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Analysis


         The Shameful Way We Treat The Mentally Ill

                                           (Part 1)

 

By Susanna Kelley

One of the most important issues that Ontario and Canada should deal with in 2015 is the shameful way our society treats the mentally ill - or should I say, mistreats them.

A number of glaring examples come to mind from recent months.

(Full disclosure: While certainly no expert in mental health, I do volunteer as a trained facilitator of support groups for those suffering mental illnesses and their families at a mental health association. I also have taken courses in the handling of those suffering psychotic episodes and am trained in suicide intervention/prevention.)

 Jailing The Mentally Ill:

We often hear of the "stigma" that the mentally ill face: shunned by society, often also by family and former friends alike, their lives are commonly turned into lonely journeys of poverty, chaos and even homelessness. 

That is a terrible existence to condemn them to, and it is our policies on the mentally ill that are mostly to blame.

But it doesn't stop there. Their lives often get much worse than that.

Because in Canada, we jail our mentally ill at an alarming rate and it is getting higher.

One study said that in BC alone, nearly 32 per cent of federal prisoners had a mental illness, 12 per cent of them with a serious mood or psychotic disorder.

Think of that.

We actually, deliberately, take people who are ill, and throw them in prison rather than treat them in appropriate health facilities.

Now don't get me wrong here, there are some crimes committed, but they are usually very minor ones, and not usually crimes of violence.

For the mentally ill, the statistics show, are much more likely to be victims of violence than to perpetrate it themselves.

So we jail them for the minor crimes they commit - such as the substance abuse that comes from their desperate attempts to self-medicate, erasing their pain for a little while; petty theft that usually comes from not being able to hold a job; or being homeless and living on the streets, which comes from the fact we "deinstitutionalized" the mentally ill in the 1970's - turned them out of institutions to "live in the community" - but without building any housing for them, hence they often really live on the streets. And get sicker.

Then, when we put them in prison we give them almost no treatment: medication is hard to get and the right medication is even harder to ascertain.  Counselling is very difficult to come by.

Here's what the Canadian Mental Health Association said in 2009:

"Once incarcerated, people with mental illnesses receive sub-standard, or in some instances, little or no care and treatment because of clinical staff shortages and inadequate mental health facilities for the prison population."

The CBC obtained, through a Freedom of Information request, records about Millhaven Penitentiary’s basement area for mentally ill prisoners last year. Here's a taste:

" Records ... refer to the "chilling" image of a mentally ill offender in leg shackle restraints at the unit that holds prisoners with schizophrenia, major depression and other mental disorders transferred there after the closure of the Regional Treatment Centre in Kingston...”

The Correctional Investigator condemned the use of the unit, which pictures show "gross neglect of hygiene and maintenance" in the crowded basement unit.

So of course they don't get any better.

Rather, they just get worse.

Difficulty of Getting a NCR Verdict:

Luca Magnotta has been sentenced to jail for life rather than to a high security hospital for the criminally insane - despite the fact he had been diagnosed years ago as a schizophrenic and often went without medication.

One of the key issues in his recent trial was whether he was having a psychotic incident at the time he killed and dismembered Lin Jun.

Some have argued just because he was diagnosed years ago and meticulously planned the killing shows he wasn't necessarily having a psychotic incident at that actual moment.

Maybe.

But it seems logical that a perfectly sane person doesn't murder someone, dismember them and mail their body parts across the country.

And any doctor who treats the mentally ill will tell you psychosis without medication doesn't get better. Period.

Sufferers hear voices and see people and things that aren't there, are extremely paranoid, and often feel they are in extreme danger and must protect themselves by lashing out at an imagined evil enemy.

Magnotta is only one of many in Canada who has been denied a "Not Criminally Responsible" (NCR) verdict and won't receive the treatment they would get if sent to a high security hospital for the criminally insane.

It shouldn't be that way.

Over the years, with the right treatment, some of these people can learn to function as a normal person again. Not all, but some.

