Evidence of meeting #42 for Public Safety and National Security in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was ottawa.
A recording is available from Parliament.
11:10 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
I'd like to bring this meeting to order.
This is the Standing Committee on Public Safety and National Security, meeting number 42. We are being televised, and we have a large number of witnesses. We're going to allow them some time to make introductory comments.
From the Rideauwood Addiction and Family Services Centre, we have Mr. James Budd, the Senior Director of Corporate Services.
On a point of order.
11:10 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
On a point of order, Mr. Chair, could I ask the other individuals who are in the room to vacate the room so we can continue with the meeting?
11:10 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Okay, all cameras have to be turned off except for the ones that have permission to be on here, please.
11:10 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
Also, could the people who are having other meetings move outside?
11:10 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Okay, we'll continue with our meeting.
We have, from the Department of Justice, Mrs. Margaret Trottier, a Senior Analyst with the Drug Treatment Court Funding Program. We'll probably start with her presentation. We also have, from the Royal Ottawa Health Care Group, Dr. Helen Ward, the Clinical Director and Forensic Services Champlain. From the Ontario Court of Justice, we will have the Honourable Madam Justice Heather E. Perkins-McVey. She's not at the table yet. From the Ministry of the Attorney General of Ontario, we have Mr. David Moffat, Crown Attorney. From the Edmonton Drug Treatment and Community Restoration Court, we have Mr. Doug Brady, the Director.
I understand that the Honourable Madam Justice Heather Perkins-McVey is not here yet.
We have quite a long agenda today, so I will ask if Ms. Margaret Trottier is ready to begin with her presentation.
Please go ahead, Madam.
11:10 a.m.
Margaret Trottier Senior Analyst, Drug Treatment Court Funding Program, Department of Justice
Thank you.
My name is Margaret Trottier, and I'm a Senior Policy Analyst with the Policy Implementation Directorate of Programs Branch within the Department of Justice. I am responsible for the drug treatment court funding program.
In recognition of the link between drug use and crime, the drug treatment court funding program was established in 2005. It is a policy partnership between the Department of Justice and Health Canada that enables federal Justice and Health officials to test horizontal approaches to addressing the challenges created by drug-addicted offenders in the criminal justice system.
The objectives of the drug treatment court funding program are to promote and strengthen the use of alternatives to incarceration for drug-addicted offenders; to build knowledge and awareness among criminal justice, health, and social service practitioners and the general public about drug treatment courts; and to collect information and data on the effectiveness of drug treatment courts so that we can promote best practices.
As a component of the national anti-drug strategy treatment action plan, the drug treatment court funding program supports six drug treatment court pilots across Canada. They are in Toronto, Vancouver, Edmonton, Winnipeg, Ottawa, and Regina. The annual budget is $3.6 million.
Drug treatment courts operate within the criminal justice system. They combine judicial supervision with substance abuse treatment in a concerted effort to break the cycle of drug use and criminal recidivism for repeat offenders whose crimes are motivated by drug addiction.
Persons with drug charges are not automatically referred to a drug court. Drug treatment courts, for example, will not accept the violent accused or persons who are involved in commercial drug trafficking. If the accused have used a young person under the age of 18 in the commission of the offence, or if they are charged with a residential break and enter, they do not qualify to enter a drug treatment court.
Participation in the drug treatment court program includes court attendance up to twice a week, random and frequent drug testing, and attendance in a treatment program. Attendance at court on a regular basis allows the participant to inform the court of his or her progress and allows the court to reward compliance, sanction non-compliance, or impose new conditions or interventions to help the participants break the cycle of crime and addiction.
Drug treatment court clients continue to participate in the program, typically for more than a year, until they meet the criteria for graduation. To graduate, they must achieve a prescribed period of abstinence from drugs while abiding by all conditions and establishing stability in the community.
Not all DTC participants graduate. Some will be terminated from the program for incurring new charges, for being dishonest with the court, for repeatedly not complying with conditions, or for failing to attend treatment. Drug treatment courts aim to reduce the harm people cause to themselves and others through their drug use and to reduce the risk that these individuals will continue to use drugs and thereby continue to come into conflict with the criminal justice system.
The pilot sites supported by the drug treatment court funding program require strong collaboration between legal and treatment professionals at the local level. The drug treatment court funding program does not specify a model for the pilot sites to follow. As a result, each pilot site has its own unique characteristics that take into account the needs of the offender population in that particular city.
