New guidance provided Quebec Appeal Court over forced hospitalizations

An elderly single woman spearheaded a significant advancement for the rights of people who are ordered to be hospitalized after the Quebec Court of Appeal considerably broadened the obligations of the courts and healthcare institutions to appoint in most cases an ex officio lawyer to safeguard their rights and interests.

The decision, hailed by mental health legal experts as a step in the right direction, all but compels trial judges to appoint ex officio lawyers to represent the interests of individuals deemed to be “incapable” by the court, underlines that hospitals must ensure that such individuals have the opportunity to obtain counsel, and emphasizes that incapable people too have rights that must be respected, according to mental health legal experts.

“The Court of Appeal calls on the courts of first instance to take these matters seriously and to give due weight to judicial debates, as it should, with the contribution of lawyers in most cases,” noted Emmanuelle Bernheim, University of Ottawa law professor and Canada Research Chair in Mental Health and Access to Justice. “The Appeal Court also stresses that the rights (of incapable individuals) are important and they must be debated, and the role of the court is not just to endorse measures taken by others who are doctors. It doesn’t matter how unfit people are. Unfitness does not mean that you can intervene and infringe on someone’s right to integrity and freedom, and that deserves a judicial debate.”

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Death shows lack of police training to deal with people in crisis

A 2017 fatal Montreal police shooting of a man underlined a lack of sufficient training to de-escalate situations when faced with people in the midst of a mental health crisis, found Quebec coroner Luc Malouin.

Pierre Coriolan, 58, was tasered, struck with a rubber bullet and shot three times. Malouin castigated police for using rapid-response tactical training, whose aim is to isolate and control the threatening person. But it is not appropriate approach to deal with people whose mental state is “disturbed,” said Malouin in his 33-page report.

“This intervention does not meet what is expected of police officers trained in recent years. And, in my humble opinion, this is the biggest problem of this intervention: police officers who have not had the most recent training in intervention with people in crisis (and) therefore acted with outdated methods that were in no way up to date with current knowledge.”

Those in the line of duty recognize that training is deficient. According to a 2021 report by an expert panel on Quebec policing, nearly 40 per cent of police consider mental health crisis management training to be inadequate. More than 70 per cent of patrol officers working for the Quebec provincial police believe their training is “deficient” to deal with people facing mental health issues. At present, about 480 hours of training in the police college training program are devoted to “interventions of a social nature.”

From the report:

On-duty police officers “lack the tools, resources and training to fulfil their social role, particularly in terms of intervention with people with mental health problems, sexual violence, domestic violence, or to make effective contact with members of ethnocultural communities.

From a police perspective, the gap between training and the challenges encountered on the street is based on the fact that many of the skills and behaviours adapted to the new realities are not easily acquired in schools or through refresher training, but rather are the result of the experience acquired or the basic temperament of the police officer. (my underlining)

In 2019 Quebec police received more than 80,000 calls to deal with people facing mental distress.

Law students hiding mental health issues and alcohol and drug use

A “significant percentage” of American law students are grappling with mental health and alcohol and drug problems, reveals a recent study, the first to assess alcohol and drug use among law students since 1991 and the first ever to assess prescription use or misuse, mental health issues, and help-seeking attitudes.

More troubling is that law students are afraid of seeking help because they fear that it may jeopardize their chances of being admitted to the bar or getting a good job. Law students, “socialized into a competitive environment in which showing any vulnerability is discouraged,” are also afraid of the social stigma that may be associated with seeking help, according to the study.

“For a self-regulating profession, these data should be very worrisome,” warned the study entitled “Helping law students get the help they need.” “We need to do something, and we need to get started now.”

The study, conducted by a law professor, a dean of law students, and the programming director of a non-profit focused on lawyers’ mental health, surveyed more than 3,300 law students from 15 American law schools about their drinking, drug use, and mental health. Twenty-two per cent of law students reported binge drinking two or more times in the previous weeks, and almost a quarter showed signs that they should go undergo further testing for alcoholism.

Use of marijuana and cocaine appears to have increased since a 1991 survey. Fourteen per cent of law students said they used marijuana in the past 30 days (compared to eight per cent in 1991), and 2.5 per cent had used coke (compared to one per cent in 1991).

Over 14 per cent of law students reported use of some prescription drug without a prescription in the prior 12 months. Approximately 13 per cent of those with a prescription shared their prescription drugs with others in the past 12 months, with stimulants the most frequently distributed.

More than a quarter of law students reported that they had received at least one diagnosis of depression, anxiety, eating disorders, psychosis, personality disorder and/or substance use.

But law future law students are not seeking help, and nor do they intend to. Only four per cent of law students said they used a health professional to deal with alcohol or drug abuse. And while 42 per cent of would-be lawyers believed they needed help for emotional or mental health problems, roughly half actually received counselling from a health professional.

That’s because a staggering 63 per cent of students thought that seeking help was a potential threat to getting admitted to the bar, 62 per cent felt getting assistance was a potential threat to job or academic status, and 43 per cent were concerned about privacy and social stigma. Just as discouraging, 39 per cent of law students felt they could handle the problem themselves, while more than a third stated they simply don’t have the time.

Existing research suggests that a significant number of lawyers who face discipline have an underlying addiction or mental health issue that could affect their ability to fulfil their responsibilities to clients.

“Those most in need of help are least likely to seek help,” pointed out the study. “The very students who most need to understand that they will be best served by seeking help and getting the help they need are the very students who are most concerned that seeking help will be detrimental to their bar admission processes.”

That’s where the culture of law comes into play. Many law students – even before getting to law school – get advice from advisors or from lawyers they consulted to “think carefully” about disclosing information and to be “wary” of how disclosure might be perceived by law schools or by state boards of law examiners. “Character and fitness” questions on law school applications or by state bars appear to be counterproductive and may discourage students from seeking help, suggests the study.

“While in law school, students are getting messages indicating that seeking help may be problematic for their professional careers,” noted the study. “The competitive nature of law school reinforces a message that students are better off not seeking help and instead trying to handle problems on their own.”

Mental health court launched, though skepticism lingers

In the works for the past two years, the Montreal Municipal Court became the latest jurisdiction in Canada to launch a mental health court even though a coalition of local community organizations sought a moratorium and a study to examine the effectiveness of specialized courts for mentally ill people.

Modelled after the Toronto Mental Health Court, the three-year pilot project has put in place a multidisciplinary team to deal with mentally ill people charged with minor criminal offenses. Based on a therapeutic model of criminal justice that seeks to provide a dignified and compassionate approach to dealing with accused persons afflicted with mental illness or developmental disabilities, the Court sits five days a week during the afternoons.

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