1. Canada's thin blue line stretched mightily
GLOBE AND MAIL DATE: 2006.10.28
BYLINE: IAN SUTTON
SECTION: Focus
WORD COUNT: 1485
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Shrinks with badges and guns
Few police recruits sign up thinking they'll need the skills of a
psychiatrist,IAN SUTTON reports, but the persistent closing of
mental-health facilities has Canada's thin blue line stretched mightily
to cope with the onslaught
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Dennis is 22, weighs 400 pounds and suffers from a compulsive eating
disorder. Although described by a judge as having "borderline
intelligence" and by a psychologist as having "mild retardation," he has
been charged repeatedly with criminal offences ranging from stealing
food to sexual assault.
As a result, he has spent most of the past 18 years either living in a
group home or a psychiatric hospital, or being held in custody while
waiting to appear in court.
Yet, according to Heather Perkins-McVey, his Ottawa lawyer, Dennis
doesn't deserve to be behind bars -- even "his probation officer says he
shouldn't be in jail." But repeated attempts to find suitable housing
for him have failed -- as have attempts to have him declared unfit to
stand trial and not criminally responsible for his actions.
So Dennis remains one of the thousandsofCanadians suffering from a
psychiatric illness, mental disability or senile dementia who are
clogging the criminal-justice systemand stretching police resources to
the limit.
Anyone unaware of how badly things can go when police and psychiatric
patients cross paths need look no farther than news reports of the
long-awaited coroner's inquest into the controversial death of Otto
Vass. The mentally ill Toronto resident died six years ago during a
scuffle with police in a 7-Eleven store. Delayed by assault charges
against four arresting officers, the inquest began two weeks ago.
Coincidentally, about 200 municipal, provincial and federal police
officers are converging on Ottawa this weekend for Psychiatrists in
Blue, the fifth annual conference where they and mental-health experts
discuss howsuch conflicts can be handled better.
Launched by the Canadian Association of Chiefs of Police in 2002, the
gathering also shows how concerned the police are, now that coping with
troubled people has become such a factor for them. This aspect of their
workload has been growing since the 1960s and 1970s, when governments
began closing psychiatric hospitals and advocating "care in the
community." The initial closings were followed by a shutdown of
government-run centres for the developmentally disabled. In Ontario
alone, 14 have disappeared in the past 20 years,leaving just three --
housing fewer than 1,000 patients in Smiths Falls, Orillia and Blenheim,

2. near Chatham. They're to go in 2009.
Governments embraced care in the community because it was supposed to
save money, and many others heralded it as a move toward social
acceptance and respect for people with mental illness, according to a
report by the British Columbia division of the Canadian Mental Health
Association (CMHA).
But community support systems have yet to receive enough financing to
meet the increased load, and in Ontario, says provincial Conservative
Leader John Tory, all three major parties have failed to manage the
transition properly.
"You can't . . . replace one way of looking after people until you have
the supposed betterway of looking after them in place," he says."With
mental-health patients,I think we're still paying the price for it.
What we discovered was . . . sometimes they had no place to live, or
they were living by themselves 24 hours a day in squalid, unacceptable
circumstances." Critics have predicted all along that the closings would
leave the mentally ill living on the street and continually in trouble
with the law. Less anticipated were both the impact on policing --
officers were not properly trained and forces incurred huge cost
increases -- and the fact that many disabled people would end up behind
bars.
Manitoba is bucking the trend, spending $40-million to upgrade its
centre for developmentally disabled at Portage la Prairie, and pouring
$160-million into community living. But in the past decade alone, the
proportion of federal offenders "with significant, identified
mental-health needs" has more than doubled, according to the last two
annual reports by federal correctional investigator Howard Sapers, in
effect, Ottawa's ombudsman for prisoners.
"Unfortunately," he writes, "mental-health services offered by the
Correctional Services to these offenders have not kept up with the
dramatic increase in numbers." In an average year, Ms.Perkins-McVey
represents dozens of clients who have mental illnesses and are being
"warehoused" for weeks in jail awaiting trial. "There is a huge lack of
resources,and too many of the developmentally delayed fall through the
cracks," she says.
The overall cost, says Lisa Heslop, one of the researchers who produced
a University of Western Ontario report on policing and mental illness
last year, is impossible to pin down, but police in London, Ont., spent
about $2.2-million, or 4.3 per cent of their 2003 operating budget.
The Law Commission of Canada says the national cost of policing reached
$8.8-billion in 2004, so based on the London rate, which some consider
modest, the country spent no less than $380-million on policing related
to mental illness.
"It's a tremendous caseload," says Chief Terry McLaren of Peterborough,
president of the Ontario Association of Chiefs of Police.
When called to a scene, he says,officers must follow the provisions of
the Mental Health Act and often spend hours (in one case 12) waiting in

3. hospital for a psychiatrist's assessment.Not only is the cost in
manpower staggering,"from a police perspective,a lot of it's pretty
frustrating because they don't have the beds and facilities for them,
and they're being released right back into the community." And that can
lead to a worst-case scenario: the death of an offender.
The police who struggled with Otto Vass after he began to act strangely
in the convenience store were acquitted,but the CMHA report says, other
officers "have been traumatized by the police shooting deaths ofpersons
in mental-health crisis, deaths which might have been prevented if
officers had appropriate training." Part of the problem, says Dorothy
Cotton, a neuropsychologist with Correctional Service Canada in
Kingston, is the conflict between what police see as their
responsibility and that of mental-health professionals.Police protect
the public, she says."That's what they're all about. But it's not what
mental-health people are all about.We have a duty to the individual
client and the welfare of the client." Yet steps are being taken to
better equip officers: * Forces in Hamilton, Toronto and Vancouver now
have special response units -- police in cruisers with mental-health
workers.
* Reception centres are being identified where police can take people
suspected ofhaving a mental illness for assessment.
* Regional crisis-intervention teams are being formed to respond to
mental-health cases.
* Joint protocols are being struck by police and mental-health centres
or hospitals.
The agenda for this year's conference includes sessions on better
co-operation between police and mental-health workers, support the
police can provide to those with mental illness, as well as their
families, and the latest strategies used by forces in major U.S.
cities.
All of this is important because,according to Helen Ward, clinical
director of forensic services at Royal Ottawa Hospital, the need for
special care for the ill and disabled is bound to increase.
Police continually have to decide between taking people to a hospitalor
taking them to jail. They try hard to avoid the latter option, she says,
but "if there are a lot of repeat calls for the same individual, the
police start to lose faith that the psychiatric systemwill be able to
deal with it, and they start to lay charges, despite their better
judgment." At the same time, increased investment in programs to keep
those with mental illness from breaking the law -- almost $28-million a
year in Ontario -- has not started to produce the necessary results,
critics say.Court diversion programs, as well as mental-health courts
established in Toronto in 1999 and just this month in Ottawa, are
positive steps,they agree. But many mentally ill people still wind up
in custody.
In the end, compromise may be the best solution to the tug-of-war
between institutional care and care in the community.

4. In its recent report, Out of the Shadows at Last, the Senate's committee
on social affairs agreed with the World Health Organization and called
for a blend of institutional and community-based support and services.
"In this balanced-care model, the focus is on providing services in
normal community settings close to the population served,while hospital
stays are as brief as possible,promptly arranged and used only when
necessary," the report stated.
As the committee's chair, Senator Michael Kirby, points out, one in five
Canadians will suffer some form of mental illness in his or her
lifetime. Who knows how many of them will, like Dennis the compulsive
eater, run into problems with the law?
Ian Sutton is a freelance writer living in Perth, Ont.
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