As mentioned, another objective of the drug treatment court funding program is to provide the opportunity to build knowledge and awareness among stakeholders and the general population about drug treatment courts. Efforts in this regard have included support to the Canadian Association of Drug Treatment Court Professionals for national conferences in 2006 and 2008, as well as round table events in 2007 and 2009. We also support an electronic bulletin board that facilitates exchange of best practices and lessons learned among drug treatment courts in Canada.
Finally, we are focusing efforts on national data collection as we implement the summative evaluation recommendations. As part of ongoing program management, Justice Canada is committed to further review and evaluation as we determine the effectiveness of this innovative approach to dealing with drug addicted offenders in the criminal justice system.
As the majority of pilot sites have been operating for fewer than four years, it's not possible at this time, based on the data available, to determine if drug treatment courts are the most appropriate criminal justice intervention for drug addicted offenders or if they are the most efficient or cost-effective way of dealing with substance abuse issues in the criminal justice system.
The Minister of Justice has recently announced that the drug treatment court funding program will continue to provide funding support until March 31, 2012, to the existing six drug treatment court pilot sites, in an effort to continue to study the effectiveness of DTCs in Canada.
That concludes my opening remarks on the drug treatment court funding program. I'd be happy to answer any questions.
11:15 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you very much.
We'll go through all the presentations first before we open it up for questions and comments.
I believe Mr. Doug Brady will be the next presenter. Any time you're ready, sir, go ahead.
11:15 a.m.
Doug Brady Director, Edmonton Drug Treatment and Community Restoration Court
Thank you.
My name is Doug Brady and I am the Executive Director of the Edmonton Drug Treatment and Community Restoration Court, as we are called, and also the Interim National Director for the Canadian Association of Drug Treatment Court Professionals.
The Canadian Association of Drug Treatment Court Professionals is a recently incorporated organization dedicated to the development and sustainability of drug treatment courts in Canada, and it demonstrates this effectiveness through a comprehensive and consistent national evaluation. I'm going to tell you a little bit about the organization, or the origin of drug courts.
The first drug court began in Dade County, Miami, in 1989 as a result of drug addicts repeatedly coming before the court system—also known as a revolving door system—and overburdening the jail system. What they found was that under the traditional court system, drug addicts continued to commit crime and never adequately dealt with their drug addiction. Traditional treatment, court, and correctional methods did not show success. They found a solution by combining drug treatment with the structure and authority of a judge. Working as a team, they were able to effect lasting change in the lifestyle and behaviour of drug court participants.
Since 1989 drug courts have grown in the U.S. to over 2,369—that's as of October 2009—of which over 1,250 are adult drug courts. In 2009 President Obama increased funding to the U.S. drug courts by 250%, and he is allocating $103 million in the coming year. This was preceded by a 50% increase the year before by the Bush administration.
The first drug treatment court outside the United States began in December 1998 in Toronto, and since then more than 27 programs have been implemented in 10 countries worldwide. Apart from the six federally funded drug treatment courts, there are three other drug treatment courts that operate independently, and they have their funding from various sources. That would include Durham, Calgary, and Moose Jaw, which has one person in their program at the present time.
Drug treatment courts operate under what is called therapeutic justice. It is a program that provides intensive treatment and services for participants who need to get and remain clean and sober. We regularly randomly test for drug use, often once a week, or more times depending on the person's need. We hold each participant accountable by the drug treatment court judge for meeting their obligations to the court, society, themselves, and their families. It requires participants to appear in court frequently so that the judge may review their progress, and it rewards participants for doing well or sanctions them when they do not live up to their obligations.
How effective are drug treatment courts? Only 11.6% of those who complete the drug treatment court program run into trouble again with the law. That's a Canadian statistic from the UN Office on Drugs and Crime. Break-even analysis showed that to provide a net economic benefit to the wider society, only 8% of offenders seen by the courts would need to stop taking drugs for five years or more following the completion of their sentence, and only 14% in order to provide a net economic benefit to the criminal justice system. Many of our statistics come from the U.S. because they've been operating now for over 20 years. So when I'm quoting some statistics from here on in, it will be from the U.S. statistics. They have learned how drug courts work and they're constantly reviving their programs and making sure they get the best information out there.
