Chilliwack Law Courts. (Progress file)

OPINION: Number of people in jail with mental illness and substance use disorder on a sharp rise

SFU researcher finds that many offenders ‘are affected by acquired brain injury from toxic drugs’

If someone is suffering with a mental illness, how much should that factor into their sentencing when they commit a crime?

Ask a victim of crime and they might say, not that much.

Ask a mental health advocate and you’ll likely get a very different answer.

I wrote last month about the case of “Patricia,” a woman who exhibited clear signs of mental illness in B.C. Supreme Court, but was still convicted of arson after she lit her own belongings on fire in her unit inside a supporting housing complex in Chilliwack.

READ MORE: OPINION: Justice system ill-equipped to tackle mental health issues

READ MORE: Sprinklers limit fire damage in Chilliwack supportive housing complex

Not only did she not have a lawyer, but she declined a psychiatric assessment – she said psychiatrists “are no better than drug dealers” – something that would have served as a mitigating factor in sentencing.

You can’t force someone to have a lawyer any more than you can force someone to undergo a psychiatric evaluation.

“There are good reasons why people should be protected from non-consensual psychiatric assessments,” said Andrea Butler, a health sciences researcher at Simon Fraser University (SFU). “It sounds like this client really needed a support/advocate.”

And because she had no diagnosis, and no legal (or other) advocate in court, there was no evidentiary reason for the judge to factor mental illness into the sentencing.

“There is no specific causal relationship between her mental health and the offence,” Justice Kathleen Ker said at the June 9 sentencing hearing. The judge did say that it seemed Patricia was suffering from persecution complex as she blamed others for her predicaments.

“It’s probably safe to say that (Patricia’s) mental health had some role in the offence.”

But Patricia’s shifting remorse to feeling persecuted meant the blameworthiness was diluted. She was sentenced to two years less a day followed by three years probation.

While it is not uncommon in that it illustrated how unfit the system is to deal with mental health issues, it was different than the much more common case where mental illness overlaps with substance use disorders.

Butler from SFU has published a number of papers on this topic, which shows a sharp rise in recent years in the prevalence of people in B.C. prisons with both mental health and substance use (MHSU) disorders.

Butler’s study published late last year in the journal Psychiatric Services found people who suffer from both conditions made up 32 per cent of the prison population in 2017 up from 15 per cent in 2009.

“I think we have seen the continued erosion of a social safety net,” Butler said. “What the findings say is that there are major gaps and that the criminal justice system is at the bottom of the funnel, often where people end up after being failed by every other part of the system.”

Of particularly noteworthiness is the increased reported use of methamphetamines among those incarcerated, drugs that have unique associations with drug-induced psychosis and schizophrenia.

It’s not coincidental that people in prison increasingly suffer with MHSU. It’s at least partly correlative.

“I have not seen any evidence that the proportion of people with mental illness alone is increasing among people involved in the criminal justice system,” Butler told The Progress. “The drugs appear to be the driver. The population is becoming increasingly more complex – many people are affected by acquired brain injury from toxic drugs and brain hypoxia from unfatal overdose.”

And while incarceration is not a great place to get treatment for mental health issues, it can provide opportunities for assessments and interventions. But most of the cases we are talking about are individuals who commit low-level crimes over and over garnering short sentences that do not allow time for officials to give proper mental health assessments.

“Most custodial sentences are far too short to provide any meaningful MHSU intervention,” Butler said.

She added that we as a society have failed miserably in poverty reduction, particularly since the BC Liberals under Christy Clark sat on massive surplus while decimating social programming.

And while there are people listening with some trying to make changes, the overarching issue is systemic.

“Besides the issues I already discussed, we need to understand that our current criminal justice is not rehabilitative,” she said. “In fact, short prison sentences are actually criminogenic. We need to take a therapeutic approach that focuses on healing and as trauma experts have explained, rather than asking ‘what’s wrong with you?’ we should be asking ‘what happened to you?’


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