Mental health and prison: a tragic cycle that repeats itself

Posted on September 16, 2023 in Child & Family Debates

Source: — Authors: – Opinion/Editorials
September 15, 2023.   By Star Editorial Board

When offenders are released, they often face homelessness, unemployment, drug use, lack of mental health care — factors that lead to being arrested.

“Given the failures of the health care and social welfare systems, the justice system will, for better or worse, be expected to continue caring for mentally ill offenders.”Dreamstime / TNS

Consider the following scenario: A young man develops a serious mental illness. He, or his loved ones, seek help, but the health care system seems unresponsive.

Eventually, the man’s troubling behaviour escalates and he winds up in jail. He’s later released without receiving adequate treatment and then he’s back — back in court, back in jail, back on the street and the cycle repeats, ad nauseam.

Sound familiar? It should because it has happened countless times over the past few decades. And it’s still happening.

Witness the case of Nigel White, a homeless schizophrenic man who pled guilty last month to assaulting two strangers on the TTC. White, who had previously attacked other people on public transit, received a sentence of 20 months in jail, where he might — might — finally receive the help he needs.

Or he might not. And then he’ll be back.

White’s case reveals a litany of failures — of the health care system to treat serious mental illness early and aggressively, of the social welfare system to address the housing needs of vulnerable people, and of the justice system to provide adequate mental health services to offenders.

As for the first failure: According to the Centre for Addiction and Mental Health, “mental illness accounts for about 10 per cent of the burden of disease in Ontario, [but] it receives just seven per cent of health care dollars,” resulting in a shortfall of $1.5 billion.

The situation is similar across the country, with a third of Canadians over 15 reporting an unmet mental health need. Furthermore, “only half of Canadians experiencing a major depressive episode receive ‘potentially adequate care,’” and 75 per cent of children with mental disorders can’t access specialized services.

Ontario’s Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System is a laudable effort to remedy this situation. But its 10-year timeline means many people will be out of luck right now and when you’re experiencing a serious mental illness, right now is all that matters.

Similarly, housing plans like Canada’s National Housing Strategy and Toronto’s HousingTO 2020-2030 Action Plan promise long-term solutions for homelessness, but offer limited help for those currently on the street — a troubling situation when the combination of mental illness and homelessness is strongly associated with criminal behaviour.

Given the failures of the health care and social welfare systems, the justice system will, for better or worse, be expected to continue caring for mentally ill offenders. It’s incumbent upon us, then, to make it better — before, during and after incarceration

Before trial, diversion programs and mental health courts offer defendants a chance to avoid a conviction or imprisonment by connecting them with both justice and mental health personnel, and providing them with a closely supervised treatment program.

If an offender is sentenced to jail, treatment for mental disorders is typically limited, but it need not and should not be. The Mental Health Commission of Canada’s literature review suggests including a screening assessment upon admission, 24-hour crisis care, suicide prevention and access to specialized psychiatric care.

That will require a significant financial commitment, but it’s one that benefits both offenders and the community and we always find ways to fund programs we value. We had no problem paying for the short-lived, short-sighted plan to increase police presence on the TTC, but that didn’t help Nigel White, or his victims.

In contrast, by treating offenders while they’re incarcerated, we reduce the risk that they’ll return to criminal behaviour when they’re released, particularly if that treatment continues upon their return to the community.

On that point, the John Howard Society recommends integrating community and correctional health care. Doing so could create a seamless transition from jail to the community and ensure that treatment doesn’t cease upon offenders’ release.

Indeed, when offenders are released, they often return to the same circumstances — homelessness, unemployment, drug use, lack of mental health care — that led to their offending in the first place.

Post-release treatment must therefore be just one part of a more comprehensive community effort, one that attends to the health, housing and employment needs of offenders. Otherwise, they’ll be back.

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This entry was posted on Saturday, September 16th, 2023 at 9:21 pm and is filed under Child & Family Debates. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.

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