Tag Archives: Ontario Ombudsman

The Mentally Ill in Prison – A Reply to the Centre For Addiction and Mental Health

newer meBy Marvin Ross

The chief of forensic psychiatry at Toronto’s Centre for Addiction and Mental Health (CAMH) , Dr Sandy Simpson, gave his explanation as to why so many people with mental illness are in the correctional system in a blog earlier in December. I learned of it because a number of people contacted me upset by what he had to say.

He gave three main reasons for this phenomenon which you can read for yourselves. His first reason is the one that people found the most upsetting as he claims that “broken families, poverty, substance abuse in the home, physical and emotional abuse experience” are “problems that increase the risk of suffering a serious mental illness. Therefore people with problems of criminal behaviour may well also have problems of mental illness, but the illness is not the cause of their criminality.”

This sounded like family blaming to those who contacted me and it does. I asked him on Twitter if he was suggesting that mental illness is caused by bad families? And I added, “Your point 1. MI in jail because of lack of services and beds”. His Twitter reply was “Agreed to last point esp in US. Family one of many relevant factors for crime generally Family problems often social context driven”. I then asked if he thought that serious mental illnesses were caused by families and he replied “no” but he did not reply to my tweet that his blog could be taken the wrong way.

His suggestion that the lack of beds might be a problem but that it is worse in the US is an interesting comment. That may be the case but so what? Is our negligence mitigated because someone else might be even more negligent? Imagine an accused murderer saying to the judge, “but your honour, I only murdered one person. Joe Blow murdered three people”.

Now Doc Simpson works at CAMH and CAMH is notorious in my mind for refusing a court order to treat a mentally ill patient. In fact, they won a legal battle that prevents judges from ordering mentally ill offenders to be taken to a hospital for treatment. In 2010, Toronto judge Mary Hogan, was faced with a schizophrenic defendant before her on a minor offence. She ordered CAMH to stabilize him as she knew that the standard policy was that these individuals were rerouted to jail rather than hospital.

CAMH left him in the hall because they had no beds and initiated legal proceedings to prevent such orders. They won. Can anyone imagine refusing treatment to someone injured in a traumatic car crash because the hospital is busy? It would not happen.

Lack of adequate mental health services and beds is the main reason that so many with mental illness are in jail. According to a thesis submitted in 2011 to the University of Manitoba by Richard Mahé, it has been known since the 1970’s that the lack of community resources resulted in the criminal justice system replacing the psychiatric hospital. The Canadian Institute for Health Information reported that the shortage of psychiatric hospital beds is resulting in people being squeezed out of hospital too early.

This closing of beds was decried by the Schizophrenia Society of Canada. And the Public Health Agency of Canada pointed out that “the rise in the proportion of prison inmates with mental illness suggests that some have exchanged the psychiatric ward for the prison ward.”

Howard Sapers, the investigator for Corrections Canada, told the Tyee that “We’ve seen a big increase in the number of men and women being sent to federal penitentiaries with a mental health issue and many of them end up with diagnosed mental illnesses such as schizophrenia.” And, he added, it is difficult to even find qualified staff willing to work in the prison system.

In fact, a state of the art infirmary and 26 bed mental health unit in the Toronto South Detention Centre has never opened due to a staff shortage. Inmates are being held in solitary confinement instead. Andre Morin, Ontario’s Ombudsman, has threatened to intervene if the situation is not rectified.

So, Dr Simpson, there is a lot to talk about on the subject of mentally ill in jail that is a lot more crucial than speculating on the adequacy of families. And we have a lot of work to do to rectify that sad reality.