Edmonton's Mental Health Court Offers Compassion & Support for Mentally Ill Individuals Who Run Afoul of the Law

It's a busy Wednesday morning at the Edmonton Law Courts.

01 September 2018

Edmonton's Mental Health Court Offers Compassion & Support
for Mentally Ill Individuals Who Run Afoul of the Law

It's a busy Wednesday morning at the Edmonton Law Courts.

In courtroom 265, Provincial Court Judge L.E. Malin works his way through a jammed docket, methodically dealing with bail applications and procedural matters in an efficient, dispassionate manner.

As a procession of orange jumpsuit-clad prisoners at the Edmonton Remand Centre appear one by one on the court's closed-circuit television monitor, their lawyers stand in turn to address the judge.

Some lawyers arrange dates for future bail hearings. In other cases bail is denied or the accused is released with conditions. A couple of prisoners are granted more time to obtain legal counsel.

Meanwhile, one floor above in courtroom 357, the vibe is distinctly different. The officious, adversarial tone that characterizes Provincial Court proceedings is missing. Instead, this feels more like a support group, albeit one with clearly established rules and protocols.

Welcome to Edmonton Mental Health Court (EMHC), the only court of its kind in Alberta, and one of just a few in Canada.

Launched last April - thanks largely to the efforts of Forensic Psychiatrist Dr. Peter Rodd, Lead Psychiatrist for EMHC, and Assistant Chief Judge Larry Anderson - the Court is in session three days every week (Mondays, Wednesdays and Fridays) and deals with individuals accused of committing offences due at least partly to their mental health issues.

The caring, compassionate tone of the judge - today, Judge Renee Cochard is presiding - contrasts sharply with the cryptic, legalistic language used by most Provincial Court Judges.

Judge Cochard greets each accused by name in a warm, friendly voice, as if spotting an old friend while shopping. After one young man tells her he plans a trip to the east coast to see his family, the judge reminds him to "drive safely."

She offers another young man a verbal pat on the back. "You seem on the mend," she says, approvingly. Later in the day, Judge Cochard steps down from the bench to hand a granola bar to a slightly cantankerous, wheelchair-bound female defendant.

Such conduct is verboten in regular criminal courts. Not here. The goal in EMHC is to use a therapeutic, collaborative and healing approach instead of a punitive model to help those with mental health issues get their lives back on track.

Like other criminal courts, the Crown Prosecutor and Defence Counsel are the key parties in Mental Health Court, and the judge strives to reach a decision that is fair and effective. The court process is also less rushed and the real-life living circumstances of the accused are carefully weighed before a sentence is rendered.

"Normally a court would ask for a full psychiatric assessment with cases like this. What we're able to do is use the information we already have available from an individual's medical file. So we're able to establish a diagnosis, what treatment they're on, and we can make recommendations for additional treatment and follow up," says Dr. Rodd, whose clinical expertise is often relied upon by the judge.

"Sometimes that's all a court requires to make an appropriate and applicable sentence for the individual. In the past they would have to wait for that assessment and get a written report. So from a cost savings perspective that's also made a big difference," he notes.

"But the principal benefit is to minimize the duration an individual must remain locked up before his or her matter can be resolved, thereby mitigating the adverse consequences stemming from a lengthy period in custody," he explains.

The sentence itself can be specially tailored to an individual's needs, either reducing or negating the need for a jail sentence, while imposing appropriate conditions.

"There are also significant time and dollar cost savings associated with Forensic Pychologists and Forensic Psychiatrists being relieved from carrying out formal pre-sentence or probation assessments for these individuals. This frees them up to perform other duties," says Dr. Rodd.

Today, a 30-something female prisoner at the Edmonton Remand Centre who pleads guilty to a shoplifting charge is grilled by Judge Cochard on where she plans to live once she is released.

After ascertaining that the accused - who has a history of substance abuse and mental health issues - has no family ties or other sources of support, Judge Cochard instructs her to go to the Boyle McCauley Health Centre, make an appointment to see a doctor, and apply for both AISH (Assured Income for the Severely Handicapped) and assistance in finding a place to live.

A $500 fine initially proposed by the Crown is reduced to $100, and then deemed served by virtue of the defendant's attendance - via closed-circuit TV - at court.

"A major difference between regular docket court and EMHC is the facility to take time and the flexibility to deal with peoples' matters, incorporating knowledge of their mental health, addictions, and developmental concerns. It's a way to bring all of that to the table upfront," says Dr. Rodd.

