Advocates call for more mental health courts in New Brunswick

Some people who have been advocating for the establishment of more mental health courts in New Brunswick are wondering what the holdup is.

"I think it's a lack of goodwill," said Paul Ouellet, who started lobbying for mental health courts in 2015, after his sister, who was suffering from acute chronic schizophrenia, was arrested and brought up on charges of assaulting a nurse.

She was led into a Moncton court in shackles.

"She was in a psychosis," said Ouellet, a retired accountant.

His sister was sent back to hospital and charges were withdrawn, but Ouellet began a quest for a more appropriate kind of judicial process for his sister and others like her.

Government seems 'reluctant': former ombud

Bernard Richard, the former ombud and child and youth advocate, is another proponent of mental health courts.

They can reduce harm, prevent the need for more costly interventions down the road and address problematic behaviour having an impact in communities all over the province, he said. 

The courts would, however, require up-front investment in things such as housing and community treatment programs, said Richard.

The onetime Liberal leader says the politics of that may be what's delaying rollout to other regions.

"It does seem that the current government is reluctant to invest in social services," he said.

"Certainly, they've indicated that they're committed to it. So … I can't understand why it's not moving ahead faster."

Courts a proven commodity

Saint John first got a mental health court in 2000. 

Mary-Ann Campbell, a professor of clinical psychology and criminal justice at the University of New Brunswick in Saint John, has studied the court, as well as a similar body in Nova Scotia.

What these courts do well, she said, is hold people accountable, while also making sure they're being hooked into the right services.

"They do have value and certainly are a better process to use than [to] have people cycle in and out of the criminal justice system because their needs aren't being met," she said.

Campbell supports the expansion of mental health courts to Moncton and Fredericton because these cities likely have the professionals and service infrastructure to support them.

In smaller communities, "it gets trickier," she said.

The people and resources all have to be in place before it can start operating, said Campbell.

That includes a judge who is sensitized to mental health issues, lawyers, psychologists, psychiatrists, mental health nurses, social workers and other case workers.

How it generally works, said Campbell, is people get referred from regular court when a judge or lawyer raises the possible involvement of mental illness in the crime.

The mental health court team reviews the case to see if it meets criteria for admission. 

There has to be a perceived connection between the mental illness and the criminal offence, said Campbell.

It's not used if the person's illness is so severe that they shouldn't be held accountable. And it's not used if the crime is serious enough — such as murder or a serious sexual offence —  to warrant a federal sentence.

In the Saint John model, the person pleads guilty, but their sentence can be reduced depending on how they make out in the program. 

It's possible a person in mental health court can still end up being sentenced to jail time, but the goal is to have them comply with conditions and remain in the community, said Campbell.

The conditions may include participating in treatment or accessing various other services to support things such as education, mental health recovery, housing and financial stability.

The program usually lasts about a year. Every so often during that period, the person meets with the judge and caseworkers to review progress. Conditions may be relaxed or strengthened, depending on how the person has been doing.

Campbell said when she studied the Saint John program, most participants completed it successfully and their risk of reoffending declined.

Re-arrest rates were similar to those in the regular Canadian justice system when a person is given a sentence to be served in the community and put on probation, she said.

Participants also had less need of hospital emergency rooms or mobile crisis services, she said.

Mental illness usually isn't the main issue behind criminal behaviour, said Campbell.

It has more to do with other risk factors such as substance use, "pro-criminal thinking," or hanging around with the wrong crowd, she said.

Difference "day and night"

Those who went through the Saint John mental health court felt everyone involved had their interests at heart and was trying to help them get their life on track, said Campbell.

They described traditional court as more adversarial and intimidating.

When the Saint John mental health court started again after a lapse from 2013 to 2017, Ouellet sat in on a session. 

The judge showed compassion, he said, and spoke to each offender as he would to a brother or dear friend, asking about the situation and possible ways to help.

The difference is "like day and night," said Ouellet.

Ouellet has lobbied a few different provincial justice ministers over the years, of different political stripes.

They've all been receptive, he said, and more than one told him more mental health courts would indeed be established.

But he's beginning to wonder if they were only making hollow promises.

Need is urgent

Ouellet was expecting an announcement about a new mental health court in Moncton in the spring of 2022.

Nothing materialized and he got no response to letters he wrote in August and September asking for an update.

He's still hoping something may be announced in the next couple of months.

The need is urgent and greater than ever, said Ouellet. 

Sending people who are mentally ill to regular court is "a complete disgrace," he said.

"What are we gaining by sending someone to the penitentiary?"

Asked for a status report on getting a mental health court in Moncton, the Department of Justice did not reveal any solid plans, but offered qualified support for the concept.

"Mental health courts and drug courts work when treatment spaces and secure housing are immediately available to new clients," the department said in an email.

The statement said the department is looking at ways to deal more effectively with people whose criminal offences are driven by mental illness or addiction and is working with the departments of Health and Social Development to investigate all options.

Justice Minister Ted Flemming is responsible for this file and was unavailable for an interview, the statement said.