Systemic Advocacy Issues: 2005
Promoting Rights through Systemic Action
2005
Rights promotion is a process that often requires action at a variety of levels within health and social service systems of care, treatment and support, the courts and government in order to effect positive change. This process requires diligence and perseverance over a long period, as lasting progress seldom happens overnight. Promoting rights is about catalyzing social change. It is about slowly and incrementally raising awareness, reducing barriers to accessing existing rights and justice, eliminating discrimination and enshrining in law recognized standards of protection for individuals with mental illness and disability.
The following captures the PPAO’s efforts to advocate for social change through action taken at the systems-level. Many of these issues require continued advocacy and are representative of the work carried out by PPAO staff and other stakeholders, over an extended period of time.
Bill C-10 - An Act to Amend the Criminal Code (Mental Disorder)
Complementing its earlier submission to the House of Commons, the PPAO presented to the Standing Senate Committee on Legal and Constitutional Affairs regarding Bill C-10, An Act to Amend the Criminal Code (Mental Disorder). The PPAO called for the inclusion of a statement of purpose within the Criminal Code emphasizing the goals of recovery and reintegration into society. Drawing upon many years of experience, the PPAO noted the profound stigma and discrimination experienced by forensic clients when seeking housing, employment and social acceptance. Also noted was the disturbing trend toward criminalizing mental illness-related behaviours, diverting individuals into the criminal justice and forensic systems. The PPAO recommended the formation of a working group to address stigma and promote understanding and acceptance through an educational campaign. The PPAO opposed the proposed change allowing victim impact statements to be presented at Review Board hearings, recommending that a more appropriate forum for these statements be considered.
Bill 164 – The Smoke Free Ontario Act
A submission was made to the Standing Committee on Finance and Economic Affairs of the Ontario Legislature. The PPAO called attention to the potential impact of a smoking ban on individuals choosing to smoke who were resident in psychiatric facilities throughout the province. While acknowledging the negative health consequences of smoking, the PPAO endorsed the right of individuals hospitalized in mental health facilities to make an informed choice about smoking and to be able to exercise that right. Accordingly, the PPAO recommended that the proposed legislation exempt the current and former provincial psychiatric facilities, forensic programs and Schedule 1 facilities under the Mental Health Act from an absolute ban on smoking or lighting tobacco and that controlled smoking areas be established to provide an area for those who choose to smoke to exercise that right.
Review of the Police Complaints System
A submission was made to the police complaints review in August 2004. Many consumers of mental health services have contact with police officers in a variety of ways, including, for example: police may transport them to hospital, be called to a disturbance, and the investigation of a crime. The Report of the Police Complaints System in Ontario, released on April 22, 2005, underscored many of the concerns raised by the PPAO. The PPAO continues to work toward the development of a complaints process that is administered by an independent body and that supports equitable access for consumers of mental health services and the public at large.
Kirby Commission on Mental Health, Mental Illness and Addiction in Canada
The PPAO made a submission to the Standing Senate Committee on Social Affairs, Science and Technology regarding its study of mental health, mental illness and addiction in Canada. Four key areas of need were targeted, namely: independent advocacy services for all individuals with mental illness; the provision of formal rights advice in the delivery of mental health services; the development of a recovery-oriented system of mental health services that fully engages and involves consumers; and the development and implementation of a comprehensive of anti-stigma and anti-discrimination education program. The PPAO supported the creation of a Prime Minister’s Commission on Mental Illness, Mental Health and Addiction with broad representation across Canada, and significant, if not majority, representation by consumer-survivors.
The PPAO also called for the strengthening of accountability mechanisms by: creating a federal ombudsman; enhancing resources to the Canadian Human Rights Commission; increasing legal aid funding to improve consumer access to legal avenues of redress regarding rights violations; and by developing a federal mental health act and bill of rights for consumers of mental health services.
Mandatory Inquests
The PPAO was granted intervenor status, together with the Mental Health Legal Committee and the Empowerment Council for the Centre for Addiction and Mental Health, in appearing before the Ontario Human Rights Tribunal regarding the alleged discrimination by the Coroner’s Office in failing to order inquests into the deaths of two patients detained in psychiatric facilities under the Mental Health Act (MHA). According to the Coroner’s Act, inquests are mandatory when an individual dies while in police custody or in jail. Inquests are discretionary for individuals detained under the MHA. The PPAO contends that this practice is discriminatory and violates both the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms, which guarantee equal treatment for those with disabilities. For this reason, the PPAO is advocating for a change in the current legislation and practice making inquests mandatory for those individuals who are held involuntarily in psychiatric facilities.
