Public Safety Committee on Dec. 8th, 2009

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

I should disclose that I spent half a day with Mr. Brady and Judge Wong at the Edmonton drug court, and it was a very fascinating afternoon. I learned a lot, and I encourage all members to do that, especially since there is one in Ottawa.

Ms. Trottier, you talked about funding for the program being extended to 2012. Bill C-15, which has been stuck in the Senate for about six months, creates some provisions with respect to an expanded role for drug treatment courts, and we haven't talked about that. I'm assuming you know what those are and what it means for the program should Bill C-15 ever become law. I was wondering if you could educate the group on those provisions.

[Margaret Trottier]

Within Bill C-15 there is an exemption for individuals to avoid the mandatory minimum sentences if they are accepted into a treatment program. That treatment element of the MMP legislation is twofold. It does make specific reference to drug treatment courts, but it also makes reference to drug treatment generally. So it will be up to the provincial attorneys general to determine what other levels of treatment would be appropriate in that context.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

I'm assuming I must be close.

[The Vice-Chair, Liberal, Mark Holland]

You have another three minutes.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

Getting back to Mr. Brady and my summer day in July, I found it very fascinating. I have a legal background, and I'm used to a more adversarial legal context, and I think that members of this group can probably appreciate my adversarial nature. Of course, it's quite different.

The word “restorative”, quite frankly, threw me off, because when I think of “restorative” and “justice”, they're almost oxymoronic, especially for an old-school guy like me. I was wondering what, if anything, you or your counterpart from Ottawa do to market your court. I do agree that, anecdotally at least, there are many success stories. But I was not familiar with your program, and I practised law in Edmonton for 17 years. What do you do or what can you do to market your program, to convince funders like Parliament and members of the bar associations to buy in, as Dr. Ward suggested?

[Doug Brady]

We do get out in the community quite often. In fact, one year I got out 52 times in one year. So that means I'm getting out an average of once a week. We go to speak to different organizations. We go to speak to universities and colleges. We've spoken at the Criminal Trial Lawyers Association. The Alberta Criminal Justice Association had an entire day just on drug courts, for Alberta courts, in Red Deer in October. We go out to probation officer conferences.

Anywhere we can go, we go out. We take participants with us. We take graduates with us, because our graduates are very supportive of our program and they continue to work with us through the alumni group. We have barbecues. We do all sorts of different things with them, which I won't get into.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

In your program, the participants attend weekly, correct?

[Doug Brady]

Once a week.

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

Mr. Budd, did I hear you correctly that initially they attend daily?

[James Budd]

Twice per week. They attend our treatment centre daily and they attend court twice per week.

[James Budd]

Can I add just one thing finally in response to your question?

[Brent Rathgeber, Conservative, Edmonton—St. Albert, AB]

In 15 seconds, yes.

[James Budd]

The other thing is that we have formed an association of courts across Canada. We have incorporated, and we have elected Mr. Doug Brady as our spokesperson for it. That's our other way of getting the message out.

[The Vice-Chair, Liberal, Mark Holland]

Mr. Kania for five minutes, moving on to the second round.

[Andrew Kania, Liberal, Brampton West, ON]

Thank you, Mr. Vice-Chair.

I thank you all for coming and being here. Obviously I support both courts. We're here today to see what we can do to try to improve things.

So I will first focus on mental health.

Dr. Ward, the most concerning thing I've heard today from anyone is one of your initial comments that the persons who are incarcerated have increased as hospital beds have gone down. So I'd like to discuss that first and to find out from you, if you have this expertise, what might be done to reverse that and to get the system back on track, really, the way it should be. It could be as simple as saying we need x number more beds, but I assume there's a little more to it than that.

[Dr. Helen Ward]

I wouldn't get very far to say we need x number more beds. I do think there is disproportionate money put into mental health as opposed to other types of health. The Mental Health Commission of Canada, I think, has been fairly clear about that. That's fairly well established.

