A steep increase in mentally ill offenders is flooding prisons and psychiatric institutions, confounding officials whose job is to find accommodation and treatment for them.
The percentage of mentally ill individuals in both systems is growing by 5-10 per cent each year, according to psychiatric experts and available statistics.
John Bradford, a leading forensic psychiatrist, said the problem reflects a widespread crisis. "It's occurring around the world," he said.
In illustration of the problem, the Ontario Review Board - a provincial body responsible for offenders found not criminally responsible for committing offences - had more than 1,500 patients under its purview last year, a four-fold increase from 1992. Almost 300 offenders are added annually, dwarfing the number who are released.
"We are struggling to keep up," said Joe Wright, legal counsel to the ORB.
The outlook is equally grim in the prison system. Since 2004, the total number of mentally disordered inmates in Ontario jails increased by 5.7 per cent, said Steve Small, assistant deputy minister of Community Safety and Correctional Services. "I have been around for 30 years, and it just keeps getting worse and worse and worse," Mr. Small said.
Just over 18 per cent of the 8,948 inmates behind bars in the province last June had a psychiatric disorder. Of 575 female offenders, 31 per cent were mentally ill.
"I am just astounded by the number of female offenders who are coming in with mental problems," Mr. Small said. He added that it is difficult to envision much improvement given the number of mentally ill street people who commit crimes just to survive, often unaware they are breaking the law.
The federal penitentiary system is no better off. "They are really struggling," Dr. Bradford said. "Despite everything we have done in the forensic system and health systems, growth continues at a rate of 5 to 10 per cent a year."
Factors behind the phenomenon include new Canadians who suffer mental collapses as they try to cope with relocating, faulty mental health legislation, and police who lay charges rather than wait for a hospital to find a forensic bed, Dr. Bradford said.
"You have got medical and surgical emergencies, heart attacks, and goodness knows what, all muddled up," he said. "Police arriving with a seriously mentally ill person are not a priority. It's easier for them to charge somebody than to hang around for six or eight hours in an emergency room."
Mr. Wright said the provincial review board is particularly troubled that offenders found not criminally responsible for crimes are languishing in jail waiting for psychiatric beds - the fate of virtually every non-criminally responsible patient in Toronto.
"They are probably going to spend 45 days in jail waiting for their ORB hearing, and a couple of months more after that," he said. "It's not good. ... The system is simply under-resourced."
The glut of psychiatric offenders was underlined recently by a string of recent orders from Toronto judges for hospital officials to stop shunting unfit offenders to provincial jails. With hospital and jail officials locked in battle over who will house them, police have been forced to warehouse them in holding cells.
Graham Glancy, a forensic psychiatrist at Maplehurst correctional facility, said that a new problem is emerging in the jail system - developmentally handicapped or low intelligence inmates.
"They are very vulnerable," he said. "Some of them can be annoying. There is so little stimulation for them in the jails that they have temper tantrums. And if they do, it is going to get them hurt."
Almost 30 per cent of the jail population is comprised of the developmentally handicapped, inmates with psychiatric disorders or serious drug and alcohol problems, Mr. Wright said.
"There are lots of people in the system who aren't getting any intervention," he said. "In some sense, the criminal law system is the social net of last resort."
Senator Robert Runciman, former Ontario minister of Correctional Services, said the problem of warehousing mentally ill can no longer be avoided.
"It ties up the police, courts and causes more pain and grief for victims," he said. "That's why we established the St. Lawrence Valley facility in Brockville - a 100-bed unit for male offenders providing hospital-level treatment with corrections-level security."
Mr. Runciman said that female offenders desperately need a similar institution.
"We have the expertise to fix these people and it's a tragedy that we're not doing it," he said. "We could easily expand the St. Lawrence Valley facility to treat women in both the federal and provincial systems. It's not only cost-effective to break the cycle of recidivism, but it's the right thing to do for these women."