In February 2005 the Government Accountability Office issued its third report on the effects of adult criminal drug courts. Although upfront costs for drug courts were generally higher than for probation, drug courts were found to be more cost-effective in the long run because they avoided law enforcement efforts, judicial case processing, and victimization resulting from future criminal activity. In Canada, those who participate in drug treatment courts would not be eligible for probation as a court disposition. The same extensive review of drug courts concluded that adult drug court programs substantially reduce crime by lowering rearrest and conviction rates among drug court graduates well after program completion.
In recent years researchers have continued to uncover definitive evidence for both the efficacy and cost-effectiveness of drug courts. The most rigorous and conservative estimate of the effect of any program is derived from meta-analysis in which scientists statistically average the effects of the program over numerous research studies. Four independent meta-analyses have now concluded that drug courts significantly reduce crime rates on an average of approximately seven to fourteen percentage points. In some evaluations, the effects on crime were as high as 35 percentage points.
Importantly, the effects were greatest for high-risk offenders who had more severe criminal histories and drug problems. This suggests that drug courts may be best suited for the most incorrigible and drug-addicted offenders who cannot be safely or effectively managed in the community or on standard probation. Some of the statistics from Canada include that 50% to 60% of the crime is done by 15% of the offenders.
One of the facts from the National Association of Drug Court Professionals is that unless drug-addicted offenders are regularly supervised by a judge and held accountable, 70% drop out of treatment prematurely. Drug courts are six times more likely to keep offenders on treatment long enough for them to get better. For every $1 invested in drug courts, taxpayers save as much as $3.36 in avoided criminal justice costs alone. When considering other cost offsets, such as savings from reduced victimization and health care service utilization, studies have shown benefits up to $12 for every $1 invested. Drug courts produce cost savings ranging from $4,000 to $12,000 per client. These cost savings reflect reduced prison costs, reduced revolving-door arrests and trials, and reduced victimization.
For methamphetamine-addicted people, drug courts increase treatment program graduation rates by nearly 80%. When compared to eight other programs, drug courts quadrupled the number in terms of abstinence from methamphetamine. Drug courts reduce methamphetamine use by more than 50% compared to outpatient treatment alone.
That's my presentation. I will be open to questions.
11:25 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you very much.
Who would like to present next? Go ahead, Mr. Budd.
11:25 a.m.
James Budd Senior Director, Corporate Services, Rideauwood Addiction and Family Services
Madames et monsieurs, honourable members, I'm very pleased to be able to address this committee on behalf of the Ottawa Drug Treatment Court. My name is James Budd, and I'm a Senior Director with Rideauwood Addiction and Family Services, which provides the treatment to the Ottawa Drug Treatment Court.
We offer a very unusual program in drug treatment courts. It's a unique feature not only within the treatment world but within the corrections world. Treatment is very intensive and very regular. Participants in the Ottawa Drug Treatment Court attend the treatment centre on a daily basis. They appear in court at least once a week, and at the beginning they appear twice a week before the judge.
They are held accountable for any problems they may have had in terms of their participation or attendance or other issues in the community, but they are also rewarded and encouraged for their successes in the program. The interaction with the judge is really a key feature of drug treatment courts. They literally have a chat with the judge every week and talk about how they're doing. It helps to forge a whole new relationship with the criminal justice system. They start to see the courts as helpers instead of punishers.
I'm going to keep my comments very brief, because I suspect that you'll have a fair number of questions for us. So perhaps I'll leave it at that.
11:25 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you.
Who would like to present next, Ms. Ward or Mr. Moffat?
Okay, we'll have Mr. Moffat and then Ms. Ward.
Go ahead, sir.
11:25 a.m.
David Moffat Assistant Crown Attorney, Ministry of the Attorney General, Government of Ontario
I just want to take the time to say thank you.
I want to correct that I'm an Assistant Crown Attorney, not a Crown Attorney, and I'm a prosecutor. My niece has asked me what I do for a living, and I say that I put people in jail. I have six years of experience. I started in the United States, in Colorado, a state known for its mandatory minimums and stiff penalties, and I'm here if you have any questions about drug treatment courts.
I am the provincial crown attorney in the Ottawa drug treatment program, and I'm here to tell you that it works.
Thank you.
11:25 a.m.
Dr. Helen Ward Clinical Director, Forensic Services Champlain, Royal Ottawa Health Care Group
Thank you.
My name is Dr. Helen Ward. I'm a psychiatrist. I'm in charge of the forensic program at the Royal Ottawa Mental Health Centre, which is the local psychiatric facility. I'm also a member of the Ottawa Mental Health Court organizing committee and I'm here to talk to you about mental health courts. I think I'm the only one to speak about this issue today.
