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February 9, 2008 -- Ottawa Citizen (CN ON)

Column: Institutions Emptied Out, And Prisons Filled Up

By Dan Gardner

Return to Drug War News: Don't Miss Archive

This week, the Vancouver Police Department released a report that deserved to be front-page news across the country. "More than one-third of all calls for Vancouver Police involve people with mental health issues," the report found. "In the Downtown Eastside, it increases to almost one in every two calls."

I'm sure the stats would be similar in almost any big city in North America, and that's what makes this report important. It provides real insight into what an effective crime-fighting strategy would look like. And it's a strong indication of what won't work.

What won't work? It's pretty much what the federal government is doing.

Tougher sentences will make thugs think twice before mugging little old ladies, the Harper government insists. More punishment equals less crime. But underlying that conclusion are two assumptions: One, that would-be criminals are aware of the sentencing provisions of the Criminal Code; two, that they factor that knowledge into the rational calculations they make in deciding whether to commit a crime or not. Does the benefit outweigh the risk? If so, they do it. If not, they don't.

There's plenty of evidence that both assumptions are wrong in most cases. The average criminal isn't a 42-year-old chartered accountant with a newspaper subscription, after all. He's an ignorant and impulsive 21-year-old who can't spell "rational calculation."

And that's before we factor in alcohol and drugs. Substance abuse is so common among criminals it's actually the sober repeat offender who stands out, and being drunk or stoned is an excellent way to stifle pesky thoughts about the long-term consequences of one's actions.

And finally, there's mental illness. What does the threat of a mandatory minimum prison sentence mean to a frightened man struggling not to hear the voices in his head? How much weighing of benefit and risk will be done by a woman in the depths of suicidal depression? If it is silly to expect an ignorant and impulsive 21-year-old criminal to engage in rational calculation, it is insane to expect it of the insane.

Crime, drugs, and mental illness are rarely seen apart. In sad places like Vancouver's Downtown Eastside, they swirl together and form dark pools of misery.

On some level, we all know this. But we rarely let it inform how we think about crime, and even if we do think about it we get the story all tangled up. Why are crime, drugs and mental illness linked? Lots of us think it starts with the drugs.

"People get hooked, and they fall out of society and onto the streets," wrote a Toronto Star columnist. No drugs, no mental illness and no crime. Simple.

In North America, this tends to be the official line, although officialdom will usually admit that, sometimes, it is mental illness that comes first. "In some cases, people suffering from serious mental illness take drugs to alleviate their symptoms," says a U.S. Department of Justice information sheet. "In other cases, mental disorders are caused by drug abuse."

That some drugs can cause mental problems in some circumstances is clear. But in most cases, causation runs the other way: Mental illness leads to drug abuse. "Recent research indicates that psychopathology usually precedes drug use," notes the European Monitoring Centre for Drugs and Drug Addiction (a European Union research agency).

Most often, mental illness is the disease. Drugs and crime are the symptoms.

Ignore this dynamic and the policies we adopt to fight drugs and crime almost certainly won't work. Acknowledge it and new possibilities arise.

The full title of the Vancouver Police Department's report is "Lost in Transition: How a Lack of Capacity in the Mental Health System is Failing Vancouver's Mentally Ill and Draining Police Resources." Change the name of the city and that title would work pretty much everywhere in Canada and the United States.

The problem goes back to the 1950s, an era when the mentally ill tended to be rounded up and locked away and forgotten in large, soulless institutions. In the 1960s, there was a backlash and the order of the day was "deinstitutionalization" -- which called for the mentally ill to be given the supports and services they need to live in the community. Through the 1960s, 1970s and 1980s, the old institutions closed.

Governments everywhere botched the job. Closing institutions was easy and it saved money. But the supports needed to make deinstitutionalization work cost money, so governments weren't nearly so enthusiastic about that half of the equation.

The institutionalized population declined. Simultaneously, the homeless population rose. The addict population rose. The prison population rose. The situation in the United States was made all the worse by the get-tough justice polices that came into vogue in the 1980s and 1990s: Instead of being locked away and forgotten in mental hospitals, the mentally ill were locked away and forgotten in prisons.

"For many individuals previously confined to mental hospitals, deinstitutionalization has been a real success," the Vancouver report notes. "For a smaller proportion, however, deinstitutionalization has been a dramatic failure."

The report calls for the construction of "a mental healthcare facility that can accommodate moderate to long-term stays," along with a plethora of new mental health programs and supports.

Treat the disease, not the symptoms.

Ah, but democracy intrudes. A politician who tells the angry residents of a neighbourhood riddled with crime and drugs that he will increase mental health services is likely to be pelted with tomatoes. Promise more punishment and they'll throw bouquets.

So more punishment is what we get. And we'll keep on getting it until we start thinking more rationally than criminals.

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