Bill S-230 would require, under certain circumstances, that a detained person who has a disabling mental health issue, be transferred to a hospital, including a mental health facility. That’s one of the requirements. How should “disabling mental health issues” be defined for the purpose of Bill S-230?

It is a challenging issue to define what we mean by “disabling mental health.” I certainly know that the litigation dealing with the damages for administrative segregation — those class action lawsuits — are looking at serious mental health problems and the challenges of people with serious mental health issues being placed in administration segregation.

I know, for example, that the Mental Health Commission of Canada is developing a national action plan or call for action associated with the criminal justice system, so look to see if there’s some possible definition there that makes sense.

I think “disabling” is as good as any. I mean, if people are unable to function, they’re sufficiently disoriented or retreating and they can’t function, then that’s debilitating and probably does require some focused professional assistance.

It seems to me that regardless of how we land on that definition that it’s suggesting that people who are suffering from that level of mental health issues would need custodial hospitalization. I’m wondering if I’m right about that in most cases. What do you think would be the implications of that, both administrative and the infrastructure demands of that requirement?

You point out a very interesting element that in Canadian society generally, there is not sufficient mental health care for everyone who needs it. Frankly, I think there needs to be a lot more effort dedicated to dealing with mental health issues in the general population and for this particular population, which doesn’t get a lot of help.

I had the opportunity to interview some people who were in the mental health unit at Millhaven who had been subjected previously to administrative segregation, and it was probably the series of interviews that left me the most sleepless. It was very tragic and very unfortunate that people with those levels of mental health problems are being subjected to something that’s making it worse for them.

We have a challenge, but if you were going to allocate resources on the basis of need, these people are very needy. Some of them are extremely needy of the resources that are available.

Would I be right to suggest that this condition would also go hand-in-hand with the need for drug treatment, which is another infrastructure issue for this country?

That’s a good question. There’s no doubt that there are often dual diagnoses and there are new types of drugs that seem to promote more of a psychotic episode in people. I don’t know if it’s long-lasting or if it’s enduring; I think it probably is enduring. Yes, I think there is a real dual diagnosis challenge there with addiction and mental health.

Thank you very much.

The question I have in my head will work just as well for the second panel.

Maybe you can ask Senator Pate later. Senator Pate, you are the sponsor of the bill. I’m going to turn over the last set of questions to you.

Thank you very much. I wanted to pick up where Senator Busson left off. One of the questions raised by some who have spoken to us about the bill is that there are an awful lot of people to whom the mental health provisions in particular might apply. One of the reasons for that is the fact that the mental health system has not been able to keep up, and when they have not, the prison system has been used. Do you see that as a viable reason, either morally, legally or ethically to continue the practice of keeping people in prison?

Not at all. I think we had a problem with deinstitutionalization and the thought that the community resources were going to be adequate to deal with the people who are no longer being subjected to custodial for mental health issues. The community was not able to keep up. The resources are just not there. So, no, I think there needs to be more resources, particularly community-based mental health services.

You pointed out, and I’m happy to have the other witnesses also join in on this, but you pointed out that when Minister Goodale was considering this bill, there was a significant allocation. In fact, there was a special application to the government to have a Royal Recommendation for funding for mental health services. The understanding was it was to contract services through existing exchange of service agreements with provinces and territories to have additional mental health beds. To your knowledge, has any of that happened?

I would say, not. I know they already had beds with Pinel institute. They used to have beds with Brockville, and I think they lost those beds. If anything, I think they’re heading in the wrong direction. Ms. Kish might know better than I do whether there are prisoners being transferred into beds.

Ms. Kish and Ms. Mitchell, would you like to contribute on this, if you have a view or insight?

I mean, not to any greater extent than there was, the very limited beds at the psychiatric centres.

What works, and speaking to the burden and the infrastructure, I know of three treatment centres in B.C. — and all addictions treatment centres respond to mental health because they are conflating in our experience — where federally incarcerated people are successfully transferred into treatment centres in the community from a custodial perspective and quite differently from the regional psychiatric centres. They are community-based and care-based, and the results are wonderful. So I recommend looking into what’s working and then building from there.

Thank you. Anything from you, Ms. Mitchell?

I have nothing to add. Ms. Latimer and Ms. Kish spoke well on this point.

The types of mental health beds that you just spoke about, Ms. Kish, those are accessed through treatment orders as part of the conditional release provisions. Is that correct?

Sometimes on condition of release, sometimes earlier. At the Fraser Valley institution, the penitentiary for women, there were two treatment facilities that were accepting people with certain criteria prior to day parole. I’m not sure if this is being done through the sections that this bill addresses.

In either event, we see when individuals are placed in conditions which cause them harm they deteriorate, and when individuals are placed in conditions which support them, we’re seeing these individuals successfully navigate treatment and have productive and fulfilling lives; whereas people who are experiencing these structured intervention units are irreparably harmed.