Judge Ted Ormston is on a mission to change lives [mental health reform]
TheStar.com – opinion/editorialopinion
Published On Thu Apr 21 2011. By Carol Goar, Editorial Board
Politicians, for all their promises and rhetoric, seldom change lives. They shift spending from one area to another, announce new programs and sometimes offer tax relief. But they don’t do the hard, thankless work required to solve deeply rooted problems.
That task falls to society’s unheralded leaders. They see something wrong and persevere till they find a way to fix it, reshaping institutions and attitudes along the way.
Ted Ormston is one of those. The Toronto judge is making life better for millions of Canadians affected by mental illness.
His mission began 15 years ago at Old City Hall Court, the province’s busiest courthouse. As presiding judge, he saw more and more people with mental disorders caught in the criminal justice system. They were invariably poor, often homeless and frequently addicted to drugs or alcohol. Many wound up in jail.
His job was to apply the law. But he was driven to find a more humane way to do it.
In 1998, he wrote a paper, proposing that the Ontario government create a special court for mentally ill offenders. The attorney-general of the day, Charles Harnick (a Conservative), accepted the logic and acted.
The new court quickly proved its worth. It steered thousands of sick offenders into treatment, not jail. And it strengthened Ormston’s plea to his judicial colleagues: “Sometimes you have to close the books and open your heart.”
In 2006, he was seconded from the court to head Ontario’s Consent and Capacity Board, the powerful but little-known tribunal that decides whether individuals involuntarily living in psychiatric institutions can safely be released.
He is now engineering a revolution more ambitious than the one he initiated in the courts. His aim: to transform the mental health system.
Ormston talked about his plans, his progress and his frustrations one recent afternoon.
When he took over the board — made up of 45 lawyers, 44 psychiatrists and 42 community members — it was an adversarial place. Lawyers cross-examined doctors aggressively at hearings. Doctors testified against their patients. Board members took sides.
“I want to get rid of that them-and-us culture,” he said. “I want this board to foster hope, encourage responsibility and treat patients with dignity.”
Five years later, he hasn’t eliminated the antagonism or replaced the old model of stern gatekeeper with a new model designed to promote recovery. But he is making progress.
The board was created 43 years ago (under a different name). Its duty is to balance the constitutional rights of psychiatric patients — autonomy, liberty and self-determination — and society’s right to safety and security. It receives about 4,500 applications a year. Roughly 80 per cent are turned down.
Ormston doesn’t dispute the refusal rate. Releasing people prematurely would be irresponsible. What he questions is the rigid, judgmental way the board treats psychiatric patients. He wants those who don’t succeed to leave with hope that they can get better and try again. “That’s part of the recovery process.”
The transformation may not yet be visible, he admits, but it has begun:
• The board now welcomes families and friends, seeking to provide patients with as much support as possible.
• It puts new appointees through a two-day intensive training session. They learn not only the statutes they must apply, but the importance of empathy and courtesy.
• And, for the first time, it is recruiting former psychiatric patients — people who, in Ormston’s words, “have spent three or four months with their butt hanging out of a hospital gown.”
The day will come, he predicts, when Ontario is seen as a leader in moving from the old system of medicating and deinstitutionalizing people with mental disorders to a new system in which they recover and live normal lives.
Right now, the province needs trailblazers. “If this board doesn’t walk the walk,” Ormston asks, “who will?”
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