Toronto is one of only four cities in Canada to offer mental-health courts that aim to steer offenders with mental illnesses out of jail and into hospitals.
Declared unfit to stand trial on minor charges, a middle-aged woman sent for a psychiatric assessment spent two weeks in police lockup and prison cells before being admitted to a mental health facility on Tuesday.
Her case, police say, is sadly typical of how the legal and mental-health systems are failing and jailing the mentally ill. A chronic shortage of space in the mental-health system has prompted judges in Ontario to use legal force to push patients on facilities with nowhere to house them. Increasingly, the care of the mentally ill is being forced on police and jailers.
Marie's strange journey in and out of police custody began in east-central Toronto's 51 Division on July 12, when she was charged with assault and threatening behaviour.
Marie - a pseudonym - had previous brushes with the law. This time, three days after her arrest and two court hearings later, she found herself in Room 102 at Old City Hall, the basement courtroom set aside for defendants with mental-health issues.
Presiding was Ontario Court Justice Mary Hogan, who has been a long-time critic of the justice system's shortfalls in accommodating the mentally ill. In a ruling last year, the judge described the province's shortage of beds for psychiatric patients as long-term and chronic. And when Marie appeared before her on July 15, it was plain that nothing had changed.
Judge Hogan concluded that Marie was unfit to stand trial and needed medication and a psychiatric assessment at Toronto's Centre for Addiction and Mental Health, the chief such clearinghouse for Central Ontario. So she ordered that Marie be taken there - this, despite the fact that a CAMH representative rose in court to tell the judge not a single bed was available.
The police took Marie to CAMH and were duly turned away because it was, indeed, full.
As operations director for the Canadian Mental Health Association in Ottawa, Donna Pettey said she has seen significant improvement during her 30 years in the field. "There is at least the recognition that the criminal justice system is not an appropriate place for treatment," she said.
That the mentally ill and those awaiting diagnosis for probable mental illness are still held in cells is partly attributable, she said, to lack of housing options for those who would otherwise be discharged from mental hospitals, freeing up space. A big reason the supply of hospital assessment beds remains clogged, Ms. Pettey said, is that they hold so many homeless patients with nowhere else to go.
With nowhere else to take Marie on a late Friday afternoon, the officers turned around and drove her back across the city to the eastern 55 Division station, the central police lockup for female prisoners.
By definition, police custody is intended to be temporary. But Marie was to spend the next four nights in a cell furnished only with a steel bed (no mattress), a sink and a toilet. There are no showers, no food except for what's in a vending machine and no medical attention.
The police at 55 Division did what they could. They let her out for fresh air and exercise in a fenced area, helped her clean herself as best she could and brought her hot food from a Swiss Chalet restaurant. She remained visibly upset.
"I really felt bad for her, we were trying to do everything we could. It was very frustrating," said acting Staff Sergeant Terry Wray. "And the big thing is she clearly had psychiatric issues that weren't being dealt with."
More than once over the weekend, CAMH was phoned to see if a bed had become available. None had.
So on Monday morning, the prisoner was returned to Room 102 to see if Judge Hogan could be persuaded to change her order specifying that Marie was to be taken to a psychiatric facility rather than a prison. She declined to do so. Marie went back to 55 Division for a fourth night.
And then on Tuesday, prosecutors and police lawyers, including Police Chief Bill Blair's counsel, Jerry Wiley, launched a "mandamus" effort in Superior Court, seeking to have Judge Hogan's ruling overturned.
Superior Court Justice Ian Nordheimer obliged, Marie was dispatched to the Vanier women's jail in Milton, Ont., west of Toronto. There she remained for eight days in a setting that, while an improvement on a police cell, is hardly a psychiatric facility.
Nobody was happy with the situation, least of all Marie's lawyer, David Connally.
"My client is currently unfit to stand trial," he wrote in an e-mail. "A police division is not the right place for her. Jail is not the right place for her."
Equally unimpressed was Mr. Wiley, who spent much of a weekend trying to get Marie out of her cell at 55 Division and into the care of a doctor.
"There's a very long history to this problem," he said.
On Tuesday, after two weeks in police cells and prison ranges, Marie was admitted to CAMH for an assessment.