Youth Mental Health Court. Provincial Youth Crown Initiative

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Youth Mental Health Court Provincial Youth Crown Initiative Panel Members: Heather Perkins-McVey Dr. Greg Motayne Tania Breton Rosemary Dilabio

Panel to address the following questions: 1. How did the YMHC evolve? Group 2. YMHC criteria: Legal and Mental Health? Heather and Dr. Motayne 3. What Collaborative partners are involved and sit on the steering committee? Tania 4. What are some client profiles? Rosemary 5. How is the YMHC going to work? (referral, pre-court meeting, Gatekeeper) Heather 6. What type of profile will appear in the court? (identified 3 groups) Group 7. Feedback on how the first court went May 9, 2008? Group

What the Initiative represents The Ottawa Youth Mental Health Court represents an effort to increase effective cooperation between two systems that have traditionally not worked closely together the mental health treatment system and the criminal justice system. The Court hopes to achieve a variety of positive outcomes for cases involving accused young persons afflicted with mental illness, including: faster case processing time, improved access to community mental health treatment services and improved general well-being among mentally ill young persons with consequent reduced recidivism. Important benefits of reduced recidivism include improved prognoses for the young persons and increased public safety.

Legal Criteria Accused young persons may thus enter the Court for a variety of purposes, such as: Where there is some evidence which may prompt the pursuit of an assessment order with respect to fitness to stand trial, or with respect to criminal responsibility pursuant to s.672.11 or s.672.12 respectively. Whether the issue of any 672.11 or 672.12 assessments are to be done with the accused in or out of custody shall be litigated before the Youth Mental Health Court, in accordance with s.672.16 and s.672.54. That shall be the only circumstance in which the Youth Mental Health Court shall consider a contested issue involving judicial interim release. For trial of the issue of fitness to stand trial pursuant to s.672.23 Where a verdict of unfit to stand trial is rendered and the Court has not made an order under s.672.54, accused persons should appear in the Youth Mental Health Court where a treatment disposition is sought by the Crown pursuant to s.672.58. Such an initiative shall involve the presentation of evidence.

Criteria Continued: Where an accused young person accepts that the Crown s case is made out with respect to the actus reus of an offence but wishes to assert a lack of criminal responsibility on account of mental disorder pursuant to s.672.34, that issue can be dealt with in the Youth Mental Health Court, either on consent or by way of a contested hearing. Where a verdict of not criminally responsible on account of mental disorder is rendered by the Youth Mental Health Court pursuant to s.672.34, the Court may on its own motion, or at the behest one of the parties, hold a disposition hearing in accordance with s.672.45 Where neither fitness to stand trial nor criminal responsibility are in issue, an accused may enter the Youth Mental Health Court in pursuit of an assessment order pursuant to s.21 or s.22 of the Youth Mental Health Act, where there are reasonable grounds to believe that an accused is mentally disordered and that the administration of justice would benefit from a psychiatric assessment of the accused.

Criteria continued: * Likely the most used out of all Criteria; Hearing applications under s.34 of the YCJA for an order requiring that a young person be assessed by a qualified person where there are reasonable grounds to believe that the young person may be suffering from a mental illness or disorder. Where neither fitness to stand trial nor criminal responsibility is in issue, an accused young person may enter the Youth Mental Health Court for plea of guilty and disposition if, in the opinion of the Crown, mental disorder is a central feature of the case and the accused would benefit from the unique sentencing approaches available in the Youth Mental Health Court.

Mental Health Criteria What sort of Mental Disorder will qualify? Given the vagaries inherent in the term mental disorder, especially as it applies to youth, it would be impossible for the Youth Mental Health Court to handle all cases which involve mental health features as they manifest in youth. Subject to further revision by the Youth Mental Health Court Committee, and subject to the ongoing discretion of the Crown, the Court shall concern itself only with those ailments outlined The most common Axis I disorders include: Major mood disorders, including Depression and Bipolar disorder Anxiety disorder Developmental disorders Schizophrenia Other psychotic disorders Substance use disorders and substance-induced mental disorders Mental disorders due to a medical problem PTSD Disruptive behavioral disorders

Special Cases: *For young persons in particular, family dysfunction and disturbed/chaotic interfamilial relationships could manifest as severe behavioral problems that bring them into conflict with law, but also set the groundwork from which personality dysfunctions arise. Such cases which clearly are not included in the Axis I criteria may, from time to time nonetheless warrant inclusion in the Youth Mental Health Court. As with any case, the discretion as to whether a clearly non- Axis I case shall be dealt with before the Youth Mental Health Court shall lie with the Crown.