The excellent documentary "Out Of Mind, Out Of Sight," by award-winning film maker John Kastner, about criminal patients at the Brockville Mental Health Centre, is an even-handed look at those sent to the strict security hospital after an NCR verdict. Following real patients, doctors and nurses in the hospital, it shows the efforts, successes and failures of treatment for those who have committed dangerous crimes. Please watch it and judge for yourself.

The purpose of the justice system, after all, is supposed to be to rehabilitation.  (Punishment too, but surely we aren't really trying to punish the mentally ill?)

And after jail, they are more likely to re-offend.

The fact people deny the proof of this is mind-boggling. 

Overuse of Solitary Confinement: 

As noted, when a mentally ill person doesn't get treatment, they simply won't get well.

Furthermore, if they were not psychotic but still are schizophrenic or bipolar or even in a severe depression, stress, street drugs (readily available in jail) and the lack of treatment may well end up sending them into a psychotic state.

So what exactly is a psychotic state?

It is a break with reality characterized by paranoia, or hearing voices, or seeing things that aren't there.

It is caused by a brain chemistry imbalance.

In other words, it's as physical a disease as a heart attack, or Multiple Sclerosis, or diabetes.

With anti-psychotic medication (to balance the brain chemistry properly) and other treatment, psychosis usually goes away or can be kept under control. Without them, it will never get better.

So if these jailed, sick prisoners are not getting medication and counselling, that means more acting out.

Which often gets them put in solitary confinement.

Which makes them much worse.

At the very least, every mental health expert will tell you that one of the keys to getting well for one with a mental illness is social interaction.

Man is a social animal, and the mentally ill are no different than the rest of us this way. Isolate human beings for weeks, months and years and we usually become depressed and even unstable.

That's what happened to Ashley Smith, who killed herself - while prison guards watched and didn't intervene - after spending 162 consecutive days in solitary confinement.

Civilized countries consider this torture.

Prolonged isolation works against prisoners being rehabilitated, and makes the mentally ill even sicker. 

How does that help society, let alone them? They come out sicker than they went in.

But despite all the expert evidence to back that up, the Harper government refuses to rein in the overuse of solitary confinement.

Putting It In Perspective

Often when considering how fair or good our policies are, as a check against objectiveness, I ask myself "how would I view that if it happened in another country?"

When the world found out that dictator Nicolae Ceausescu had put Romania's mentally ill and disabled into crowded, dirty institutions where they were neglected and sexually abused, it was disgusted. 

Joseph Stalin sent the mentally ill to psychiatric hospitals or prisons for their entire lives.

Most Canadians would be appalled at such policies, and rightly so.

But a similar thing is happening right now, right here, right at home.

Imagine - Canada acting as badly as Nicolae Ceausescu or Joseph Stalin?

The first colonists in the United States thought the mentally ill were witches or possessed by demons and locked them up in asylums or worse, burned them at the stake.

We seem to have progressed just about one step past that.

At the very least, when it comes to the mentally ill, we should change the name from the justice system to the injustice system.


NEXT WEEK: NOT ENOUGH HELP ON THE OUTSIDE, EITHER



 

 

 

 

 

 

 

 

 

 

 

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About Susanna Kelley

Susanna Kelley is Editor-in-Chief and Queen’s Park Bureau Chief for Ontario News Watch. A veteran political and investigative reporter, documentary-maker, host and media commentator, Susanna oversees and has final editorial control over all news production at Ontario News Watch. Susanna has reported for the CBC, the Canadian Press and served as Queen’s Park Bureau Chief for TVOntario for 13 years. She has also hosted a number of documentaries for CBC’s The Current, CBC Radio News and TVOntario’s Studio 2. Passionately dedicated to excellence in political journalism, and having covered both Parliament Hill and Queen’s Park, Susanna believes quality political reporting is essential to a healthy democracy. You can find Susanna here: @susannakelley
Posted date : January 05, 2015

View all of Susanna Kelley's columns
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