael Bryant and Graham Brown noted, “From arrest to prosecution, conviction, sentencing, use of segregation, all stages of our criminal justice system are now consistently overrepresented by people who are suffering from psychosis, mania, mood disorders, depression, alcoholism and addiction, anxiety disorders, and personality disorders.” Consequently, those who had been institutionalized in asylums are now institutionalized in jails, which ultimately makes the criminal justice system in Canada the largest provider of mental health services. The problem with this approach from a sociological perspective is that the mentally ill persons that are unfortunately swallowed up by the criminal justice system come out with unmanaged or aggravated health issues, which could potentially contribute to recidivism.

The Way Forward

While there is no panacea for mental illnesses, the criminal justice system is not the right place to diagnose the mentally unwell and prescribe treatment. It is all about the approach and the best approach, in this case, is to ensure that those in medical help get it in time before they are exposed to the risk of unemployment, homelessness, and the ultimate conflict with the law. This means that the government should review its funding policies and invest in promoting accessibility to mental health care by supporting communities and various agencies involved in this work. There should also be deliberate efforts to focus on social determinants of health including employment, homelessness, and poverty as a preventive measure to keep people away from developing mental illnesses. Additionally, in the courts, there should be an elaborate way of screening individuals for mental health before sentencing to ensure that they get the needed help instead of being locked up in jails. As the 2013 Mental Health and Criminal Justice Policy Framework by the Centre for Addiction and Mental Health (CAMH) states,

A social justice approach that focuses on prevention, diversion, and treatment/rehabilitation can help minimize the number of people with mental illness who come in contact with the criminal justice system, provide diversion options for those who do become involved, and ensure that treatment and supports are available at any point throughout the system.

This approach is grounded on sociological theory and it would go a long way in decriminalizing mental health problems in Canada. The mentally ill in our society are some of the most vulnerable individuals and they should not be punished for their health status – they deserve our collective help, not incarceration.

References

Bryant, M., & Brown, G. (2017). Judge exposes how we criminalize mental illness. Toronto Star. Web.

CAMH. (2013). Mental health and criminal justice policy framework. Web.

JHS. (2021). Broken record: The continued criminalization of mental health issues. Web.