Collaborative Partners Involved Internal Steering Committee members: 1. Hilary McCormack- Crown Attorney, Ottawa 2. Dr. Greg Motayne- Forensic Psychiatrist, Family Court Clinic, ROHMC, Ottawa 3. Walter Devenz- Assistant Crown Attorney, Youth Team Lead, Ottawa 4. Heather McVey-Perkins, Barrister, Ottawa 5. Johanne Leger- Supervisory Duty Counsel, Ottawa 6. Tania Breton-Youth Mental health Court Worker, Ottawa External Committee Members: Agency Reps from- 1. Children s Aid Society 2. John Howard Society 3. Elizabeth Fry Society 4. Robert Smart center 5. Children s Eastern Ontario Hospital 6. Royal Ottawa Mental Health Center 7. Youth Services Bureau 8. Rideauwood Addictions Center 9. Federal Crown s office 10. Provincial Crown s office 11. Legal Aid 12. Young Offenders of Eastern Ontario Services 13. Ministry of Child and Youth Services 14. Ottawa Youth Probation services 15. Federal Justices Services 16. Ottawa Polices Services

How is the YMHC going to work? (referral, precourt meeting, Gatekeeper) 1. Defense Attorney s/ Duty Counsel can fill out the referral form for the court 2. The Youth Crown has been identified as the Gatekeeper and will look over the referral to see if the youth meet the criteria. If the file meets the criteria, the youth crown notifies the defense and places the file on the next YMHC dockets (first Friday of every month). 3. The Monday before each YMHC day, the defense counsel and/or duty counsel, crown, and community partners involved meet for a pre-screening to ensure that everything is in order prior to the Friday. * A youth picked up over night and in need of mental health screening ASAP, may be placed in the Adult Mental Health Court for the purposes of Mental health screening and to allow the assessment process to be started. The matter will then be adjourned to the next YMHC sitting date for follow-up.

What kind of profiles are identified? 1. Not Criminally Responsible (NCR) and Fitness to stand trial 2. Multi-Faceted profiles that need specialized sentencing and ongoing case management in the community 3. Diversion profiles with minor offences

Profiles that are currently in the court: Subject A-Tania Behaviors: Currently living in Brindle GH (Crown Ward) and participating in some risky behavior. Recent behaviors include putting his head through a glass window, assaulting female staff, not adhering to house expectations, climbing in and out of his bedroom window when he is supposed to be in school and hiding in the closets to elude daytime staff. Increased use of Marijuana. Suspended from school for drug use. Currently on probation at the Group home and if he continues this behavior will be kicked out of GH and placed at Walker GH. Mental Diagnosis: Diagnosed with Anxiety and Depression-Receives ongoing clinical support from Dr. Lena (CHEO) once a month. Currently on five different psychotropic medications. Charges: Assault (going through Collaborative justice), new charges of assault coming in to the system. Both on female staff.

Profile cont. Subject B-Heather Behaviors: Currently living with his Aunt (mother-figure and surety). He struggles with interpersonal relationships and anger. He resorts to burning things to cope and has previous incidents with Arson. Missing school, not following through with the rules at home, and associating with negative peers. Appears to be very open to help. Surety thinking of removing their name. Always sleeping-drinking, smoking marijuana. Mental Diagnosis: Diagnosed with ADD when smaller, Birth mother is an alcoholic, no recent assessment. Community assessment was booked, but did not attend. Charges: Indictable offences

Profile Cont. Subject D-Tania Behaviors: Currently homeless and living on the streets. Parents would like him home, but father is too rigid. Currently banned or kicked out of all shelters in Ottawa, but YSB may remove the ban based on safety concerns. Not in school or working and continues to accumulate by law infractions ($) for trespassing or being intoxicated and making a scene (Provincial Offences). Passing out in snow banks, using any substance that is free and available. Five different YSB workers from different sites are trying to wraparound this youth, but instability and cognitive difficulties are acting as barriers. Case conference set for next week. Mental Diagnosis: Dr. Spencer educational psychosocial- anxiety and indicators of ADD. Grade 7 Charges: Summary offences to date.

Profile cont. Subject F-Rosemary Behaviors: Currently a Crown ward of CAS. Has burnt out every GH in Ottawa, by chronic running, property damage, assaults and not adhering to rules. Functions well in a structured setting and with firm but fair staff. Mental Diagnosis: FCC completed, ADD, indicators of Conduct disorder, birth mother alcoholic. Charges: summary and indictable-currently on probation