Bill 159 – An Act to Revise the Private Investigators and Security Guards Act
The PPAO made a submission to the Standing Committee on Social Policy of the Ontario Legislature regarding Bill 159. Many consumers of mental health services have contact with security personnel in a variety of settings, including, for example: hospitals, mental health programs, community drop-ins, shelters, public transit, and local shopping malls. The PPAO has often been informed by its clients about the difficulties they have encountered during interactions with security personnel. Some individuals have voiced concern that they are not taken seriously by security personnel as a consequence of their mental health histories. The PPAO recommended changes to the proposed legislation calling for specialized training for security personnel who work with vulnerable individuals in hospitals and mental health facilities. Also recommended was the inclusion of guidelines for conduct, the use of electronic surveillance, and the maintenance of confidentiality.
World Health Organization International Forum on Community Mental Health Services)
The World Health Organization (WHO) held its first international consultation on community mental health services in September 2005. The PPAO, in its submission to the WHO, recommended that independent advocacy and rights advice be considered integral and included in the development of any community-based psychosocial rehabilitation program or services. The development of a multi-tiered anti-stigma and anti-discrimination initiative was also recommended to WHO in the development of community-based services. Such an initiative would address factors at individual, health practitioner, community and systemic levels. The PPAO called for the development and implementation of a rehabilitation model that is non-discriminatory and grounded in the principles of recovery.
Consultation on the Regulation of Psychotherapy and/or Psychotherapists
The PPAO responded to the Health Professions Regulatory Advisory Council’s consultation request regarding the possible regulation of psychotherapy and/or psychotherapists. At present, both psychotherapists and the practice of psychotherapy are largely unregulated. The PPAO is, therefore, particularly concerned with the protection of vulnerable individuals who are consumers of mental health services and who may have difficulty in safely navigating the vast array of available psychotherapeutic and counselling approaches. The influence, authority and relative power of the counsellor or psychotherapist has the power to help or harm clients. Where there is a lack of regulation, consumers may be harmed through contact with unprincipled practitioners who may intentionally exploit them for personal gain. Consumers may also risk harm through contact with practitioners lacking adequate knowledge, skill or training. Broadly, the PPAO called for the regulation of both psychotherapy and counselling practitioners and the practice of psychotherapy and counselling, as a two-pronged regulatory scheme. A new regulatory scheme was proposed to address quality assurance, complaint and discipline issues. The PPAO recommended a comprehensive consultation with consumers, families, practitioners and other stakeholders to define, develop and implement this new regulatory and accountability mechanism. Within the proposed framework, aboriginal and other culturally-specific healing and counselling practices would be exempt from regulation.
The Regulated Health Professions Act
The PPAO participated in the Health Professions Regulatory Advisory Council’s consultation on the Regulated Health Professions Act. The PPAO made recommendations in the areas of public protection, accountability, quality assurance, fairness and efficiency. The PPAO highlighted the myriad barriers encountered by vulnerable individuals in accessing professional regulatory and protective mechanisms. Among its recommendations, the PPAO called for an effort to sensitize members of professional colleges to the difficulties faced by mental health consumers seeking access to the complaint and discipline process. The PPAO recommended further that the Act include provisions to support and accommodate the special needs and circumstances of individuals with mental illness. Guidelines were also called for to define the criteria under which complaints may be dismissed as frivolous or vexatious, as well as a public reporting mechanism to monitor complaints that are dismissed on this basis. In the area of rights protection, the PPAO recommended that colleges establish clear guidelines for the provision of rights information to individuals found incapable of consenting to treatments proposed by member practitioners. In this scheme, colleges would be responsible for ensuring that members understand the information to be provided and are able to assist individuals in applying to the Consent and Capacity Board; members failing to provide the requisite information or failing to assist incapable individuals in exercising their right to review when requested to do so, would be sanctioned.
Pinet v. Administrator, Mental Health Centre, Penetanguishene et al.
The PPAO sought intervenor status in this matter being brought before the Ontario Superior Court of Justice. The PPAO is particularly concerned that psychiatric facilities are failing to transfer those found not criminally responsible, in a timely manner (“forthwith”), to the least restrictive environments in accordance with their Review Board disposition orders; such untimely delays may disadvantage not criminally responsible accused through an unwarranted restriction of their liberties and potentially negative impact on their rehabilitation and recovery.
< Back
