Canadian Commission on Mental Health and Justice Act

An Act to establish the Canadian Commission on Mental Health and Justice

This bill was last introduced in the 41st Parliament, 1st Session, which ended in September 2013.

Status

Second reading (Senate), as of June 12, 2013
(This bill did not become law.)

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment establishes the Canadian Commission on Mental Health and Justice. The purpose of the Commission is to facilitate the development, sharing and application of knowledge, statistical data and expertise on matters related to mental health and criminal justice. Its role includes providing recommendations for improving laws, policies and practices that address the needs of individuals who live with mental health problems or illnesses and are involved — or at risk of becoming involved — with the criminal justice system, in order to contribute to the health, safety and well-being of Canadians.

The enactment also establishes the Mental Health and Justice Advisory Council to advise the Commission on the Commission’s program of studies and other matters.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Not Criminally Responsible Reform ActGovernment Orders

June 17th, 2013 / 10:35 p.m.
See context

Liberal

Hedy Fry Liberal Vancouver Centre, BC

Mr. Speaker, I rise to address Bill C-54, the not criminally responsible reform act.

Over the last two weeks, the justice committee has heard a great deal of compelling testimony from mental health experts, legal professionals, law enforcement and victims who courageously shared their heart-rending experiences of pain, of loss, of anger and frustration and of their efforts to grieve and overcome. One of those experiences was shared by the member for Hamilton East—Stoney Creek. I want to thank him and all the witnesses who provided personal accounts that were often heart-rending, but all the more important for it.

On the whole, the testimony we heard confirmed our reasons for opposing this legislation. I want to note that my belief is grounded in statistical analysis and in expert opinion that Bill C-54 would prove counterproductive by complicating treatment for the mentally ill and, as a result, increasing the danger to the public.

The testimony at committee also demonstrated something else: that the government's approach to this bill has had the effect of pitting mental health and legal experts against victims of violence, and it does not have to be this way.

I offer as evidence some quotations from committee testimony, as follows:

It is not about putting them in prison, it is about getting them the help they need.

One witness said, “I believe strongly in increased supports to help those with mental illness in our communities”.

Another witness said:

I am in favour of rehabilitation and I understand the suffering caused by a mental illness.

It may surprise members that those words came to the justice committee from victims and victims advocates. They were saying this.

The following quotation that I will read are from the testimony of mental health and legal professionals who are opposed to the bill.

...the association supports an approach that fully addresses victims' needs...it also recognizes that there are major flaws in the support services and financial aid offered to victims...

Another witness said, “we wholeheartedly support changes that create greater involvement for victims in the process. Without a doubt we want all victims affected by crime to be part of the process”.

Those words came from people who supported victims, but opposed the legislation.

Common ground exists between victims and the mental health and legal communities, irrespective of their views on this bill. The victims who spoke were not simply out for revenge. They recognized the importance of effective treatment for the mentally ill, including accused found not criminally responsible, or NCR.

At the same time, those opposing this bill have demonstrated genuine compassion for victims. It is disappointing therefore that the government did not endeavour to find this common ground before it prepared the legislation.

To be clear, opponents of the bill do not oppose victims, as has been callously and hyperbolically suggested. Indeed, we and other experts support measures to increase the notification of victims and the provision for no contact orders between victims and NCR accused.

It would have been, and, indeed, it still is quite possible, given good faith and openness to the perspectives of all concerned, to draft a bill that first, simultaneously protects the safety of the public; second, respects the interest and wishes of victims; and third, facilitates both preventative and rehabilitative treatment for the mentally ill. Those three things could have existed simultaneously in the bill.

Not only would such a bill have received more widespread support, it would have been less suspectible to constitutional challenges and it would have been far more effective.

I regret, however, that this was not the government's approach. Stakeholder after stakeholder and expert after expert came before the justice committee and stated that the government had not sought their input. Shockingly, while preparing a bill that deals specifically with mentally ill individuals, the government apparently had a grand total of one preliminary meeting with a mental health group before the bill was tabled.

It never consulted, for instance, with Centre for Addiction and Mental Health, which is Canada's largest mental health and addiction treatment facility, or the Schizophrenia Society of Canada or the Canadian Psychiatric Association, among many others.

The Canadian Mental Health Association was granted one meeting, and that was after second reading.

On the legal side, the government ignored no less an authority than the Canadian Bar Association. It consulted with crown attorneys whose input is important, but not with attorneys who represent the mentally ill, whose input is equally important.

