Commentary

Forensic Psychiatric Patients and the Politics of Fear

The west mountain councillor's fear-mongering about psychiatric patients is undoing years of work to de-stigmatize people living with mental health concerns.

By Deborah Grace
Published July 19, 2018

On July 13, 2018, Ward 8 Councillor Terry Whitehead put forward a motion requesting: "an Independent, Provincial review of Forensic Psychiatric Patient Escapes from the St. Joseph's Healthcare Forensic Psychiatric Unit (Hamilton) and Mandatory GPS Monitoring for those Forensic Psychiatric Patients with Outside Passes" after three involuntary patients left the hospital grounds while on passes.

This motion, after being reviewed by council, was amended and unanimously voted on to ask that: "the provincial government be requested to provide additional resources for increased nursing and non-medical staff."

This request may at first appear innocuous. The Councillor has merely identified a safety risk and is offering a possible solution. I do not take specific issue with the Councillor's request to have the hospital review its processes. Like any good policy or practice, it should be - and likely is being - reviewed and updated on an ongoing basis.

It is the context in which the request is made and the information that is being left out that should have Hamilton residents concerned.

If you attempt to follow the Councillor's winding narrative, he identifies risk to public safety and concerns regarding the internal process of responding to the patient's 'escape'. He suggests that the risk is not merely that patients with passes may leave the grounds, it is that they may leave the grounds and cause harm.

This is a bold claim, so one would think he would be able to substantiate it.

Upon reviewing the articles, press release and other media available to the public regarding the three events occurring in 2018, it appears that each incident was resolved without incident. No one in the public was harmed and the protocol regarding when a patient leaves the campus was followed (staff, police and public alerted, and so on). Win-win.

I attempted to engage the Councillor over Twitter - my first mistake - to understand what information I was missing.

A basic skill of any decent leader is to take information and disseminate it. Unfortunately, to do this it means you have to have actually read something or consulted with someone.

I asked specifically about Councillor Whitehead's tweet inviting another concerned Hamilton resident to look into past situations when previous patients leaving the St. Joseph's campus had "resulted in death or serious harm including one in this very neighbourhood."

I repeatedly asked him to provide some data on how many had resulted in death or serious harm, because as far as I could find there have been none.

The Councillor told me to talk to the staff at the hospital. Or the Union. Not once did he point me in the direction of any resources a public citizen could realistically access.

He also assured me that he has heard from a former Ward 8 Councillor about someone who was assaulted years ago. This is the stuff of urban legends, not political discourse.

Where is he getting his information? He won't say, because uninformed fear is a powerful motivator that has social and political capital. The Councillor is cultivating emotional bias against those currently in treatment and the perceived fear of a crime.

The backbone of the Councillor's argument is asking if anyone can prove that there is zero risk to the public, knowing that no one can. I can't prove there is zero risk for just about anything. This is merely a tactic to distract, confuse and further embed the emotional bias in his favour.

With his tweets, media coverage and ultimately his motion, the Councillor is deliberately cultivating a climate of fear regarding something which is statistically unlikely to happen. This has been pointed out to him on multiple occasions and still he continues with his agenda of fear.

He has even contended that, yes, "many journals will say the risk is small none have stated there is zero risk. Statistically speaking based on escapee across North America there has been serious offences although again the number is small."

Risk of what? By his logic, anything!

The Councillor makes no effort to help the general public understand what happens at a Forensic unit [PDF]. He poses open-ended questions with complex answers that are unique to the individual receiving treatment. I can't help but conclude he has forgotten that at the centre of his political circus, he is sloppily and directly meddling with people's lives.

He wrote: "So what is the risk of a patient that has not completed the program is still been treated and has not qualified for discharge escaping into the community."

He does nothing to help citizens how understand risk is assessed or privileges like ground passes are given. Nor did he share that the general public can review one of the tools St. Joseph's uses to assess risk, the Hamilton Anatomy of Risk Management-Forensic Version.