Essentially, mental health courts came along subsequent to drug treatment courts when it was realized that problem-solving courts had a role to play and that mental health could also be addressed in this manner. We're a little further behind in terms of outcomes and structure.
They started in the United States. The first mental health court in Canada started in Toronto. In the last three to four years there's been a profusion of mental health courts erupting across the country in pretty much every city, and in some sense, quite small centres have started to get involved with mental health.
The reason for this is that there has become a recognition of the criminalization of the mentally ill and of the Penrose effect. You're probably familiar with the idea that there has really been a trans-institutionalization. Back in the 1950s we had all these psychiatric beds and now we have all these correctional beds. As the psychiatric beds have gone down, the correctional beds have gone up, and the same numbers of the mentally ill are institutionalized, just in the wrong place.
The idea behind mental health courts is to try to address some of these issues. Particularly, mental health courts should recognize that, but for the person's mental health condition, they wouldn't have come to the criminal justice system in the first place. That's the kind of person we're trying to treat at a mental health court. We're not trying to capture every criminal who claims a mental illness, but we are trying to capture people whose mental illness was in some way a strong contributor to their being in trouble at all.
One of the ways this is done is by diversion, and that's one of the purposes of mental health courts. As we've gone along, we've come to recognize that the crowns' offices and the courts are pretty good at diversion on their own. They've been doing diversion for a long time.
Shoplifters who might have a depression don't need a mental health court for the most part, but there are more serious cases and more serious offences where mental health has been involved, where the Criminal Code in terms of a section 16 or a not criminally responsible offence doesn't apply, or a fitness to stand trial issue doesn't apply, but there's still a serious mental illness that needs to be addressed. These people may well not be eligible for diversion because they may have committed a level two offence. They're not going to necessarily end up with a stay of their charges or anything like that; there's going to be some penalty, but there can be an improved outcome if they are connected with mental health services.
One of the big purposes is to connect people with mental health services. It's a real patchwork out there. There's some improvement, but it's very difficult for the mentally ill and the families of the mentally ill to get access to the services they need in the civil psychiatric system. They often end up in this funnel called a mental health court.
Another thing that's important to consider, especially for the seriously mentally ill, is that they may not have much of an idea about why they're in court at all. They may not have much of an idea about how the whole thing works and they can often be highly intimidated. They often come across defence attorneys who really don't have a good sense of how to communicate with them, or may not understand their problems, or may not understand the questions to ask them about their problems. All of this plays a role in how they're treated by the court.
As you probably know, people with a mental illness who are convicted for an offence end up serving more time than people without a mental illness convicted for the same offence. This is probably for a few reasons. One of them is that the seriously mentally ill may not have supports. Another is that when they're in jail they may end up with poor institutional behaviour that ends up with their having the maximum sentence or being re-sentenced.
Because there isn't really as big a movement yet with mental health courts, and because it's not as clearly a federal matter as the drug treatment courts, there's been a real diversity in what has sprung up across the country in terms of mental health courts. They tend to come up quite informally.
For example, in Ottawa we started our mental health court without any additional funding. We basically focused our resources. We took some resources that had been provided to the hospital to provide outreach clinics, and we started running an outreach clinic at the courthouse. The Canadian Mental Health Association had been paid by the province to put in outreach workers, and we kind of expanded the role of that intake worker. The crown attorney assigned a particular assistant crown attorney to the mental health court. So we all basically pooled our resources and put them together in one court, but with no extra money. That's fairly common across the country. People just saw there was a need and started to do it.
In Toronto the model they run uses a lot of bail appearances, similar to what you've heard about drug treatment courts, where the accused appears in front of the judge very frequently, and there are court support workers based at the courthouse. For those people, they did get extra funding in order to help those people access resources in the community. That's the model they use.
In New Brunswick there's a model in which they set up a program and the person signs on. They follow this program, and at the end of the program they get X, Y, or Z outcome. That's similar to one of the very interesting courts--even though it's outside Canada--the Brooklyn Mental Health Court, which is a felony mental health court. This is a court that offers people with a mental health condition who have committed a very serious offence a placement and treatment for their mental health, rather than jail. That's the kind of thing we want to try to offer here when we can.
