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Canada’s first youth mental health court launches

By Elizabeth Scott

As our understanding of mental health and mental illness grows and evolves, our social institutions, including the justice system, are also slowly changing. In 2005, I became acutely aware of the need for the justice system to reflect progress in our understanding of mental illness when my 20-year-old son who has schizophrenia was referred by a criminal court to Toronto’s adult mental health court. As a result of that positive experience, his recovery continues, without the permanent black mark of a criminal record.

This is the hope for other youth. Involvement with the legal system is often the first interface between youth – and others – with mental health issues and mental health professionals. Over the past 10 years, specialized “problem-solving” courts aimed at treating rather than incarcerating people in the hopes of decriminalizing behaviour linked to mental health issues and reducing recidivism have emerged. Canada’s first drug treatment court opened in 1998; the country’s first adult mental health court opened in 2001; and earlier this year, Canada’s first youth mental health court launched in Ottawa. Today, approximately 20 cases are under the auspices of the court, which sits once a month.

“Everyone was noticing that there was a need,” says Tania Breton, a mental health court worker and one of the court’s founders. “Many people played a role in starting the court – judges, defence lawyers and crown attorneys, among others. Since we all had a common interest in youth, we worked together to develop the court.” Surprisingly, the new regional provincial youth crown initiative did not require additional government funding in order to establish itself.

Support for the development of the court came from as far away as New Brunswick, where Dr. Bernard Richard, the province’s ombudsman and child and youth advocate, released a report this year called Connecting the Dots: A Report on the Condition of Youth-at-Risk and Youth with Very Complex Needs in New Brunswick, that decries the lack of services for youth with mental health issues.

But why exactly did the youth court’s founders think there was a need for such a court? Those who work with youth knew that traditional youth court was ill suited to deal with youth who have mental health issues. But they also knew that although more than 50 per cent of youth cases involve substance use issues, creating a youth drug treatment court would not have helped because these courts focus solely on treating the substance use issue. “Drug treatment courts are not able to deal with concurrent disorders, even though an overwhelming number of people have mental health as well as addiction problems,” says Heather Perkins-McVey, a lawyer and one of the youth mental health court’s founders.

Extra time is also required to compile a comprehensive historical picture of each young person’s past and, in the case of youth, includes accessing everyone who has had any relationship or interaction with the young person, from parents and extended family, to children’s aid and community agencies, schools and mental health professionals. Breton says the new youth mental health court is very collaborative and aims to provide supports to the youth’s family members, as well, “so they don’t get burned out.” All of this takes valuable time. According to Mary Jerrold, youth lead and assistant crown attorney at the Youth Justice Court in Scarborough, “There isn’t time in a busy courtroom to delve deeply into the young person’s issues, but if judges were aware of mental health issues, outcomes may be different,” she says, adding that “time spent helping young people at the front end may make a difference.”

In addition to issues of time, young offenders with mental health issues also face very different concerns that are inextricably intertwined with the process of growing up and maturing. Youth are at the forefront of their lives, a time when serious mental illness or first episode occurs. Is a young person’s behaviour the result of normal teenage angst, youth conduct disorder or symptoms of an emerging psychosis or mental disorder? asks Perkins-McVey. The challenge is deciphering and reading the clues. Inevitably, whichever is the case, youth workers agree that an offence sensitively handled and a psychological need addressed in the courts early on could “nip” a youth’s potential life of crime “in the bud.”

Young people are also sensitive to the effects of stigma, says Perkins-McVey. “Youth are particularly affected by what’s said in public in court and how their peers react,” she says. “I had a client with a difficult family history and an extensive mental health history,” she recalls. “He couldn’t stand up in court with all of his peers laughing and jabbing at each other. What’s needed is sensitivity, not ostracizing or stigmatizing.”

An offence sensitively handled and a psychological need addressed in the courts early on could “nip” a youth’s potential life of crime “in the bud.”

Given these unique issues faced by youth with mental health issues who become entangled in the law, it would appear that the formation of Canada’s first youth mental health court is a positive step forward in treating and addressing youth mental health issues.

Dr. Lindley Bassarath, a psychiatrist in the Child, Youth and Family Program at the Centre for Addiction and Mental Health in Toronto, conducts court-ordered youth assessments for Toronto-based judges. He says that extenuating family issues and vulnerabilities like a learning disability or trauma can also affect a young person’s behavioural choices, but that, “there are differing opinions about the need for a youth mental health court in Toronto. “The vast majority of cases sent here generally don’t have a serious and persistent mental illness, but most have a diagnosable condition such as substance abuse or conduct disorder,” he says. However, he adds that research into the prevalence and effect of youth mental health issues in Toronto’s youth court may be warranted to determine whether there is indeed the need for a youth-focussed mental health court in Toronto.