Note from the editor

CrossCurrents

For centuries, mental illness, substance use and criminality have gone hand in hand. Even today, people with mental health or addiction issues languish in prisons because assessment spaces in psychiatric hospitals are scarce. Our failure to provide appropriate options contributes to disproportionately high numbers of individuals who eventually find themselves in the criminal justice system. Many of these offenders, particularly those with mental health or addiction issues, cycle through the criminal justice and social services systems.

Treatment versus punishment has long been the natural dichotomy in the intersection between the mental health and addiction fields and the criminal justice system. But the two sides are gradually moving toward each other as they seek preventative and rehabilitative measures to deal with offenders with substance use or mental health issues. The stories in this issue of CrossCurrents illustrate how attitudes among professionals in both fields are slowly becoming more liberal and how collaboration can enhance outcomes.

The lack of adequate community treatment programs that grew out of deinstitutionalization means that people with mental health and substance use issues are increasingly coming into contact with police and the criminal justice system. Anita Dubey’s story about mobile crisis intervention teams discusses how police and mental health workers can work together to appropriately address the needs of people in the community who are experiencing crisis.

The issue also discusses mental health court and drug court. Identifying individuals with mental health and addiction problems at the first possible event involving contact with a criminal justice official and streaming them into diversion programs is a secondary prevention that is far better than “treatment” in prison.

Helen Buttery discusses exciting health promotion work being done in prisons that focuses on meditation and yoga. And in her article, Astrid Van Den Broek discusses another innovative prison program – one that addresses the unique treatment needs of women offenders with substance use issues. Until recent years, treatment programs for women offenders have adopted models developed for men. The new Correctional Service Canada program addresses the unique needs of women that often centre around histories of trauma.

Despite progress, much work still needs to be done. In his article, Dan Werb asks why Canada still does not have prison-based needle exchange programs, despite international evidence that such programs are a success.

Finally, the Last Word section provides two sides of the debate about what kind of treatment psychopaths should receive.

Enjoy this stimulating read. Send us your comments, suggestions and ideas. Write a letter to the editor expressing your thoughts on our stories. It is your input that furthers the dialogue around mental health and addiction issues.

Hema Zbogar

tel 416 595-6714

hema_zbogar@camh.net