The government's choice not to consult with so many of the relevant experts is yet another manifestation of a trend to which we are now regrettably accustomed to in the House, particularly with respect to justice legislation. The government does not base its policies on facts. Indeed, one of the principal reasons the Liberals oppose this bill is that, despite flaws in Canada's overall approach to issues of mental health and justice, the evidence demonstrates that the not criminally responsible regime works well in its current form. Undoubtedly, there are shortcomings with respect to the notification and involvement of victims. There are shortcomings which the Liberal Party has sought to address through amendments. There are also major improvements needed in terms of preventative treatment so people with severe mental health problems can get an early diagnosis and be treated before they commit serious violence.

Moreover, as was recently argued in a feature in L'actualité magazine about Isabelle Gaston, whose children were killed by Guy Turcotte, we might also consider re-examining the way our courts approach expert testimony at trial.

However, the crux of the bill before us does not address most of these problems. Rather, Bill C-54 is focused on changing the way our system deals with mentally ill individuals after they have been found not criminally responsible, yet this is the aspect of Canada's approach to mental health and justice that already works very well. We know it works because several studies have been done on the subject, the most recent of which was finally tabled by the minister last Thursday in its corrected form.

Before continuing, I want to acknowledge and thank the minister for doing so, even if I still do not understand why he tabled the incorrect report in March, one week after being provided with a revised draft, or why the government continued to cite the incorrect figures for months.

While I am on the subject, I must also express my dismay at public statements made by the minister's office and by his parliamentary secretary, questioning the credibility and competence of the researchers they commissioned. In fact, the researchers behaved in exactly the manner top level scientists and academics should. Instead of saying, as the minister did on Thursday, that “mistakes were made”, as though mistakes can make themselves, the researchers did the right thing by immediately acknowledging their error and correcting it. The minister should also do the right thing and apologize to them for tarnishing their reputations.

As we now know, according to the corrected version of that research, only 6.1% of individuals found not criminally responsible in a serious violent offence had a prior NCR finding. The recidivism rate for NCR accused released by review boards was 7% for serious violence. I said that in the House when I made my very first speech. It came from reputable people, from forensic experts to people who worked in the criminal justice system to mental health authorities. In other words, it is demonstrably exceptionally rare for an NCR accused person to be found not criminally responsible of a second violent act upon release. Naturally, the rarity of the occurrence is of no comfort to those who have been victims. It is certainly worthwhile to seek to improve the system further.

However, if we are to make significant changes to a largely successful system, such as creating an entirely new category of NCR accused deemed “high risk” on the basis of medically suspect criteria, we must take great care to ensure the changes we make do not have unintended negative consequences. Regrettably, witnesses at committee warned of that potential, that this bill would have several troubling unintended consequences, complicating treatment for the mentally ill and therefore increasing the dangers to the public.

Here are some of the reasons. By keeping the NCR accused institutionalized for longer periods of time, this legislation would risk overburdening treatment facilities. As Dr. Sandy Simpson, co-chair of the Canadian Forensic Mental Health Network, testified:

Most forensic services nationally are at or near capacity. If you look at Ontario, most of us are running over capacity. Clearly, if one gets overcrowding within secure mental health facilities, your risk of violent behaviour, both patient to patient and patient to staff, rises, and those environments become more dangerous and less therapeutic.

Repeated questions about whether the government considered this potential effect of Bill C-54 have been met with evasive and even dismissive responses.

Second, the bill may result in more mentally ill offenders going to prisons instead of hospitals. Dr. Simpson warned that this could happen as a result of overcrowding, since patients are often detained in prison while waiting for a forensic bed to become available in an institution.

Moreover, as Paul Burstein of the Criminal Lawyers Association argued, the punitive restrictions placed on NCR accused deemed high risk could cause certain defendants, who would otherwise be found NCR, to plead not guilty instead. If these individuals were acquitted, they would be discharged without receiving treatment of any kind, and if they were convicted, they would likely receive either inadequate treatment or none at all. When they rejoined society after their sentence, they would be at least as dangerous as they were before.

At committee, some Conservative members were skeptical about whether this would actually be the case, claiming that defence attorneys have a fiduciary responsibility to advise their clients to plead NCR if such a finding is appropriate. However, if the consequence of such a finding is likely to be inappropriate in its result and its sentencing—for instance, overly punitive restrictions or a longer detention than necessary—it would be entirely correct for a defence attorney to advise against an NCR plea, especially given that many NCR accused are already detained for longer periods of time than if they had remained in the prison system.

Third, and perhaps most critical of all, the bill contributes to the stigmatization that makes many who suffer from mental illness reluctant to seek treatment in the first place.

The rarity of violent acts caused by mental illness in no way diminishes the pain of victims. I want to stress that. However, by using rare occurrences as justification for significant reform, and by designing those reforms so as to limit the role of medical expertise, the government overstates the problem of violence by the mentally ill and understates the potential effectiveness of treatment.