He wrote: "I am worried about the ones that the Ontario Review Board has said are dangerous and have a high chance of reoffending"

He doesn't take the time to identify the possibility why a patient may be deemed a 'threat' by the Ontario Review Board. He doesn't have to, knowing that just using the word "threat" is enough to cause fear.

As Richard Kagbrun highlighted in a 2015 essay in The Walrus:

Both the criminal justice and forensic-psychiatry systems confine people who've committed crimes in order to protect the public. But that's the only similarity. Prisoners have defined sentences; forensic patients are treated until they are no longer deemed a threat to the public...These incremental increases in their privileges only occur when psychiatrists are confident that they come with minimal risk to the public...in countless cases we never hear about, [when] those boundaries of trust are honoured. Despite the occasional panic over a missing patient, the peaceful end result of these episodes is, in a way, an ironic testament to the efficacy of their treatment.

Providing the public with context or even basic information does not help the Councillor incite fear, so he glosses over the fact that all three patients returned without incident. All three. One even called the hospital to initiate his own return. But remember, the Councillor heard once from a former councillor about a citizen who was attacked years go...

Another citizen shared a very user-friendly diagram [PDF] highlighting that of the 37 percent of patients found Not Criminally Responsible (NCR), only 23 percent of those crimes were committed against a stranger - the majority are against someone known to the patient.

National Trajectory Project
National Trajectory Project

The Councillor didn't even respond or engage with this information. Instead, he returned to his zero-risk argument - the digital equivalent of digging in your heels - again showing he is not really interested in a genuine conversation.

Councillor Whitehead is systemically attempting to undo years of work to de-stigmatize people living with mental health concerns. He is quoted in a local news article saying, "Let's be clear: When you are dealing with dangerous offenders and they are escaping fairly regularly, there will be a serious incident."

This is dangerous rhetoric and a self-serving political move. He is using an already stigmatized group as political capital and he leaves the onus on others to prove him wrong.

Central to a healthy democracy is the healthy exchange of information and of disagreement - both of which both Councillor Whitehead has demonstrated he is unwilling or incapable. Accept his version, don't question and maybe he won't Twitter troll you.

This is not the first time this Councillor has presented his opinion as fact, and I hope on October 22 (if he enters the race) his constituents will vote to put a stop to his abuse of power.

Text of Original Motion

CITY OF HAMILTON

NOTICE OF MOTION

Council: July 13, 2018

MOVED BY COUNCILLOR T. WHITEHEAD

Request for an Independent, Provincial review of Forensic Psychiatric Patient Escapes from the St. Joseph's Healthcare Forensic Psychiatric Unit (Hamilton) and Mandatory GPS Monitoring for those Forensic Psychiatric Patients with Outside Passes

WHEREAS, the City of Hamilton understands the significant work and value of the St. Joseph's Healthcare Forensic Psychiatric Unit in the treatment and reintegration of forensic psychiatric patients into the community;

WHEREAS, the City of Hamilton supports the spirit Of reintegration into the community of those experiencing mental health issues. who have been involved in a criminal act, upon the completion of the appropriate rehabilitation;

WHEREAS, there have been approximately 26 patients, who have gone missing, from the St Joseph's Healthcare Forensic Psychiatric Unit in the last three years:

WHEREAS, two of the three patients who have escaped in the last 4 weeks had deemed as being high-risk, violent offenders by the Ontario Review Board;

WHEREAS, although Mohawk College, which is adjacent to the St. Joseph's Healthcare Forensic Psychiatric Unit, has protocols in place to protect the students in the buildings when notified of an escape, cannot protect students outside of the facility or in student housing;

WHEREAS, the community is demanding that higher standards of monitoring and securing the forensic psychiatric patients at the St. Joseph's Healthcare Forensic Psychiatric Unit, and the right to not only feel safe, but to be safe;

WHEREAS, although the St. Joseph's Healthcare Forensic Psychiatric Unit has protocols in place to address matters of missing forensic psychiatric patients, those protocols are clearly not sufficient;

THEREFORE, BE IT RESOLVED:

(a) That, in the interest of public safety and to assist the St. Joseph's Heatthcare Forensic Psychiatric Unit in determining more effective methods of monitoring and securing forensic psychiatric patients, the Mayor correspond with the Honourable Christine Elliott, Deputy Premier and Minister of Health and Long-term Care, to request the Ministry to perform and independent, provincial review of all escapes to-date from this facility. and to provide a report of their findings and recommendations: and,

(b) That the Honourable Christine Elliott, Deputy Premier and Minister of Health and Long-term Care. also be requested to consider making it mandatory tor ail forensic psychiatric patients, who have outside passes. to be fitted with a GPS monitor to assist those charged with their custody and treatment to better monitor the whereabouts oi those patients.

Text of the Revised, Approved Motion

CITY OF HAMILTON

MOTION

Council: July 13, 2018

MOVED BY COUNCILLOR T. WHITEHEAD

SECONDED BY COUNCILLOR T. JACKSON

Request for an Independent, Provincial review of Forensic Psychiatric Patient Escapes from the St. Joseph's Healthcare Forensic Psychiatric Unit (Hamilton) and Mandatory GPS Monitoring for those Forensic Psychiatric Patients with Outside Passes

WHEREAS, the City 0f Hamilton understands the signiicant work and value of the St Joseph's Healhcare Fatensic Psychianic Unit in the treatment and reintegration of forensic psychiatric patients into the community;

WHEREAS, the City of Hamilton supports the spirit of reintegration into the community of those experiencing mental health issues, who have been involved in a criminal act, upon the completion of the appropriate rehabilitation;

WHEREAS, there have been approximately 26 patients, who have gone missing, from the St. Joseph's Healthcare Forensic Psychiatric Unit in the last three years;

WHEREAS, two of the three patients who have escaped in the last 4 weeks had deemed as being high-risk, violent offenders by he Ontario Review Board;

WHEREAS, although Mohawk College, which is adjacent to the St. Joseph's Healthcare Forensic Psychiatric Unit, has protocols in place to protect the students in the buildings when notified of an escape, cannot protect students outside of the facility or in student housing;

WHEREAS, the community is demanding that higher standards of monitoring and securing the forensic psychiatric patents at the St. Joseph's Healthcare Forensic Psychiatric Unit, and the right to not only feel safe, but to be safe;

WHEREAS, although the St. Joseph's Healthcare Forensic Psychiatric Unit has protocols in place to address matters of missing forensic psychiatric patients, those protocols are clearly not sufficient;

THEREFORE BE IT RESOLVED:

(a) That, in the interest of public safety and to assist the St. Joseph's Healthcare Forensic Psychiatric Unit in determining more effective methods of monitoring and securing forensic psychiatric patients, the Mayor corresponde with the Honourable Christine Elliott, Deputy Premier and Minister of Health and Long-Term Care, to request the Ministry perform and [sic] independent provincial review of all escapes to-date from this facility, and to provide a report of their findings and recommendations; and

(b) That the Honourable Christine Elliott, Deputy Premier and Minister of Health and Long-Term Care, also be requested to consider increased capital expenditures to enhance the security of patients above and beyond the St. Joseph's Healthcare Forensic Psychiatric Unit's current infrastructure;

(c) That the Provincial Government be requested to provide additional resources for increased nursing and non-medical staff in the St. Joseph's Healthcare Forensice Psychiatric Unit facility.

The Main Motion as Amended CARRIED on the following Standing Recorded Vote:

Yeas: Eisenberger, A. Johnson, Farr, Green, Merulla, Jackson, Whitehead, Conley, Pearson, B. Johnson, Ferguson, Pasuta, Patridge.

Total: 13

Nays: --

Total: 0

Absent: Collins, VanderBeek

Total: 2

Deborah Grace is a Hamilton resident who just wants city council to be better. Follow her on Twitter @editablankpage.

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By Connie (registered) | Posted July 19, 2018 at 13:12:55

"The backbone of the Councillor's argument is asking if anyone can prove that there is zero risk to the public ..."

No one can prove that there is zero risk to the public from C'or Whitehead either.

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