Executive summary

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At the request of the National Justice Statistics Initiative, the Canadian Centre for Justice Statistics (CCJS) examined the feasibility of collecting data on the involvement of adults and youths with mental health issues in the criminal justice system. The results of the feasibility study will help guide future consideration of the development of ongoing data collection to gather information on the nature and extent of the involvement of individuals with mental illness in the criminal justice system.

The feasibility study has three main goals:

1. to provide an overview of the history of societal and legislative treatment of mental illness in Canada and studies on the relationship between individuals with mental illness and the criminal justice system;
2. to consult criminal justice stakeholders on their information priorities, data collection, barriers to data collection, and the feasibility of collecting data on the contact of individuals with mental health issues in the criminal justice system; and
3. to propose viable options for data collection involving police, courts, and corrections.

The following report is divided into two parts. Section A addresses the first goal of the feasibility study by examining the background of the mental health issue. Section B addresses the remaining goals of the feasibility study in presenting the results of the consultations and proposed options for future data collection.

In response to a demand from the justice community, this current report focuses on issues related to mentally ill individuals who come into contact with the criminal justice system through calls for service to the police, or as accused or offenders in the criminal court and correctional systems. It does not examine issues involving persons with mental illness who are victims of crime.

Section A

Section A discusses the societal shifts in views on mental illness, definitional challenges regarding mental illness, criminal justice system processes, and previous studies on the prevalence of individuals with mental illness in the criminal justice system, and the relationship between mental illness and the justice system.

The perception and treatment of persons with mental illness has changed over time, including key developments in the criminal justice system. Since 1992, amendments to the Criminal Code have increased the rights of offenders found not criminally responsible by moving away from the prerogative to hold persons for an indeterminate period of time.

Each criminal justice sector approaches the issue of mental illness based on their particular roles and their legislated obligations. As such, there are often differences in the way mental illness is defined, ranging from observational and reportable behaviours to official diagnoses. For an accused person, contact in the criminal justice system may involve all three levels of the criminal justice system, namely police, courts and corrections, or contact may be limited to one or two levels of the justice system.

Determining the prevalence of mental illness within these sectors has been attempted by a number of researchers, but these studies have been generally restricted to samples that were not nationally representative. Researchers' explanation of the relationships between mental health and the criminal justice system is presented in Section A, including two leading explanations: the increasing visibility of mentally ill individuals, as well as the increased risk to commit crime under aggravating circumstances.

Section B

Section B discusses the results of the consultations, including general objectives of data collection, definition of mental health and mental illness, information needs and priorities, data availability, a proposed data collection approach involving police, and other options for data collection.

Objectives for data collection

Those consulted were presented with five possible objectives for collecting data on persons with mental health issues in the criminal justice system and were asked to rank them in terms of importance. The five objectives presented to the stakeholders were:

• Improve public awareness regarding the issue;
• Assist those in the field and in policy to make information-based decisions regarding responses to the issue, including program development;
• Measure workload, performance and outcomes;
• Establish baseline information; and,
• Work toward consistent data recording practices.

Stakeholders often indicated that these objectives could not be viewed as mutually exclusive but would be overlapping.

Definitional issues

One of the main challenges to gathering consistent data on the involvement of individuals with mental illness in the criminal justice system is a precise and common definition. To assist with developing data collection, the consultation document (Appendix 3) asked stakeholders to consider what types of behaviours or disorders should be included when defining persons with mental health issues.

The results of the consultations reveal variations in definitions across the sectors. These differences in defining mental illness stem from differences in the operational demands and distinct roles of police, courts, Review Boards, and corrections. For instance, as the first tier of the criminal justice system, police must take immediate action on calls involving a variety of individuals, whether or not they have committed a criminal offence and whether or not a clinical assessment has taken place. This is unlike the traditional criminal courts that strictly deal with individuals who have been charged with an offence and judge the accused persons based on the evidence. Typically, mental illness is raised in court when there is a question of fitness to stand trial or when the accused is believed to be not responsible for the crime on account of mental disorder. An assessment is required in these cases.

Some stakeholders argued that given the differing roles and expectations, a definition should be customized for each sector. On the other hand, a few argued for a more uniform conceptualization of mental health issues across all criminal justice sectors. This discussion examines the definitional issues based on the viewpoints of justice stakeholders.

Priority issues and information needs

As part of the discussion surrounding data needs, those who participated in the consultation were asked to identify the priority issues in their jurisdiction with respect to youth and adults with mental health issues. These priority issues covered the areas of police, courts/Review Boards and corrections. In this report, data needs related to the identified issues are listed directly following their description. Across the sectors, a few key issues were repeatedly mentioned. These issues are outlined below.