In Ottawa, we very much run a court that is intentionally quite flexible. You don't have a lot of requirements to sign on. It set the requirement that there has to be a mental health condition and that the mental health condition has contributed substantially to the offence, and you have to have some willingness to participate in some treatment. We basically take it from there. We try to engage people in treatment. Then we have special pretrials, where people from all kinds of mental health agencies participate with the attorneys in deciding on the legal outcome. It may end up being a section 810 or peace bond, but it also may end up being a conditional sentence served in their home, and further probation, but this is less than what they would have gotten otherwise.
When we're looking at what makes up a mental health court--there are some good documents out there, so I won't try to go through the whole thing--I would say you really do need people who are specialized. You have to have teams that have some familiarity and get some training, so crown attorneys, and ideally legal aid, duty counsel, should have special training. You want to make training available across the board. You really need to have the treatment people engaged in the court. As I said, we run a clinic at the courthouse. People can see me and my team and start to get treatment from the courthouse. You need to have a judiciary that are willing to consider these issues as well, of course, and are educated.
Funding is pretty important. You don't need a lot of funding, though. As I've shown, you can do a lot with pretty much no extra funding, but very small amounts of funding in terms of coordinators would really make a big difference across the country.
Concerning outcomes, what we know about mental health court outcomes is less than with drug treatment courts, and basically what we know comes from the States. Justice Schneider, who runs the Toronto Mental Health Court, wrote a book on mental health courts that came out last year. In that book he said there aren't good outcomes yet, particularly from Canada, and I would concur. But there is some good preliminary information from the United States that shows that if you compare people's interaction with the criminal justice system in the year before they went into the mental health court with the year after, you'll see that it reduces their arrest rate by four times, which is a significant improvement. It also would show that people who complete the program are much less likely to recidivate than people who did not complete the program.
There are also, of course, mental health outcomes you can measure. It's quite clear from our court that there are improved mental health outcomes. People get better. They stay well. They get into treatment. They get into housing, which is often a very important component. And these people are much less likely to end up in the mental health system, which is even more expensive. If they end up in an in-patient bed, it's even more expensive than ending up in corrections.
It is not clear yet whether there are financial benefits. One of the things you have to consider is that you are taking people from a corrections system and potentially shifting them to a mental health system, and of course, both of those are still state-funded. Really, it is about making sure people are getting the right treatment, and if people get the right treatment and get established on treatment, then they're going to stay well and stay out of hospital. Of course, we're a provincially operated treatment system, so it makes it difficult, but in my opinion, there should be better community treatment provisions in place, in terms of legal provisions, to treat the seriously mentally ill. This would help to make the Mental Health Court successful.
Finally, what are the challenges? You have to have buy-in. You have to have buy-in from the crown. You have to have buy-in from defence counsel. Defence counsel will often shy away from the mental health court because they can make pretty good deals on the side with a crown attorney in another court. So they don't always take people through a mental health court if they think it won't be of use.
My colleagues aren't always pleased with me for going to mental health court. They think I'm case-finding and bringing them more business. And you know what? I might be, but it's business they should be dealing with anyway. It does put pressure on these people when my patients, whom I've picked up in mental health court, show up in their emergency rooms and are now connected with people who are advocating for them. It makes a difference in who gets treated.
Those are my comments. I can answer any questions later.
11:35 a.m.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you, Dr. Ward.
That brings an end to our presentations, and we will begin with questions and comments from the Liberal Party.
Mr. Holland.
11:35 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
Thank you, Mr. Chair, and my thanks to the witnesses. That was very informative.
Mr. Brady, you talked about the efficacy of the drug treatment courts, but there are a couple of things I wanted to know.
First, you reference the cases in which these courts are most effective, cases in which there's a persistent problem or nothing else seems to be working. We have a limited number of drug treatment courts. How many more should we have to fill present needs? What's the unmet demand, in your estimation?
11:40 a.m.
Director, Edmonton Drug Treatment and Community Restoration Court
I can speak for the Edmonton drug court, but it is a little different. We're the only court in Canada that brokers out treatment. We rely on the treatment providers in the communities to provide the treatment for us. There is a real problem in finding treatment space. Right now we have 24 people in our program. We have 22 people on a waiting list. They're waiting in custody, trying to get treatment beds, housing in some cases. I think housing is a major concern across Canada. Those are some of the challenges we face.
11:40 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
I'd like to hear about some of the additional challenges you're facing. We know that some 80% of inmates are facing addiction issues, and we know that one of the problems is the continuity of care. People who turn down a dark path and commit a crime generally experience a lack of access to community resources. Then, after they come out of the system, they have trouble re-establishing contact with a community that's going to help them stay on the rails.