"In a standard courtroom, delays are detrimental to the individual because they are forced to wait. If they are in custody that adds an additional stressor. We endeavour to minimize delays while bringing our knowledge of their mental health concerns to the courtroom, and sharing that with counsel and the judge. That streamlines the process. I think that is the biggest positive in terms of the structure of this court."

Four Provincial Court Judges - including Judge Michele Collinson and Judge Janet Lynn Dixon - have been appointed to EMHC. The judges are assisted by Dr. Rodd as well as a Social Worker and Legal Aid Navigator.

There is currently no formal training for Crown Prosecutors to work in EMHC. Prosecutors are being provided to EMHC on a rotating basis, but it is expected that a dedicated number of Prosecutors will eventually be assigned to the Court.

"The successful operation of EMHC also depends on two experienced Community Mental Health Nurses from the Forensic Assessment & Community Services branch of Alberta Health Services (AHS). One is in attendance throughout the day for each sitting. In most cases, they are the initial point of contact for the Defence Counsel or Duty Counsel to obtain relevant historical information about the individual's mental health issues," Dr. Rodd explains.

They may be called upon to share this information with the Court. Equally critical is the advice they provide about the availability and suitability of programs to address the individual's specific treatment and psychosocial needs, says Dr. Rodd. In this regard, they offer suggestions to the Legal Aid Navigators, whose responsibility is to connect the individual to those services.

"Part of my job is in Youth Court, so usually I'm a youth worker. But since Mental Health Court has evolved they've seconded some of my duties here as a Navigator. That's my title in Mental Health Court, and I've been doing this since April when this court started," says Mark Cherrington, who works for Legal Aid Alberta.

"I'm here to assist. I think that's the key aspect of my role. So where the lawyers might deal with issues around guilt or innocence and the rules of evidence, I'm here more to look at the systemic issues and to focus on the area of social justice, ensuring that the people who are coming through these doors have every opportunity and resource made available to them to put in as many protective factors in their life as possible, and to reduce the risk factors."

In keeping with the more relaxed decorum of EMHC, Cherrington dresses informally in blue jeans and a plaid shirt, and interacts frequently with Judge Cochard, whenever he is needed.

"I really enjoy it. My role is a helping role. People in court look at me working with Duty Counsel as someone who is on their side, so their approach is a lot different than if I was in a position of authority," says Cherrington.

"I'm here as a resource for the court but more importantly as a resource for the client. I don't even call them clients. They're human beings who are traumatized by environmental or organic issues that have led them here, whether it's FASD (Fetal Alcohol Spectrum Disorder), Bipolar or Schizophrenia."

An accused is not automatically streamed into EMHC. This is largely a voluntary court, and an accused person must meet certain criteria to participate in the proceedings. The Court also handles assessments to determine fitness or criminal responsibility, fitness hearings and applications for treatment orders.

"For anyone who is seen in any of the courts, if the issue of fitness to stand trial has been identified as a potential concern, those individuals are streamed from that courtroom, after their assessment, into Mental Health Court," explains Dr. Rodd.

"The other referral process can be at the request of their Defense Counsel, the Duty Counsel, or at the request of a Crown, if the Crown feels there is a mental health concern. It could also be at the judge's own discretion. In addition, for those making an initial appearance - often for bail - before a Justice of the Peace, if a mental health concern is identified, those individuals may be referred to Mental Health Court."

Although EMHC has only been operating since April, Dr. Rodd says the early results are extremely encouraging.

"Judge Anderson and I first met about forming Edmonton Mental Health Court in December 2016. But it wasn't until November of 2017 that the first of many interdepartmental stakeholder meetings took place, involving Alberta Justice & Solicitor General, Alberta Health, AHS and Alberta Community and Social Services," he recalls.

"I attended all of them and was impressed by how quickly the process unfolded from there. The fact that the system was flexible enough to allow this to happen so quickly was quite amazing."

As Lead Psychiatrist for EMHC, Dr. Rodd worked in close collaboration with Judge Anderson throughout the entire process, committing many long hours to the undertaking, including related processes to ensure the immediate and continuing success of EMHC. In doing so, Dr. Rodd and AHS played a pivotal role in shepherding EMHC from concept to fruition.

"I think this Court has been a significant success. I'm very pleased with how we have managed to implement it and how we have seen it in action," he says. "I think that individuals have benefited and I think the system in general is serving their clients much better."