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walter hall from France writes: Mental health is a very wide and encompassing category. When it refers to schizophrenia, a clear cut bipolar disorder, dementia, there is little debate about the 'disease', medical aspect of it, along with the medicolegal implications of responsibility and accountability. But how about the underdiagnosed personality disorders, (the antisocials, the psychopaths, the borderlines, etc.), and the drug induced disorders? They are often misdiagnosed as an axis I disorder and included in the 'mental health' category with the social and legal implications. The medical and the legal system was not intended to address personality disorders as 'medical illnesses', and probably rightfully so, but they are generally included in the 'mental health' overinclusiveness drive
Val Villeneuve writes: Thanks Walter. Very often in our forensic mental health system in Alberta we see people who have the personality disorders that you have listed. These people are entitled to service and they have a psychiatric diagnosis; thus we make attempts to ensure they are assessed and treated accordingly to our professional standards.
dee vancouver writes: ms villeneuve....... i am thankful to you and the globe and mail for giving so many people more insight into the problems faced by the mentally ill. i would like to ask, as in my case, part of my problem is a family member who is having a lot of personal problems and how they generate to me. as long as that member cannot help herself and i myself feel helpless to do anything, i am in constant anxiety. others tell me 'there is nothing you can do about it , so forget it. as you know that is easier said than done. do you have any advice for this sleepless in vancouver, weary old lady?
Val Villeneuve writes: One of the most difficult things to deal with is being the support system of a family member who may be experiencing personal and/or mental health issues. Please ensure that you have your own support system and be in touch with the local mental health associations such as Canadian Mental Heal Association. Continue asking questions to mental health professional as to what can be done for yourself and your family member.
Emma Hawthorne from Canada writes: I have been told that sometimes the homeless and mentally ill commit minor crimes, especially as the weather grows cold, to acquire a warm cell, three square meals, campanionship, tv viewing and even medical and psychiatric care. Is this true? If so, wouldn't supportive housng with on-site mental health assistance be far more helpful and much less costly?
Val Villeneuve writes: Thanks Emma. I have also heard those types of comments, but I have no reality to base them on. I do know community resources for the homeless and/or mentally ill must be increased and strengthened. In a previous response, I spoke about the Calgary Diversion Service which was initiated to ensure the mentally ill are not jailed, but given appropriate support to help keep them functioning in the community.
Christine Diemert, globeandmail.com: Ms. Villeneuve, Do you think there should be special courts and/or special prosecutors and police departments that deal with people who have mental health issues?
Val Villeneuve writes: I believe the correctional and justice systems need to increase partnership with the mental health community to assist in breaking down the silo's that have been built in the past. If these silos's can be broken we will all benefit from a much more coordinated community response. The introduction of mental health courts and police assisted mobile response teams are excellent first steps. Further education and improved communication by all parties will assist in reaching better solutions.
Christine Diemert writes: Thanks for joining us today Ms. Villeneuve. Before we close the discussion, I'd like to ask a question based somewhat on the comment from a reader who said the justice system existed "...to protect the citizenry from the criminals, not to make life easier for the criminals."
What I'd like to know is, if some of those so-called criminals are there because of a mental illness, who should protect them?
Val Villeneuve writes: The forensic services assist in giving recommendations to the courts that protect the patient and public at large. In offering our forensic services we will assess dangerous offenders and long term offenders to assist the courts in disposition. There certainly are offenders with mental illness who must be kept in jail due to the seriousness of their offense, and it is up to those of us working in the various systems to protect and offer quality support and/or treatment to these inmates.