The issue about trans-institutionalization is also pretty well accepted. That is what has occurred. What we need, I think--and the Mental Health Commission has started to look at this--is more housing for people with mental illness. We need more affordable housing for people with mental illness. You can't put treatment in place in communities unless you have proper housing. That's what we really don't have. If you don't want people to be in hospital beds, that's fine. But I can't keep people well when they're in rooming houses full of drugs or in shelters where they have to be out throughout the day. So that's probably one of the main things that could be done: housing programs specifically targeted at the mentally ill.

The other thing would be looking at funding or models that would encourage mental health practitioners, including physicians, to treat mentally ill people. There's really no incentive to try to help this population when pretty much any psychiatrist in the country could close their practice tomorrow and be living comfortably. Sorry, I'm a little blunt. You need to be creating incentives for us to work with this population other than our own values.

[Andrew Kania, Liberal, Brampton West, ON]

Do you have studies or written proposals that are very specific in terms of what you might suggest should be implemented for both, both affordable housing...?

[Dr. Helen Ward]

I don't know that I can give you specifics. There are projects out there. There are models out there already. Certainly on a provincial level, there is housing for the mentally ill out there. There are, for example, safe beds in Ontario that are designed as crisis beds for people with mental illness involved with the justice system. Those things exist. There are just not enough of them.

I'm not sure how much of a study needs to take place. More specifically with mental health courts, though, we don't have outcomes. That's because there's been no money targeted towards outcomes. We can all come at it with our clinical resources, but every mental health or health organization has been slashed to the bone. So we don't have a lot of analysts sitting around ready to do studies. Those are the things that probably should be funded here.

[Andrew Kania, Liberal, Brampton West, ON]

I have four different points in terms of mental health courts before I move to the drug treatment courts, if I have time.

First, the crown acts as the gatekeeper. The crown decides whether somebody goes into the mental health court.

[Dr. Helen Ward]

Yes, they do, but usually there is assistance from mental health professionals as to whether or not that person should be there. So in Ottawa we screen people who have been arrested by police and who have been identified as having a potential mental health issue. We also offer an out-of-custody clinic, which can also screen. So that can assist the crown.

[Andrew Kania, Liberal, Brampton West, ON]

I've just been told I have one minute.

I'm going to go to point number three. During your presentation you mentioned something about better community legal provisions needed. That's what I wrote down. Can you describe in full what you meant?

[Dr. Helen Ward]

There are different provincial things for community treatment--civil orders--to get someone with a mental illness who needs treatment, but doesn't recognize that they need treatment, to remain in treatment. This is usually for people with schizophrenia or related illnesses who need anti-psychotic medications. They can often be delivered injectably every two weeks. But if they exist, most of the community treatment provisions are weighted towards the rights of the person with the illness and not weighted very well towards the interests of the person's family, or the people who actually can see that the person is ill, or in fact the community if the person has been committing offences against the community.

[The Vice-Chair, Liberal, Mark Holland]

Mr. MacKenzie, for five minutes.

[Dave MacKenzie, Conservative, Oxford, ON]

Thank you, Chair, and thank you to the panel members here today. I've got so many questions I wish we could have each of you for two hours.

A couple of things have arisen, I suppose, over the last few years, particularly with drugs. Methadone is an area that is quite interesting because it seems that opiates being legally prescribed has taken off in leaps and bounds. As a result, not only the legal use of them but the illegal use--or the improper use--has spurred all kinds of methadone clinics in our communities. What I'd really like to know is, do you see any improvement with those people addicted to opiates in the methadone, or do we just trade the opiates for methadone and it goes on forever?

[James Budd]

Thank you.

No, we see significant improvement with people participating in methadone maintenance programs. It is medically monitored. It's prescribed in a setting where they come into daily contact with service providers. It does not result in the same type of high, if you will, that street opiates do.

You are correct, we are seeing a lot of participants who are addicted to illegally obtained prescription medication. For us, methadone maintenance has been a very successful route for many of our participants.