That's great. Thank you, Mr. Chairman.
Good afternoon, members of the committee.
Thank you for inviting us here today. My name is Dr. Patrick Smith. I'm the National CEO of the Canadian Mental Health Association. Bill C-375 is a very important bill to us. I would definitely have been there in person if today weren't April 26, 2018. Today marks 100 years to the day when, in 1918, Dr. Clarence Hincks came together with other prominent Canadians in the historic Château Laurier, just around the corner from you, to form what is now the Canadian Mental Health Association. Today we are a Canada-wide organization with divisions in every province. We provide services to more than 1.3 million Canadians in over 330 communities across Canada.
We are celebrating this important milestone today in Toronto with some of Dr. Hincks' immediate family, in honour of his vision and commitment to two very clear goals: to end stigma and discrimination, and to provide more humane care for people with mental illness. In many ways—100 years later, to the day—this discussion on Bill C-375 is about addressing these same issues.
Today, I'd like to focus on some of the ways in which mental illness, including addiction, intersects with our criminal justice system, as well as on key areas that we believe will help to ensure that Canadians with mental health problems are supported in their treatment and in their recovery.
Specifically, I will be speaking in favour of passing Bill C-375, because we know that it will confer significant benefits onto many Canadians who are marginalized and living with mental illness and substance use problems. We're also confident that the bill will lessen the burden on our criminal justice system.
We talk about the current shortfalls.... As many of you are aware, in the 1970s, the deinstitutionalization of mental health services transferred mental health service delivery from psychiatric facilities to more local communities, resulting in the closure of psychiatric hospitals across Canada. This shift has been heralded as a positive step in respecting the rights, dignity, and self-determination of people with mental illness.
However, the psychiatric deinstitutionalization has been replaced by a new form of institutionalization: the Canadian prison system. Given that mental health supports at the community level are often underfunded and poorly integrated, many people with mental illness and in need of treatment fall through the cracks and end up in the criminal justice system. You now know, through the debates over the last few years, that Canada has invested a lower percentage of its total health care budget in mental health care than any G7 country. Basic primary mental health care provided by addiction counsellors, psychologists, social workers, and specialized peer support workers form the bedrock and the foundation of other G7 countries' response to the mental health needs of their populations. They're not covered in Canada's universal health care system. Thoughtful, targeted investments in treatments that are effective and save money have been replaced by the high burden of costs of untreated mental illness that we see in jails and prisons. These unnecessary costs are carried by every Canadian.
The Office of the Correctional Investigator estimates that at least one in four admissions to federal correctional institutions present with a mental illness, and many of these also have a concurrent substance use disorder. This number is highly disproportionate to the number of people with mental illness in the population at large.
Despite the high number of people with mental illness in Canadian correctional facilities, Canada's prisons are not equipped with enough staff, resources, and funding for mental health supports for people who are incarcerated. As a result, Canadians with mental illness who end up in the correctional facilities do not receive the treatment that they need to facilitate their recovery and rehabilitation. In fact, the absence of treatment for many inmates can result in violent confrontations with other inmates and staff, as well as additional charges and time spent in segregation, which typically exacerbate mental health problems.
Once out of prison, Canadians with mental illness are more likely to experience homelessness and to have difficulty reintegrating into the community. Many do not have the necessary wraparound supports, and subsequently end up cycling through the criminal justice system at high cost. They often face discrimination and stigma as a result of having been incarcerated, and have difficulty finding meaningful employment. That's unjust, especially because people with mental illness who enter the criminal justice system are far more likely to have committed minor criminal offences when compared to offenders who don't have a mental illness. The majority of arrests are for minor crimes, such as causing a disturbance, mischief, minor theft, and failure to appear in court, which may be directly or indirectly related to the mental illness or substance use itself.
As a community-based organization with a long history of supporting people with mental illness and addictions at the local level, CMHA knows from experience that providing the necessary supports and care for people can greatly change the course of their lives, the course of the lives of their families, and their communities.
An ideal health care system—and here I'm not even talking about the ideal, but even one that's based on smart investments in treatments that work—can actually save many people and can save money. People with mental illness would have easy and timely access to well-funded, integrated community-based services, including housing and employment supports and individual and family supports, in addition to accessing a range of professionals, including family physicians.
This continuum of services allows individuals to receive support in the community and to thrive in recovery. In Canada we don't have to take a leap of faith on this. When you're a pioneer, you often have to go out on a limb and see how it works. On this front, we're not pioneers; we're laggards.
We can learn from other G7 countries that have been in our situation and have made the smart investments in health responses to mental illness, and dramatically reduce the high cost of untreated mental illness. When community-based services are well coordinated, they can also positively impact people with mental illness who come into contact with the law. Although the research on court support and diversion programs is limited, these measures that divert people with mental illness, pre- or post-charge, have been shown to increase access to mental health services, improve mental health functioning, and reduce hospitalization and recidivism, again saving money. They also relieve some of the pressure on the criminal justice system.
Supporting people at the community level is also much less expensive than incarcerating them. In Canada it costs over $100,000 per year to house and support a male federal inmate and $180,000 a year for every female inmate. Offenders who are supervised in the community, on the other hand, cost considerably less, about one-eighth of those amounts. The funding that would be spent on the incarceration of people with mental illness would be better spent on proactive investment in treatment and social integration.
This brings me to Bill C-375. This bill proposes to amend the Criminal Code to introduce information about mental health issues and disorders in pre-sentence reports. The goal of the bill, as I understand it, is to make the criminal justice system aware of and more responsive to individuals with mental health issues and to ensure that they receive the appropriate treatment and supports that they need throughout their rehabilitation.
Although some jurisdictions already collect information on mental health in pre-service reports, this bill would create a national standard for all jurisdictions to consider mental health during sentencing. It is important that you don't have to win the postal code lottery to know that you live in a province that just so happens to provide and seek your mental health information. That's good for you, but what about the ones who don't? We really are applauding this bill to ensure there is a national standard.
This is important because research conducted by Public Safety Canada suggests that pre-sentencing reports make a difference in sentencing outcomes. They've been shown to increase the likelihood that offenders will receive a community sentence rather than a custodial sentence. We believe that with the right supports, community sentences can better facilitate recovery for people with mental illness.
In conclusion, we believe that the Government of Canada needs to continue showing leadership by addressing the current gaps experienced by people with mental illness and addictions in our criminal justice system. We strongly support the government's efforts to conduct a comprehensive review of the criminal justice system, and one of its stated goals, which is to determine how services can be improved for offenders who suffer from mental illness.
Bill C-375 presents an important opportunity to achieve this goal and ensure that people with mental illness and substance use problems are treated with care and compassion. It is also an opportunity to break the vicious cycle of institutionalization that unfairly impacts people with mental illness and substance use problems.
We also encourage the government to continue to make smart investments in early health responses to mental illness, which not only save lives but also lower the high cost of untreated mental illness in our communities. As such, we strongly urge the government to support Bill C-375.
Thank you again for inviting me here today. I'd be happy to answer any of your questions.
