Where delusional does not equal criminal

TheStar.com – healthzone.ca/health/mindmood/mentalhealth
April 29, 2011.   Bill Taylor, Special To The Star

The man is articulate, pausing sometimes to choose his words.

“I’ve been hospitalized numerous times,” he says. “But basically I regarded myself as being abducted. I think people were paid thousands of dollars to abduct me, maybe.”

Dr. Michael Colleton asks him why.

“To steal my liver,” the man says matter-of-factly.

He’s not stupid, but he is clearly delusional. That’s why he and Colleton are sitting in a room next to mental health court in the Old City Hall basement.

There’s more than one way to dispense justice. The best, for some offenders with psychiatric disorders, is to keep them out of the courtroom altogether.

Mental health court is already very different in its approach, with Crown attorneys, defence lawyers and judges working together to try to keep low-risk offenders out of the criminal justice system.

Rather than punishment, the court seeks to offer them the support they need to get their lives back on track.

Colleton is the first part of that process.

A psychiatrist with CAMH’s Law and Mental Health Program, he does preliminary assessments. Depending on his recommendation, the person may never even stand before the judge.

“The question is whether special consideration should be given because of their mental state,” he says. “Broadly speaking, it’s intended for people with serious mental illness but relatively minor charges who are out of custody.”

The man he’s talking to is in his late 30s and charged with breaking and entering and weapons offences after he was accused of pulling a knife on the owner of a junkyard. The man had slept in a car there.

He was arrested, he says, “by real police or maybe they were fake police, I don’t know. I want to charge them with kidnapping. They tried to steal my liver seven or eight times, maybe.”

“Let’s back up a little,” Colleton says.

He walks the man through his past. Education? Grade 11. Where does he live? In a hostel. Married? No. Children?

“Er … yeah … a lot, maybe.”

He sees them every day, he says.

“They live in Canada?” Colleton asks.

“No,” the man says.

He’s held various jobs, he says, from bartending to working in a fast-food joint.

He used hard drugs “a long, long time ago,” and enjoys marijuana and beer “socially.”

Colleton asks if anyone in his family had a drinking or drug problem. The man chuckles.

“Other than them not being able to get enough? No.”

He rambles off track, talking about his fear of the dogs that he says constantly attack him, the abductions, the dangers that haunt him.

He peppers his speech with “basically” this and “basically” that. Of his arrest, he says, “they kidnapped or abducted me and took me to what you call prison or jail, whereby which I am now at court.”

He hasn’t been hospitalized lately, he says, “except I went with a rotten tooth. They weren’t inclined to extract it, whereby which I left.”

Colleton asks about the liver-stealing.

“They thought they’d make money off it … When I’m in a jail cell, I can tell when someone’s sucking half my liver out.”

Colleton is usually at mental health court twice a week.

“I get a referral, either from the Crown or duty counsel or court support workers, saying here’s a potential candidate,” he says. “What I’m looking for is evidence of serious mental illness — some connection between illness and charges.

“An easy example would be someone with a known history of schizophrenia who goes off medication, becomes psychotic and threatens someone with violence. They might have been hospitalized after the arrest, treated and gone back to their normal self. If there’s no significant risk factor, that would be a clear case for diversion.

“It’s not generally that easy. There are other reasons for criminal acts. It might be substance-related or a drunk in a bar fight … that doesn’t cut it from my perspective.

“They may steal simply because they want money and it’s not connected with their condition. My job is to find the reasons.”

Under a diversion program, the person is supervised and given help with housing and any necessary medical, psychiatric, substance-abuse, financial or anger-management counselling.

If everything goes well, the charges can be withdrawn.

The Crown doesn’t have to accept Colleton’s assessment. But this, he says, can go both ways.

“There are times I’ll say, ‘This isn’t a good candidate’ and the Crown will say, ‘We’ll try it, anyway.’“

After a 45-minute interview, Colleton says the man is a reasonable candidate for intervention and the “concrete benefits” it could bring.

“I’m not a criminal,” the man insisted. “I would love to be able to work and live like a normal human … food in the fridge, clean clothing, not to be harassed.”

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