Can you tell us about your experience in extending the continuity of care? What support does the community offer, beyond the courts and prison?
11:40 a.m.
Director, Edmonton Drug Treatment and Community Restoration Court
We have learned that any treatment program under 90 days for drug-addicted offenders is apt to be ineffective. In Alberta, most of our programs are about 42 days long. About 70% to 80% of our people go through residential treatment, to begin with. They come out of treatment on a high. They think they can do it. But almost immediately they're facing challenges that they never imagined. At that point, we deal very closely with them. Our treatment team sees them once a week. They attend the court at least once a week. We keep them honest by doing frequent and random urine tests to make sure they're staying on board. We reward them when they're doing well. We get them hooked up with 12-step programs, which are important. We connect them with relapse prevention programs in the community and with other outpatient programming. We try to get them back on track. We work to put back in their lives some of the things they've lost, like ID. We try to interest them in education. Some of these people have great potential, but they don't have much education, so we're trying to get them back into the educational system so they can return to the workforce.
11:40 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
Would it be fair to say it's the exception and not the rule that the kind of treatment you were just describing is being administered—in other words, that today most are not getting that continuity of care, that support to make sure the person is given the skill set they need to not reoffend, not go and commit another crime, and not constantly be in and out of the system?
11:40 a.m.
Director, Edmonton Drug Treatment and Community Restoration Court
I would say that's true. Most people coming out of the jail system, of course, come out and there's nothing for them. In our system, this is where we are putting them. We're programming and putting them into different programs right away, so they're busy when they come out of treatment. Generally, they go from jail to treatment and us.
And we keep in contact while they're in treatment. We try to meet any needs they have while they're in treatment, as well. So we try to really connect with them, so they know they have support out there in the community; they know they have an arm to lean on; they know they can trust us. That sometimes takes a little longer, but those are the things we do to get them going again and put a foundation underneath them so that, when they finally graduate from our program, they have the skills so they can focus on their recovery, continue to focus on their recovery and other areas, as well.
11:40 a.m.
Conservative
11:40 a.m.
Senior Director, Corporate Services, Rideauwood Addiction and Family Services
If I may, your question goes very much straight to the heart of what drug treatment courts are about, in my opinion.
First, I should make it clear, just in case it's not, that the drug treatment court is really an alternative to incarceration. While the vast majority of our participants come to us from custody, and they may have an extensive history of incarceration, they're coming to us after a brief period.
What is particularly beneficial about the drug treatment court program is that the participants receive treatment in the community in which they live. They learn to stay clean and avoid committing criminal acts in the community in which they live. They're not sent to an artificial environment or to an institution to do that. They learn how to refuse the drug associates they've been using; they learn how to avoid them. They learn how to avoid those situations in their community.
11:45 a.m.
Liberal
Mark Holland Liberal Ajax—Pickering, ON
If I could, I'll ask this question of Ms. Ward.
I'm interested because we hear varying statistics on the prevalence of serious mental health issues within our prison system, some that peg it as high as 20% for male inmates and 60% for female inmates. You reference the American model, with mental health treatment courts, and the efficacy it's demonstrated.
I'm wondering if you can compare the models that are being used in the U.S. to the couple of different models you referenced that are being used here in Canada. Is there a model you think is working particularly well? How do we contrast against the models being applied in the United States?
11:45 a.m.
Clinical Director, Forensic Services Champlain, Royal Ottawa Health Care Group
I don't think you can really draw clear parallels with the United States, because sentences are so much longer for what we would consider often relatively minor offences in Canada. Obviously there's a much greater incentive in a court that says, if you do this, you won't go to jail. There's much greater incentive for people than there may be in the mental health courts.
I would say that I actually am not an advocate of a particular model. I think it's important that the model fit the community. Different communities have different strengths in terms of treatment, and you'll never make treatment and treatment options universal. So I think it's fairly important to allow particular communities to set up the models that work for them, but you have to give them guiding principles. The principles really need to be that you've got specialized people, that you've got treatment available, that you have housing available when you need it, and that you have some way to ensure that participation is voluntary and participation results in a better outcome than they would otherwise get.
One of the criticisms of mental health courts has been that people sometimes are made to jump through more hoops than they would if they weren't mentally ill. So you really have to be careful in Canada not to do that, which is why I'm saying I think the focus should be really on the level two offence rather than just the level one non-violent offences. I think there should be an emphasis on level two offences because that's where you get more bang for your buck.