The Impact of Therapeutic Jurisprudence: A Critical Study of Toronto's Mental Health Court.

Abstract

Background: Specialty courts, based on the concept of therapeutic jurisprudence (TJ) are spreading rapidly across North America following reports of reduced rates of recidivism in U.S. drug courts. TJ posits that seriously mentally ill adults accused of minor crimes need social assistance and medical attention, not jail time. The Toronto Mental Health Court was the first of its kind in Canada and is a model for national expansion despite no formal evaluations of Canadian mental health courts. There are a few studies of Canadian mental health courts from a professional (social work and legal) perspective, but there is a notable gap in the literature from a client perspective, which this project seeks to address. The findings were analyzed through a Foucauldian theoretical lens.

Methods: The impact of the Toronto Mental Health court on the mentally ill accused was assessed using two complementary methodological approaches: 1) An Interpretative Phenomenological Analytic approach involved nine open-ended interviews with adult accused diagnosed with schizophrenia or bipolar disorder. This exploration of subjectivity focused on their experience of court processes and the meaning of the court in their lives 2) Participant observation of the court for eight months between January and August 2012 to assess the processes of subjectivation, the routinized discourses of the court, and how legal, psychiatric, and social services impacted accused.

Findings: Ethnographic findings include racial disparities among the accused, processes that may lead to increased jail time compared with the regular stream of justice, and the prevalence of pharmacological surveillance. Phenomenological findings emphasize the continuum of violence experienced by marginalized accused despite the interventions of the court, the importance of individualized and non-pharmaceutical coping techniques, and the importance of the court as a threshold for accused.

Implications: Findings point to a gap in knowledge concerning ethno-racial disparities in the criminal justice system and the medical system in Canada. The importance of the court as a threshold to a new life for accused is evident, but the system can undermine therapeutic relationships and prolong detention. The importance of individualized coping techniques in the recovery of accused may impact delivery of services.