Mental Health Courts: Processes, Outcomes and Impact on Homelessness

The Mental Health Commission of Canada released its first Canadian mental health strategy in 2012. In their report, Changing Directions, Changing Lives: The Mental Health Strategy for Canada, is the alarming finding that people with mental health problems are over-represented in the justice and corrections systems, and that this trend appears to be on the rise. One of the major recommendations is to increase the availability of programs to divert people with mental health issues from the corrections system, specifically by increasing the usage and availability of mental health courts. Diversion programs (including mental health courts (MHC) and restorative justice programs) were cited as measures to redirect people with mental health problems implicated in the criminal justice system by providing access to needed services, treatments and supports.

The purpose of this study was to explore such a court by examining the processes and effects of a Mental Health Court (the Programme d'accompagnement Justice - Santé mentale (PAJ-SM)), situated at Montreal’s municipal court. In particular, the aim was to study its impact on preventing and reducing homelessness. While mental health courts continue to proliferate, relatively little is known about their points of entry, the nature and scope of judiciary intervention, interprofessional and intersectoral collaboration, the experiences of participants and key actors, and whether such forms of intervention enhance users’ quality of life, including whether they have an impact homelessness (chronic, acute, or preventative). This project attempted to respond to these knowledge gaps and examine the effects for those who are homeless or at-risk of homelessness and gather evidence for a ‘promising practices’ approach.

From February, 2013, until March, 2014, the research team deployed a multi-method project utilizing semi-structured interviews with twenty participants and eleven key informants of the multiprofessional team operating at the MHC. In addition, over 125 hours of participant observation took place, observing: team meetings, courtroom proceedings and shadowing individual team members. Quantitatively, data was also collected from 100 court files during the years 2008 (the inception of the MHC) to 2012 to dress the socio-demographic, judiciary and mental health paths of the accused. As will be demonstrated in the pages to come, homeless people are overrepresented in the MHC and tend to have burdensome judicial and mental health histories, making this population difficult and complex to serve in a fast-paced and rigid environment that is frequently under-resourced. Moreover, in over half of all the cases processed, charges are withdrawn or dropped or a verdict of not-criminally responsible is found. Thus, 52% of cases are not criminalized, begging the question as to what the purpose of judiciarizing mentally ill accused serves. It is hoped that this study will address the paucity of Canadian scholarship on MHCs.

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