1. Lack of mental health resources

It was argued that a lack of mental health services and resources in Canadian communities for persons with mental illness was a significant contributor to the growth in the number of persons with mental health issues entering the criminal justice system. In the absence of sufficient services, many mentioned that the criminal justice system was being used as a primary mechanism for delivering service and healthcare to persons with mental health issues. These issues were particularly pronounced for rural areas and northern communities.

The corresponding data needs for the resource issues include:

• Prevalence, demographic, and mental health characteristics of persons with mental health issues in the criminal justice system; and,
• Number of persons with mental illness in the community who are not receiving services.

2. Relationship between mental illness and involvement in the criminal justice system

There was also some interest in the etiological link between mental illness and contact with the criminal justice system. This interest stemmed from a concern of the impact of limited access to social services in the community (such as housing, employment, and education opportunities) on those individuals with mental illness. The corresponding data needs relating to risk and protective factors on the involvement in the criminal justice system were identified as:

• Social determinants of mental health and contact with the criminal justice system (e.g., homelessness, education level, substance abuse, lack of employment opportunities);
• Offender's history of victimization; and,
• Type of mental illness that contributed to the offence.

3. Sharing of information and collaboration between service sectors

Many stakeholders also expressed the opinion that perceived system inefficiencies were rooted in restrictions on the sharing of information, including privacy legislation and the need for informed consent by clients, and a need for more collaboration between justice sectors and between justice sectors and the health sector. Barriers to information sharing affected the continuity of services to individuals with mental illness. To inform this issue, the following data needs were identified:

• Information on barriers to sharing information; and,
• Data on relationships between different sectors.

Data availability

To determine the data that are currently being collected or have ever been collected on persons with mental health issues and the criminal justice system, participants were asked about their organization's current and past data activities. These activities include systematic, on-going tracking of information or one-time studies. Within the three criminal justice sectors, namely police, courts/Review Boards, and corrections, it was revealed that there is little standardization in the types of data collected and the method of data collection and storage.

Among the different police services, information on the involvement of persons with suspected mental health issues may be captured on a regular or one-time basis. In all, eight types of data collection approaches related to mental health were identified through the consultation process. The majority of these data are stored electronically.

For the courts, data collection occurs within traditional criminal courts, specialized mental health courts, and Review Boards. The majority of provinces and territories collect information on fitness hearings and decisions of "not criminally responsible on account of mental disorder". These data are reported through the Integrated Criminal Court Survey (ICCS), which is managed by the Canadian Centre for Justice Statistics. Very little detail on specialized mental health courts is available through the ICCS, due to difficulties in distinguishing mental health courts from other criminal courts. Review Boards, which monitor cases where individuals have been found unfit to stand trial or not criminally responsible on account of mental disorder, record information within individual case files. This information is often not aggregated and is stored in paper format. In jurisdictions with larger caseloads, electronic databases are maintained.

At the corrections level, some standardization exists with the Integrated Correctional Services Survey (ICSS), which is managed by the Canadian Centre for Justice Statistics. However, this survey is limited in its application to the issue of mental illness. Only one ICSS data element contains information on mental illness and it is restricted to security concerns, namely it is limited to inmates with mental illnesses who are displaying coping problems within the prison environment. Data are also collected independently by provincial/territorial and federal governments. Correctional Service of Canada (CSC), which is responsible for federally sentenced offenders, has two data collection approaches that contain indicators of mental health status.

Feasibility of data collection involving the police

Part of the consultation focused on the policing community and the feasibility of a specific data collection approach. All stakeholders who felt in a position to comment on the policing sector were asked about the feasibility of conducting a survey with a sample of police services. It was proposed that the study would be conducted for a period of time during the year, whereby the sample of police services would be asked to complete a one-page survey on incidents involving persons with mental health issues.

Challenges to the specific approach were expressed (e.g., burden upon police services to take part, accuracy of the information that would be collected, etc.) as well as suggestions for modifying the approach.

Options for data collection

Section B concludes with a set of options for data collection involving police, courts/Review Boards, and corrections. These options are based on the results from the consultations.

Household survey on contact with police and courts
An option to include questions on contact with police and courts should be considered if a general household survey on the mental health and well-being of Canadians is conducted in the future.

Police
One option is for police services currently using "Emotionally Disturbed Persons" forms to collaborate to standardize the data collection tool, as well as data capture and storage systems. Once standardized, police services using the EDP forms could make this form available to other police services to assist with increasing the collection of standardized data.

Courts
Options that could be considered are improvements to the Integrated Criminal Court Survey (ICCS) data, which is managed by the Canadian Centre for Justice Statistics (CCJS). This could be done by promoting consistency in reporting across jurisdictions, increasing survey coverage and identifying specialized mental health courts.

Review Boards
Justice Canada to repeat their 2006 study and expand the number of provincial/territorial Review Boards included in the study.

Corrections
Federal, provincial and territorial correctional systems consider collaboration to identify standardized questions regarding mental health and methods to collect and store the data in an electronic format that would be in accordance with each jurisdiction's privacy legislation.