With staffing issues and limited available beds prompting mental health assessment backlogs in Manitoba’s criminal justice system, field experts are recommending the province tap into federal rules which allow trained psychologists to shoulder some of the burden.
"If there’s shortages in the mental health area, it’s going to impact the legal system, if there’s interplay between mental health and the law," clinical forensic psychologist Dr. Barry Cooper said in a phone call Wednesday from British Columbia.
"It’s clearly the case that there are bed shortages, there are assessment delays across the country. There’s little doubt that by adding qualified clinical forensic psychologists to the roster of people able to do this, that would mitigate delays."
Currently, Manitoba’s justice system is burdened by hospital delays, which leave patients waiting in custody — sometimes months — for a berth at the specialized Winnipeg Health Sciences Centre unit.
There are just 15 beds and three forensic psychiatrists in the unit to manage patients with a range of needs, including: fitness for trial assessments, criminal responsibility assessment, treatment orders, and those who are severely ill and unable to be released to community.
According to a 2019 file review of criminal responsibility and fitness for trial assessments, conducted by psychologists at the University of Manitoba, demand for assessments has risen steadily between 2003 and 2019.
In 2015, the data found criminal responsibility assessments took an average of around 30 days to complete — in line with Criminal Code requirements — but by 2019, the average had risen to 80 days. The Criminal Code mandates assessments take no longer than 60 days to complete.
Cooper sits on a national task force, commissioned by the Canadian Psychological Association, tasked with asking government officials to adjust the code to specifically allow forensic psychologists to perform criminal responsibility and fitness assessments, thereby lightening the load for forensic psychiatrists.
Forensic psychologists are already being called upon to perform specific testing under the banner of these psychiatric assessments, or to provide second opinions for defence and Crown counsel, Cooper explained. Final reports must still be completed by the small complement of forensic psychiatrists.
"Psychology has a lot to bring to the table because we can assess and treat mental illness," he said. "The benefit would be allowing more qualified people to do a job that they’re qualified to do; it would be increasing the pool of qualified professionals."
In 2005, the Criminal Code opened room for both medical professionals and "any other person who has been designated by the Attorney General as being qualified" to perform these assessments.
But in more than 15 years, no province has officially opened the doors to qualified forensic psychologists, said Dr. Jo Ann Unger, president of the Manitoba Psychological Society.
"Right now, nowhere in Canada are clinical forensic psychologists doing this independently, but there is opportunity to make that happen very quickly," she said in an interview Wednesday. "It would help a lot to be able to have them do those independently and increase this access for that really important service."
To proceed, the minister of justice would need to designate clinical forensic psychologists with relevant training as permitted to complete the assessments. Currently, Unger said there are at least five such psychologists working in the province, with ongoing recruitment efforts underway.
Unger said the formal designation from Manitoba's attorney general could provide permanent support for the growing problem.
"The demand for these assessments is increasing every year," she said, "So this shouldn’t be a stopgap solution because the gap is going to continue."
In a statement to the Free Press, Manitoba attorney general Cameron Friesen noted the province has taken an "interdepartmental approach" to the backlogged system in order to reduce delays and maximize use of resources. Whether psychologists will be added to the list of qualified assessors, however, remains to be seen.
"While there have been calls by MPS to allow psychologists to additionally undertake these assessments, the issue is complex," Friesen wrote. "The Canadian Psychiatric Association has responded to indicate that there are additional factors which must be properly considered, including; scope of training and practice, resource allocation, and more.
"In the meantime, our government is in the process of hiring additional forensic psychiatrists and working with clinical leadership to address the issue and free up capacity."
Julia-Simone Rutgers is a general-assignment reporter.