times a week Arne Nes, CAMH's Manager of Court Liaison Services, stands in
front of a judge in Court 102, Mental
Health Court. He tells the judge if and when CAMH
or another psychiatric hospital is ready and able to admit a person that the Court
has ordered to receive 60-days of psychiatric treatment in order to be made fit
to stand trial.
his submission to the Court on the level of security required by the
individual. (CAMH does not have a maximum secure unit). He also bases his
decision on when he anticipates availability of a bed in CAMH's 28-bed
assessment unit, which is usually full. This depends on calculations as to whether
any of the patients scheduled to return to Court will receive bail or be
admitted to jail--all challenging determinations. If Arne tells the Court that
a bed will be available at CAMH or another facility no later than in a couple
of days, the person can likely be held in custody in jail. (The Superior Court of Ontario has ruled that this is acceptable)
all judges heed Arne's information regarding bed availability and occasionally
the person is ordered to be immediately
delivered to CAMH or another psychiatric facility. This causes stress on
everyone in the system including the person, the hospital staff and the court
officers who occasionally have no option but to bring the person back to a holding
cell in the police station when they are turned away by the hospital due to the
lack of available and/or appropriate beds.
question becomes, Arne says, "How much say should the court have and how
much say should the hospital have in the determination of how and when a person
should be admitted to hospital?" This past October, he travelled to Ottawa to hear this
question argued in front of the Supreme Court of Canada.
Arne Nes, Eric Hoaken (external counsel), Kristin Taylor, Jonathan Lisus
(external counsel), Ian Mathews (external counsel), Jim McNamee and Dr. Padraig
Darby in the Supreme Court of Canada chambers.
Counsel Kristin Taylor also attended the hearing. "The high court judges
were grappling with issues that Arne lives every day. It was empowering for
Arne and the rest of us to hear this issue we face regularly to be debated
at the highest court in the land," she says.
that while the focus is often on the number of beds available within the
system, the bigger questions are why do people need a bed and how can we solve
the problem without a bed? He says that there is often a revolving door where
homeless people are charged for stealing an inexpensive item like a can of pop,
brought in front of the Mental Health
Court, deemed unfit and sent to CAMH or another
facility for 60-days of treatment to be made fit to stand trial. Returning to
court, they may receive bail and not being well, fail to show up for the
required regular reporting. They are then arrested and the process starts again.
Arne favours alternative solutions. “We need more
and better housing for people with mental health issues. It is better for the
individual and also far more cost effective for society that good care can be
provided in the community where people live. “
The Mental Health Court
has recently made new orders for people to receive intensive follow-up in the
community after a stay at CAMH to help ensure they stay fit and do not get
brought back into the correctional system.
Arne is back in Courtroom 102, advising the court when beds will be available, and
awaiting a Supreme Court decision expected in the next few months, which will
hopefully offer different solutions to this long-standing problem.