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CAMH Stories Centre for Addiction
and Mental Health

CAMH goes to the Supreme Court of Canada

Several 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.

Arne bases 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)

Still not 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.   

So the 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.

CAMH goes to the Supreme Court
(L-R):  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.

CAMH General 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.

Arne 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.

Meantime, 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.

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