LEGAL AID ONTARIO MENTAL HEALTH & ADDICTIONS STRATEGY Ryan Fritsch, Lead, Mental Health Strategy Policy, Research & External Relations January 2015.

LEGAL AID ONTARIO

MENTAL HEALTH & ADDICTIONS STRATEGYRyan Fritsch, Lead, Mental Health StrategyPolicy, Research & External Relations

January 2015

Starting Points

Providing high quality services to clients with mental health issues is a priority for LAO

LAO has a specific statutory directive to provide mental health law services: s.13(2) of the Legal Aid Services Act, 1998 provides that LAO “shall provide legal aid services in the areas of criminal law, family law, clinic law and mental health law”

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Current MH Services

LAO has traditionally delivered its mental health mandate through two programs: Consent and Capacity Board (CCB)

certificates to clients in the civil mental health system, exercising rights under Ontario’s Mental Health Act and Health Care Consent Act before the CCB

Ontario Review Board (ORB) certificates to clients in the forensic mental health system, including “mentally disordered accused” under the jurisdiction of the Criminal Code of Canada and the ORB

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Current MH Services

Specialized Duty Counsel – LAO trains duty counsel who specialize in mental health cases, attending criminal courts around the GTA

Enhanced tariff payments for vulnerable clients – criminal certificates may qualify for an enhanced block fee tariff when the client has a history of mental illness

Appointment of counsel – LAO arranges for the appointment of counsel pursuant to orders made under LASA s. 85(2); Health Care Consent Act s. 81 (for unrepresented clients appearing before the CCB); and Criminal Code 672.24 (for unrepresented clients found unfit to stand trial)

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LAO Mental Health Strategy

April 2012: LAO’s Board of Directors initiated development of a Mental Health Strategy (MHS) with a five-year mandate

October 2012: Work on the MHS began The objectives of the Strategy:

Scope Review all LAO services and mandate through a mental health lens

Study How does MH&A intersect with LAO? Sequence Consultations on client and service

provider needs Stakeholders Involve stakeholders in the initial and

ongoing development of the strategy, and in new partnership initiatives

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MHS: Scope

The MHS is adopting a broad definition of mental health and addiction, including: serious and persistent mental illness, addictions, intellectual disabilities, trauma, and dual/concurrent diagnoses and disorders

The MHS is taking a corporate-wide scope, asking how mental health and addictions impacts across: LAO’s mandate: family, refugee, criminal, clinic,

aboriginal, etc. LAO’s services: duty counsel, clinics, staff lawyers,

private bar certificates, etc.

Critical questions Are LAO services accessible to clients with mental

illness? What are the specific and unmet legal and service

needs of clients with mental illness? How are intersecting and concurrent legal issues

addressed?

Scope

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MHS: Study

How does MH&A intersect with LAO? The majority of LAO clients are between the ages of 18

and 35, the age when most mental illness emerges 1 in 3 LAO certificates may go to a client with mental

illness. 73% of LAO’s certificate clients are on ODSP, OW, or have no income (incarcerated / homeless)

Clients have high and recurring legal needs. Just 10% of all clients with a previous ORB/CCB certificate are issued 50% of crim certs and 30% of family & CFSA certs (within that cohort)

Litigation impacts health and wellness. 37% of clients with legal problems report adverse effects on mental health

Demand for core service is increasing. Since 2005/06, CCB certificates are up 25% and ORB certificates by 40%

Study

Mental Heal Strategy • Consult Themes

8April 2014

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MHS: Sequence

Sequence

Consultations: What are the Client and Service Provider Needs ? LAO launched a discussion paper and 4-

month public consultation process in November 2013

2500+ unique visits to the MHS website and 650+ unique downloads of the consultation paper

24+ in-person consultation sessions in Kenora, Thunder Bay, Sudbury, Toronto, Peterborough, and Hamilton

Written feedback from over 65 individuals and organizations

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MHS: Consultation Feedback

Consultation

Rights: LAO has a special responsibility to ensure a rights-based approach to mental health services and supports

Access to justice: legal services should be provided along the service pathways clients take through health and social supports

Service models: proactive and accommodating programs and services may reduce the number of self- and unrepresented litigants; legal and financial eligibility should be expanded; retainers should be more flexible

Competence: Advocates need training in communication skills, trauma-informed approaches, health and service options, cultural and religious competence, etc.; training should be locally driven

Unmet needs: expand legal eligibility to cover legal issues of particular concern to clients with mental illness

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MHS: Stakeholders

LAO is exploring potential initiatives with stakeholders, including: Pilot projects for new and expanded services in

the community, courthouses and health facilities Training for all staff and empanelled lawyers,

including the participation of persons with lived experience

Development of intake & triage tools Relaxed eligibility and expanded legal coverage

policies for clients with mental illness Inter-professional service models Innovation frameworks to support local solutions New certificate services for mental health

appeals

Stakeholders

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MHS: Next Steps

LAO is actively developing the Mental Health Strategy for release early in 2015

Several core commitments are already under development, including training programs, updated panel standards, new / expanded programming, and intake interview & needs assessment tools

Contact Me!

Ryan Fritsch, Policy CounselMental Health Strategy

[email protected] LAO_RFritsch (Twitter)

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