Winnipeg Free Press - PRINT EDITION
Posted: 02/28/2013 1:00 AM | Comments: 0
The Manitoba courts have run into a new source of backlog -- lengthening lineups for psychiatric assessments are delaying cases, forcing accused persons to sit in pre-trial custody in jail or the remand centre. A shortage of forensic psychiatrists is the problem, but at root of the issue is what appears to be a historical deference to medical professionals.
The courts traditionally have relied on psychiatrists, who are medical doctors, to prepare reports on and testify to the competence or mental health disability of those charged with crimes. Courts have relied on the forensic unit at the Health Sciences Centre, typically staffed with five forensic psychiatrists, to complete these pre-trial assessments. That unit will soon be reduced to one physician as a result of retirements or the decision of some to leave to set up a more lucrative private practices.
The Winnipeg Regional Health Authority is recruiting, but it's a tough job in a country where psychiatrists are paid less than other specialists. Furthermore, forensic psychiatry is a subspecialty of limited interest.
Courts, like the broader society, have moved to adopt greater sensitivity to the role mental health plays in criminal conduct. The advent of a court dedicated to dealing with accused persons debilitated by disorders, meanwhile, has increased pressure on the system's ability to gather psychiatric evaluations. Court-ordered assessments, increasingly, are central to the justice system's ability to determine criminal responsibility. Amid this, HSC's forensic unit has lost physicians and now assessments are being delayed excessively, with some being scheduled into April.
The WRHA (finally, some note) is planning now to include other practitioners, including psychologists, in the forensic unit to diagnose, treat and monitor people with mental illness who come into conflict with the law. It is also looking at improving the pay packets of psychiatrists.
This may help speed along requests for assessments, but it is anticipated that court reports will have to be signed off by psychiatrists. That reveals an unnecessary bias to physicians, whose skills are required in specific, but not all, cases where compromised mental health is in question.
Courts have defaulted to physicians (psychiatrists) to write assessments because the Criminal Code specifically sets out the necessity of a medical practitioner's assessment.
Sec. 672.1, however, allows the attorney general to decide if other qualified professionals can do the assessments. Forensic psychologists also provide advice, sometimes alone or in tandem with psychiatrists, to the courts. But courts continue to defer to medical doctors for evaluations of competency of the accused.
The idea has long past that most things related to health are the purview of those with MD attached to their names. Scope of practice for various health professionals has expanded, particularly in community hubs of health and wellness. Even the holy realm of drug prescription and referrals to specialists has been breached now that nurses, physiotherapists and psychologists are writing 'scripts' for patients. Canada is catching up to moves made in other jurisdictions.
The skills of forensic psychiatrists are specifically required for some severe medical illness. But many cases can be assessed by forensic psychologists, so the delay in the courts' ability to proceed with cases in which there is a question of mental capacity results from an archaic and exclusive bias.
What the criminal courts need is the educated advice and guidance of experienced professionals who can determine whether mental health and competency plays a role in criminal conduct. Manitoba's adherence to a strict reliance on forensic psychiatry is unnecessarily restrictive. Attorney General Andrew Swan should change the rules for court-ordered assessments to expand the expertise courts can rely on.
Editorials are the consensus view of the Winnipeg Free Press’ editorial board, comprising Catherine Mitchell, David O’Brien, Shannon Sampert, and Paul Samyn.
Republished from the Winnipeg Free Press print edition February 28, 2013 A14
Having problems with the form?Contact Us Directly
WRHA issues boil-water advisory
Ambulance delays cost WRHA $1.4 million
More help promised for Manitoba child welfare in light of Phoenix Sinclair inquiry
Oswald makes campaign pledge to boost workplace health and safety enforcement
Brother charged for alleged assault on boyfriend
Big banks cut prime rate to 2.85 per cent
Firm fined $4,800 for massive fire
Watchdogs want Conservative bill quashed
Obama floats offering first-ever drilling lease in Atlantic
Mom who used iron to scald boy loses appeal
Dog killed during break-in
Super Bowl, Tiger make Phoenix centre of sports universe
Mayor Bowman to launch a website to solicit ideas on beating racism
Grain shippers face railway backlog: report
Electronic music duo Purity Ring to play Garrick in June
Three men's teams clinch playoff spots
Tim Hortons lays off staff at headquarters
Experts: Gold nuggets stolen from museum may be tough sell
Mexico: Investigation shows that all 43 students are dead
Michelle Obama navigates limits on women in Saudi Arabia
Snubs, surprises of this year's Juno nominations
Jets hoping to extend their season-best winning streak against depleted Pens
Goaltender Martin Brodeur to retire
Cinematheque program explores how novels translate into films
Balanced books possible amid oil slump: PBO
Facebook blames glitch for global outage
Teen acquitted in fatal assault
RCMP arrest Portage la Prairie man in sexual assault case dating back to 2013
Marriott buying Delta Hotel & Resorts brand
Manitobans earn 12 Juno nominations
Big-box chain Lowe's could replace Targets here
Paramedics scare off suspect of attempted abduction
Mom heading to Australia with son aquitted of abduction
Documentary chronicles "Clara's Big Ride"
Passenger traffic increases in airport's fourth quarter
Monarch butterflies rebound in Mexico, numbers still low
Blizzard howls its way into Boston but largely spares NYC
Secret talks in Jordan try to win release of hostages
On Auschwitz anniversary, leader warns Jews again targets
Long-term care probe makes progress: ombudsman