Support at court: Connecting people facing criminal charges with mental health treatment

February 21, 2024
For over two decades, people who are arrested and taken into custody in the Greater Toronto Area and who are experiencing mental illness or addictions have found support through CMHA Toronto’s Mental Health Court Support Services.

The recent amalgamation of the court system has altered the landscape of support and advocacy for individuals involved with the justice system. Nevertheless, the program continues to provide comprehensive assistance from the moment of arrest to the case's resolution.

The program provides those who are experiencing serious mental health issues with appropriate services, including in some cases the option of diversion from the criminal justice system to the mental health care system, explains Mandy Calver, manager of the Mental Health Court Support program for CMHA Toronto. The goal is to prevent further involvement with the criminal justice system.

Not everyone is eligible for diversion, but for those that are it can be life changing. The person will be getting appropriate support for their mental health and, potentially, other challenges, such as housing and employment and they can avoid a criminal record which has life-long impact.

Leann Gallant and her colleague Mary Jane Ellis, court support workers from CMHA Toronto, collaborate with staff from COTA Health and Fred Victor, forming the mental health office at the Toronto Regional Bail Centre in Etobicoke. These three agencies handle cases on a first-come, first-served basis, and are the initial point of contact for those taken into custody.

The team works with people between the time they are charged and when their case is resolved through a trial or plea. "We meet with people in the cells, get mental health histories, and determine if people meet the criteria to offer a mental health plan for a release from custody,” Leann explains.

Navigating bail release: The first step

The crucial first step is to prepare a bail release plan, which is submitted by the person’s legal representative to the justice of the peace. If the person has consented, and the plan is accepted by the court, the individual is released on bail and the bail release plan is put into action.

The person will then have their day in court at the newly centralized Ontario Court of Justice on Armoury Street in downtown Toronto. There, for clients from Scarborough or Etobicoke, another CMHA Toronto court support worker, Rachel Ross-Vance or Graham Barker, will work with the Crown Attorney and the judge to assess if the person’s case should be diverted from the criminal justice system and handled within the mental health care system.

To obtain a diversion, “the person needs to follow the plan, meet with their case manager regularly, see a psychiatrist, and report back to the court. If they are successful, the charge is dropped so people don't have a criminal record,” explains Mandy. “Each situation is unique. It requires a lot of conversation. Court support staff spend a lot of time gathering collateral information to help the court make informed decisions,” says Mandy.

Diversion can be a life-changing inflection point for the individual. They get appropriate support for their mental health and often housing and employment assistance. And perhaps most importantly, they will avoid a criminal record which has a profound impact on the person’s life, often for the rest of their life.
Mental Health Court Support’s own record is impressive: for the past several years, over 80 per cent of their clients are successfully diverted from the criminal justice system.

Post-pandemic and mid-amalgamation: More cases, more complexity

Since the amalgamation of the courts in August 2023, Mandy and Leann have seen an increase in the volume of cases. The pandemic has made the situation worse, leading to more people with complex mental health needs, including substance use, and more serious charges.

“Over the pandemic, people have become really unwell. People have told me that they had maintained their sobriety for 10 or 15 years. They ended up losing their housing over the pandemic and started using again, just to be able to manage the difficulties of living on the street. They’d lost their supports, were unable to attend virtual appointments or even know where they could go to access the technology that might have helped them stay connected to support,” Leann says.

The logistical challenges of handling cases from across the GTA at a single downtown location have added further complexity. Clients who formerly had their entire cases managed from their own community’s courthouse now must travel downtown. “Some of our clients have never been downtown. That's not where their life happens,” Leann says.

“A lot of people involved in the justice system have low socioeconomic status and so travelling is really challenging for them. Scarborough to downtown can be two hours on public transit,” Mandy adds. It means that people who cannot afford it may have to take a day off work. And while there are still some virtual appointments available, the process to request a virtual rather than in-person appointment takes several extra steps and the backlog is considerable. Many people who do secure a virtual spot spend half a day or more online waiting for their time in court.

Adjusting to growing pains and new realities

Referrals have risen as everyone involved in the system learns its new parameters. “Previously we would have a duty counsel that worked out of each court,” says Mandy. “Having a set duty counsel at each location, you build relationships with those people, they get to know your program. They understand the clients and what kind of service you provide. They refer based on their knowledge of you and the program.”

There are other growing pains as people gain an understanding of what can be done (and by when) in locations that may present unfamiliar challenges. Mandy shares an example of the court requesting a psychiatric appointment in the next week.  “Our court support worker had to explain that we can't necessarily make this work. First of all, the client lives in Scarborough. Second, they don't have a health card. You can't see a psychiatrist without a health card. We had to work on getting the health card first,” Mandy reports.

Signs of hope and progress amidst change

Despite these initial hurdles, there are signs of hope as the teams work through the issues and settle into a more comfortable rhythm. There’s a new judge acting as a leader in the mental health court who is “very open, really inclusive, and wanting to hear everyone's feedback,” says Mandy.

Everyone is committed to making the new arrangements work for the clients they see. “Instead of trying to jam a square peg into a round hole, we're saying, ‘okay, let's think about this logically. Who are the clients that we're serving? What are their differences, what are their similarities?’ It's getting back on the same page, recognizing that we have a different client group, and figuring out how we can make the system function best for them,” she adds.

Leann says that one of the upsides is leaning into the new resources now available. “We're accessing more resources outside of traditional mental health services to try and make things work for people. I've really come to use [the John Howard Society] a lot because they have resources in different places. They're more than willing. Despite the many changes, everybody's really invested in working together as much as possible to help people succeed,” she says.

One thing that has not changed is the satisfaction Leann and other court support staff take in their clients’ successes. “You have somebody who's really unwell, and you see them get to a place where they're doing much better. They’re able to get out of jail, and get connected to services, to housing. They may eventually be able to get a mental health diversion and have their charges withdrawn. They can go on to be really successful – and ultimately find a sense of hope and belonging in their community.”

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