Social Policy in Ontario

One of the biggest barriers to justice is a mental disability. No agency is more aware of this thanLegal Aid Ontario (LAO), whose clients are disproportionately impoverished, underhoused, criminalized and incarcerated. Approximately one in three have mental health problems.

For years, the agency has made incremental reforms; some effective, some still being tested. ButJohn McCamus, chair of LAO’s board, knew these ad hoc efforts were not enough. He had come to the inescapable conclusion that the traditional legal model simply didn’t work for people with mental disorders.

A year ago, he commissioned the development of a comprehensive mental health strategy. He recruited a young lawyer who had spent his career working with psychiatric patients to canvas Ontarians with mental disabilities, their caregivers, social service providers, housing advocates, health-care professionals, judges and lawyers to come up with a blueprint.

It is now ready. LAO will release the plan on Wednesday and invite public comment. Only after the strategy has been thoroughly discussed, improved if possible and amended if necessary, will it be finalized.

Even in its preliminary form, it is a sharp departure from the way legal services have been delivered to clients with mental disabilities.

“You can’t just sit behind a desk waiting for the clients to come to you,” says Ryan Fritsch, who drafted the plan. “You’ve got to be in the psychiatric facilities, in the drop-in centres and in the buildings where people get social services. A lawyer is often the only person taking a rights-informed approach to health care, housing and income support.

“There is an absence of dedicated mental health advocacy in Ontario. This is where LAO has the opportunity to play a leadership role.”

Fritsch’s official title is policy counsel at Legal Aid Ontario leading the development of the Mental Health Strategy. He calls himself the agency’s mental health champion.

His blueprint sets out a four-step program to knock down the legal barriers confronting Ontarians with mental disabilities:

First, every lawyer employed by LAO would be trained to assist clients with mental disabilities. The course would cover human rights, privacy, professional and ethical issues that arise in treatment and competency to make decisions and how to direct clients to the right social service agency.

The program would begin with the agency’s 250 staff lawyers, then fan out to the roughly 350 lawyers working in local legal aid clinics and finally be extended to the 6,000 or so private lawyers who receive legal aid certificates to represent low-income clients. “This would be the first mental health training for lawyers that’s ever been done in Canada,” Fritsch says.

Second, LAO would embed its lawyers in drop-in centres, social service agencies and community clinics, on a trial basis, to head off problems before the police get involved. A refugee mental health problem can balloon into a criminal matter. A family dispute rooted in mental illness or addiction can escalate into violence and criminal charges. A lack of housing can land a person with a mental disability in jail. A hospitalization without a person’s consent can trigger a protracted legal battle. “We’ve identified tons of potential clients,” Fritsch says.

Third, LAO would make advocacy for clients with mental disabilities a formal part of its mandate. Over time, it would move from a courtroom model to a mental health model, which moves from criminal culpability to recovery.

Finally, LAO would press the Attorney General of Ontario to strengthen the province’s mental health court at Toronto’s Old City Hall. Unlike regular criminal courts, “102 Court” aims to divert people with mental disorders into community treatment with social assistance, a safe place to live, clothing and psychiatric follow-up.

Fritsch is eager to find out if he has the broad brush strokes right and if teamwork is possible in the fragmented mental health field.

No one at LAO is promising miracles. But the agency is determined to reshape legal aid to fit the people who need it.

< http://www.thestar.com/opinion/commentary/2013/12/03/legal_aid_ontario_releases_pioneering_mental_health_strategy_goar.html >