Mental health strategy

About the strategy

The Mental Health Strategy marks the beginning of Legal Aid Ontario’s long-term commitment to prioritizing, expanding and sustaining mental health rights and advocacy in Ontario’s legal system.

Working with partners in the justice and health care sectors, the Mental Health Strategy will enable legal aid lawyers to approach the intersecting legal issues of mental health clients in a more coordinated fashion.

Contents

Mental health courts for youth

By Krista Davis and Michele Peterson-Badali

It is a comment which, perhaps, is not often heard – or expected – in Ontario’s criminal justice system.

Someone finally cared about us as people…the court encouraged and acknowledged his hard work. The judge said ‘I believe in you’ and congratulated him.”

This is just one of many similar responses we recently gathered as part of a pioneering evaluation of youth mental health courts in Ontario.

Recognizing the mental health needs of justice-involved youth
“Mental health courts” are becoming a familiar feature of the Ontario criminal justice system. These courts provide an alternative court process that links accused persons with community supports and treatment options, rather than jail time. And they’ve demonstrated promising results. Research shows how adult mental health courts encourage adherence to supportive programs and reduce recurring cycles of criminalization.

But in recent years there has been growing concern regarding the mental health needs of justice-involved youth. Rates of mental illness are generally two to five times higher amongst justice-involved youth than in the general youth population. And while the first youth mental health court opened in Ottawa in 2008, with several more opening since, relatively little is known about their operations and effectiveness.

Evaluating the first mental health court for youth
We were invited to evaluate one of Toronto’s first mental health courts for youth, the “Community Youth Court” at 311 Jarvis. The goal of our evaluation was to understand the court process and test to see if its functions align with effective practices for supporting justice-involved youth with mental health needs.

Information was gathered by closely following youth cases at the Community Youth Court from beginning to end, during the period of 2011 through 2013. Interviews were also conducted with dozens of youth, their parents, and the professionals involved with the court, including judges, crown attorneys, defense counsel, and community and health service providers.

Our results revealed a number of strengths of the program that are important for the rehabilitation of justice-involved youth with mental health needs.

Our findings
For instance, the court focuses on engaging the youth and their family in the court process. This is in keeping with research that has found a significant relationship between positive treatment outcomes and the degree of collaboration and warmth shared by clients and treatment providers, as well as evidence that engaging families is an important part of rehabilitation.

In addition to these findings, one of the prominent themes in our interviews was the importance of the collaborative relationship between the members of the mental health court team: the judge, crown attorney, duty counsel, and youth mental health court worker. Parents and youth felt that the court sought to understand their needs and cared about their well-being.

Another strength of the program was use of mental health screening for all youth entering the court. Screening has proven essential for identifying at-risk youth and triaging those who require more comprehensive follow-up assessment and care. Just over half of youth in Community Youth Court were referred to treatment services that were sufficient for addressing their mental health needs. Many of the participants spoke about the importance of being linked to accessible treatment that the youth would otherwise not have received.

One of the last important areas of strength was how quickly the court responded to youth. Timely intervention is important from both a treatment perspective as well as a criminal justice perspective.

Areas for continued improvement
Our research also revealed several areas for continued improvement.

While mental health screening was a strength of the Community Youth Court program, some researchers support the use of universal screening of all youth before the courts to earlier identify youth requiring mental health services.

Another concern is how to address the multiple needs impacting this population. Research suggests the importance of addressing not only mental health needs to improve well-being, but other factors – called ‘criminogenic needs’ – that have been more directly linked to criminal behaviour (e.g., antisocial attitudes and peers, family functioning difficulties, and academic difficulties and lack of school engagement) to help reduce reoffending. We found that only 20% of youth committed crimes that directly resulted from their mental health issues. In the majority of cases, offences were related to criminogenic needs that may have been connected with young people’s mental health needs. Comprehensive assessments could be better used to further understand young people’s criminogenic needs, mental health needs, and other issues such as a history of trauma.

These areas of improvement provide insight into the types of factors that are important to consider across any program working with justice-involved youth with mental health needs.

For more information about the study or to receive a copy of the evaluation report, please contact us at m.petersonbadali@utoronto.ca or krista16@yorku.ca.

Krista Davis is a PhD student at York University in the Clinical Developmental Psychology program. Her research and clinical interests are focused on the intersection between mental health and justice-involved youth.

Michele Peterson-Badali. Ph.D., C. Psych., is  a professor in theDepartment of Applied Psychology & Human DevelopmentOISE at the University of Toronto.