Assisting the Client Living with the Effects of Serious Mental Illness.

• Author: Mcnary, Averie

What are the challenges involved when working with clients living with psychotic illnesses, and what is some practical advice for their lawyers and advocates?

I was asked to write an article on the challenges that those experiencing mental illnesses face when engaging with the legal system. What follows are my observations on providing legal services to a person living with the effects of a serious mental illness, especially in the "simple" civil law realm. It is based on my experience as a lawyer, policy maker and manager for government, as well as private practice in high conflict estate matters and pro bono work at the Edmonton Community Legal Centre. I am also a supporter of a loved one living with the effects of schizophrenia. My goal is to describe the challenge involved, to acknowledge there are no easy solutions, and to offer some practical advice for navigating this rocky road.

The Challenge

Write an article on the mentally ill in the justice system. That is a task equivalent to eating not just a mere elephant, but an entire herd and the surrounding forest one spoonful at a time (as Desmond Tutu said). Civil or criminal matters? If criminal--police encounters? Arrest? Bail? Jail? Indictable? Provincial? Mental Health or Drug Courts? If civil--debtor or creditor issues? Immigration? Landlord or tenant? Trusteeship? Estates? Family? And what about those "neither fish nor foul" matters, such as a Mental Health Act arrest, confinement and compulsory care? Bylaw enforcement? Traffic tickets?

And just what do we mean by mentally ill? Being so filled with fear and anxiety you cannot leave your home? Hearing voices? Stubbornly insisting on your innocence or guilt? Depression so intense that one lacks all volition? Believing your neighbour is whispering about you? Unable to comprehend the justice system? (Take a moment to consider which of these are "real" and which are not.) Diagnostic and Statistical Manual of Mental Disorders 5th edition anyone? (The American and Canadian gold standard for classification and diagnosis of psychiatric disorders.)

Let's narrow the field to representation of a subset of clients: individuals living with psychotic illness, such as schizophrenia spectrum or bipolar disorder. The life of a person living with one of these chronic and serious mental illnesses is one of managing delusions and other forms of break with reality. The client is also dealing with "negative" symptoms. This includes impaired executive...