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Last year, the Mental Health Commission of Canada published a landmark national strategy on mental health, calling for significant changes to the way services are provided and a greater focus on prevention and early intervention.
The Commission, which was created by the federal government in 2007, drew particular attention to the barriers that can keep people from accessing health care services, including pervasive negative attitudes toward mental health problems and the people they affect.
For many mental health advocates, the report signalled a potential turning point in the federal government's approach to mental health problems.
But when the Conservative government introduced a bill last month advocating a new "high risk" designation for some mentally ill offenders, advocates worried its focus on a small number of people who commit violent acts would dramatically undermine broader efforts to tackle stigma.
Bill C-54 applies to individuals who have been found not criminally responsible for an offence on account of a mental disorder. Two of the most frequently cited cases in Canada are those of Vince Li, who beheaded and cannibalized a passenger on a Greyhound bus, and Allan Schoenborn, who killed his three children in Merritt, B.C.
The legislative changes would, in part, aim to give victims like Darcie Clarke, whose children were killed by Mr. Schoenborn, a greater opportunity to participate in review board hearings that look at an individual's detention and treatment. They would also help ensure victims who want regular updates are informed about any changes to an individual's status.
At the same time, the new "high risk" label would lengthen the time between reviews of some offenders' detention and prevent them from being considered for release at all until the designation is removed.
Some lawyers and psychiatrists have questioned the value of the new designation, suggesting efforts to improve public safety could backfire. But a more pervasive concern for mental health advocates is that the high-profile way in which the legislation was announced – and ongoing references to violence and mental illness – could damage efforts to confront stigma at the national level.
Louise Bradley, the Mental Health Commission's president, said recently that focusing on just a few high-profile cases can create "a misleading picture of violence and mental illness."
A spokeswoman from Justice Minister Rob Nicholson's office said the legislation responds to concerns from victims and others who want public safety should be the paramount consideration in deciding when an individual found not criminally responsible should be released.
Prime Minister Stephen Harper, who introduced the legislation last month, and other ministers who have spoken about the bill, have been cautious to avoid using the terms violent and mentally ill in the same sentence. But advocates say they could have done more – by consulting with psychiatrists in advance about their messaging and highlighting the low rates of violence among those with mental illnesses.
Chris Summerville, head of the Schizophrenia Society of Canada, said the way the bill is presented is important, because stigma often leads to discrimination and can further isolate those who may need assistance. "We believe the way this bill was unfolded was counterintuitive to the anti-stigma work that all of us have been doing," he said.
Kim Mackrael is a parliamentary reporter in The Globe and Mail's Ottawa bureau.