In an Edmonton courtroom on a Thursday morning near the end of May, a prosecutor quietly dropped a minor criminal charge against a bipolar middle-aged woman, and ushered in a new era for offenders struggling with mental illness.
For the first time in the city's history, mentally ill adult offenders charged with low-risk, non-violent crimes can now be diverted out of courtrooms and jails and into the hands of mental health professionals who will get them the medical and social services they need to keep from reoffending.
The Edmonton Diversion Service has been taking clients since January, and the first two of fenders completed the program and had their charges withdrawn late last month.
Crown prosecutor Dave Hill, who is overseeing the service, says at least 20 offenders are now taking part in the program.
"If these people are stabilized, then they are not out committing crimes in the community," Hill says. "They don't have to pay for mental illness with a criminal conviction. They get supports so they can live a happy, productive life."
The program aims to stop the "revolving door" of the justice system.
"Right now, if someone comes into court with a mental illness having committed a crime, they will receive a sentence like anyone else and then treatment--if there is any--is only achieved through probation," deputy chief Judge Allan Lefever says. The result is a "revolving door" that sends untreated, mentally ill people back into the community where they commit more crimes and repeatedly return to court to face minor charges.
"What I'm hoping we can do is get them connected to mental health professionals at the outset, and get them connected to the community, and provide a holistic, integrated approach to mental illness," Lefever said. "The goal is to close that door, and if we succeed, they won't be back at all."
On the street, police are handling more mental health calls than ever. Between 2005 and 2008, the number of calls to Alberta RCMP to deal with emotionally disturbed people doubled, while an Edmonton police crisis team that handles mentally ill people has reported a 36-per-cent increase in calls since 2005.
In prison, one in 10 inmates has a diagnosed mental illness, 60 per cent more than in the late 1960s. At the same time, roughly 135 people are under the jurisdiction of the Alberta Review Board because they were found unfit to stand trial or not criminally responsible for an offence due to a mental illness, a number that has been rising for the past five years.
In court, there is only anecdotal evidence to suggest a growing number of mentally ill people are coming before the bench. However, when a pilot diversion program for mentally ill offenders opened in Calgary in 2001, the program received 428 referrals in a two-year period--twice as many as expected.
Edmonton's new diversion service is modelled after that pilot program, which achieved remarkable success. Two of every three people who took part in the Calgary program succeeded in having their charges withdrawn, according to a 2007 study in the Journal of Mental Health Policy and Economics.
In the 18 months after the program, the study showed those successful offenders were 87 per cent less likely to be charged. In the 18 months before the program, they went to court more than 1,300 times; in the 18 months after the program, they went 114 times.
Successful participants were also 25-per-cent less likely to visit an emergency room after taking part, and almost half as likely to be admitted to hospital.
The study concluded the program saved the justice and acute health-care system more than $1,700 per client--a figure that does not include court costs.
The success of the Calgary program led to expansion into St. Paul and Lethbridge in 2005. This month, the provincial government announced an $11.8-million contribution to mental health and addiction programs as part of the Safe Communities Initiative. Some of that money is expected to fund the expansion of mental health diversion programs not only in Edmonton, but also in Airdrie, Fort McMurray, Medicine Hat, Grande Prairie and Red Deer.
The service provides focused, short-term intervention, Hill says. First, a Crown prosecutor, defence lawyer, judge or family member identifies the accused as a potential candidate for the program. Mental health workers then complete an evaluation and consult with prosecutors. Together, they decide if the accused will benefit from the program.
If accepted, the lawyers return to court and seek a three-month adjournment. During those three months, social workers and psychologists work with accused to link them to mental health and pharmacy services, secure housing, income, employment, meaningful activity and education.
Then the accused returns to court; in roughly 80 per cent of cases, the accused has succeeded in reconnecting to the community, and charges are dropped.
Aggy King-Smith has been the manager of the Provincial Diversion program since its inception. She says offenders accepted into the program most commonly suffer from schizophrenia and other psychotic disorders as well as mood, adjustment and anxiety disorders. Most participants are charged with thefts under $5,000, minor assaults, or they have simply failed to appear in court--all minor, non-violent offences.
King-Smith says the province moved away from a mental health court model because of concerns about stigmatizing people struggling with mental illness and increasing the burden on the court system. Diversion program participants will appear in all courtrooms, just like anyone else.
"This is a cost-effective, less stigmatizing response," she says. "It is a co-ordinated, community-based response where everyone takes on a certain degree of responsibility to make sure that person stays connected."
Unlike drug courts, accused people do not have to plead guilty because doing so brings in vexing issues of fitness to stand trial. To work around the problem, co-ordinators have decided the requirement for entry is simply an agreement to participate.
Tom Shand, executive director of the Alberta division of the Canadian Mental Health Association, says diversion is a positive step that will help address increasing criminalization of the mentally ill.
"Jails have become like the sanatoriums of previous generations," he says. "What happened in Alberta and across Canada is that the government recognized that most mentally ill people could be more effectively treated in the community than in a facility, so they closed the institutions. But they didn't put any money back into the community supports, so there wasn't anywhere for these people to go."
That was when the revolving door opened. Shand says the diversion program is a solid first step to closing that door, but he worries the government won't follow up with adequate mental health resources in the community.
"This is a very positive step, and will address people again who come into contact with the law and need help instead of punishment," Shand said. "But you still need places for people to get the services they need once the court releases them into the community."
Veteran criminal defence lawyer Robbie Davidson represented the bipolar woman who was among the first to complete Edmonton's new diversion program. She is in her 50s, a gifted woman with a long history of mental illness. He says the program has given her the opportunity to address her illness with renewed support from the community.
"The diversion program is arguably long overdue, but it's a recognition of the unfortunate people in our society who, because of mental illness, get enmeshed in the criminal justice system.
"This is a way for those people to be liberated from the criminal justice system."