Yet fear of the mentally ill is often a self-fulfilling prophecy. We find mentally ill individuals are largely dangerous; that is the idea we are giving here. We discourage them from acknowledging their illness and they go back into hiding, to being underground, not wanting anybody to know they are ill. A person whose severe mental illness goes undetected is far more dangerous than an NCR accused who has been treated and released by a review board.

Consequently, it is incumbent upon the government to temper its rhetoric and base its policy on facts instead of headlines, thereby reducing stigma and encouraging early diagnosis and intervention.

My colleague, the justice critic from Mount Royal offered numerous amendments at committee in an attempt to address these concerns. Some of his amendments would have introduced or reintroduced principles established by the Supreme Court with respect to NCR accused, such as that NCR accused are not to be punished or left to languish in custody.

The Conservatives explain their opposition by saying that there is no need to codify prevailing jurisprudence, and yet by specifying that public safety is to be the paramount condition of review boards, Bill C-54 would do precisely that. Indeed, two review board chairs testified at committee, and they were already bound by jurisprudence to make public safety their primary concern.

My colleague also proffered amendments to deal with the problematic aspects of the bill, according to which the “brutal nature” of a past act committed by an NCR accused would be an important factor in determining whether the accused posed a future risk, which is a medically dubious causal link. I can assure members of that.

However, Conservative members rejected his efforts in this regard, even going so far as to reject his proposals to define the term “brutal” using existing case law. They preferred the ambiguity that the Canadian Bar Association testified might very well contravene the charter.

The government also refused to include the supports and resources available to the accused upon release as criteria for courts to consider when determining risk, despite expert opinions that such support can be a significant factor in lowering risk of recidivism. Perhaps most egregiously, the Conservatives rejected repeated attempts to ensure that the decision of courts and review boards would be based on medical expertise.

Thus we have before us a bill with little evidentiary basis. It is rife with the potential for unintended consequences. Due to the breadth and vagueness of some of its provisions and the possibility that it will subject NCR accused to unduly punitive restrictions, the bill is likely to raise a whole host of charter concerns. Moreover, because the bill does not even attempt to address primary prevention, it misses the nub of the nature of mental illness altogether. As one of the victims said at committee:

Primary prevention completely failed us.

The member for Kootenay—Columbia, a former RCMP officer, echoed this sentiment by pointing out that when police officers approach individuals who have mental illnesses to try to apprehend them, they are often powerless to ensure that these individuals receive sustained, appropriate treatment. In an effort to address the problem, the Centre for Addiction and Mental Health in Toronto recently instituted a program to screen inmates for potentially dangerous mental health issues as soon as they come in contact with the system.

With federal government support, this kind of program, rather than Bill C-54, would do much to protect the public. Indeed, to address this and other problems related to mental illness, health and justice, members of Parliament must work together and with mental health and legal professionals to develop an effective, evidence-based approach that would support Canadians with mental illnesses and their families and protect the public.

For that reason, I am very pleased that Senator Cowan has introduced a bill that would establish a Canadian commission on mental health and justice. This commission would collect data on the ways mental health and justice intersect, highlight areas that require improvement and facilitate co-operation and the sharing of best practices across jurisdictions. I am hopeful that his Bill S-219 will receive broad-based support so that future policies with respect to mental health and the law would be ground in comprehensive, reliable research and expertise.

In 2005, when he was minister of justice, the member for Mount Royal introduced the most recent reforms to the NCR system. Members of all parties supported both the content of that legislation and the collaborative process through which it was developed. At the time, the current Minister of Public Safety said, “I am pleased to add my support to this bill”.

The Conservative member for Yorkton—Melville said, “The entire debate of the bill in the House and in committee should serve as an example of how Parliament should work”.

I wish I could say the same about Bill C-54, but the legislation we are debating today is regrettably a step backward for the NCR regime, for public safety and for the cause of collaborative evidence-based policy. To keep Canadians truly safe, we must rely on the facts to determine which aspects of our mental health and justice systems are working well and which are in need of improvement. The facts clearly demonstrate that the new high-risk accused category is a solution in search of a problem. As such, Liberals have sought to remove that section from the bill. I support the efforts of my colleague from Saanich—Gulf Islands to also do that.

At the same time, there is much that can be done in the way of mental health and justice policy to support victims of violence by the mentally ill and to reduce the occurrence of such violence in the first place. These are goals that all Canadians support. It could have been possible, through an evidence-based consultative process, to develop effective legislation with similarly broad appeal.

I hope that in the future, mental health and legal experts will not be pitted against victims but will be consulted and included alongside them to better enact effective policies and keep Canadians safe.