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Published on October 26th, 2017 | from CAMH

Forensic Practices and Systems: Focus on South Asian Communities

A joint initiative of FORCAT (Forensic Consultation and Assessment Team and The Collaborative for South Asian Mental Health, CAMH) 

By Dr. Smita Vir Tyagi, Forensic and Clinical Psychologist, CAMH

Mental illness doesn’t recognize boundaries, languages, cultures or nationalities. When it appears, it causes pain and distress to everyone involved. Even though it is talked about more openly than before, mental illness is still a taboo topic in many families and in many communities. Consider the story of Ravi:

 Ravi is a 24-year-old, single man who was occasionally employed, living with his parents in Mississauga.  He had been using crack cocaine for some time and had been in trouble with the law for offences like assault and burglary. He was arrested for breaking into a home to steal things which he intended to sell afterwards. The owners called the police saying the intruder was “acting crazy”, shouting, throwing things and had attacked the homeowner, who managed to escape. Ravi was sent to jail and later diagnosed with schizoaffective disorder.

 Ravi started acting strangely about a year before this incident, but neither Ravi nor his family understood what was happening to him. His family believed someone had put a curse on him. They prayed for him and had a priest perform healing rituals to no avail. Neither Ravi nor his family thought that he might have a psychiatric disorder that could be treated. Ravi was found NCR (Not Criminally Responsible) for this crime and instead of jail, was sent to a forensic psychiatric hospital thus entering the forensic mental health system – a journey that lasted four years.

Mental illness through the cultural lens

I am a South Asian psychologist who has lived and worked in India as well as Canada. I’ve seen first-hand the difficulties that people face, not only recognizing mental illness but also taking the necessary steps towards getting help. These problems are compounded exponentially when the person with mental illness also comes into conflict with the law, and a host of systems come into play: Psychiatric hospital, courts, jail, probation and parole. Navigating these systems can be confusing at the best of times even for people who work within them. This is incredibly bewildering and intimidating for the general public, even more so for newcomers who are cultural minorities or lack fluency in English.

Front-line workers trying to help individuals or their families facing these types of problems also face barriers in understanding these systems and the challenges they present. As I work in forensic mental health, I am often asked about what it means when someone has a ‘fitness’ hearing, what is meant by NCR (Not Criminally Responsible) or what is the role of an SDM.

South Asians (ie. people from India, Pakistan, Bangladesh, Sri Lanka) are one of the largest ethnic minorities in Toronto as well as in Peel Region totaling  almost 1/3rd of the population in cities like Brampton. As the population grows more South Asians are coming into contact with the psychiatric and court systems and front line service providers are expected  to respond to their needs and concerns.

A need for education

It occurred to me that there may be a role for education in this area and that we could share the expertise and experience we have at CAMH with the community.

I was delighted to find a very positive and warm response from The Collaborative for South Asian Mental Health at CAMH, and we decided to put together a pilot training workshop on November 20-21 about the forensic system. The workshop aims to educate people on what happens when a mentally ill person is charged with a criminal offence, what is meant by NCR, how forensic systems work and what to expect when these processes start to unfold.

The event is also meant to be a knowledge exchange opportunity to host a conversation with the community on issues and concerns that are facing them. Following the training we are hoping to chart a path forward in developing ongoing forums for continuing this type of training and knowledge exchange.

For people like Ravi and his family, positive outcomes are attainable, and it is possible for people to navigate the system. But that comes with proper education, and through collaboration between an informed community, and healthcare practitioners who understand the specific needs of people from various cultures.

Let’s work together to build a future where these outcomes are a reality.

For more information on the training workshop: https://forensicpractices-southasian.eventbrite.com

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