From shackles to the streets: How the mentally ill are treated in Yellowknife

In a Yellowknife courtroom on Thursday afternoon a man from Cambridge Bay, Nunavut, appeared with his arms and legs shackled. The man had spent almost two months in prison, much of it in solitary confinement, some of it in a special suit designed to prevent him from hurting himself. (The prosecutor said he's not a danger to the public.)

The 34-year-old was sentenced to time served on charges of assault and assaulting a peace officer and, less than an hour later, walked out of the courthouse alone to resume his life as a homeless person on the streets of Yellowknife.

It was a remarkable example of the shortcomings of mental health care when it's mainly delivered by police, lawyers, judges and jailers.

The next day, in Yellowknife's day shelter, the man said he doesn't know what to do — he has suffered from seizures since he was a child and only has enough anti-seizure medication to last until Monday. He said he had photo ID before he went to jail, but cannot find it and needs it to refill his prescription.

CBC opted not to name the man, due to his vulnerable situation.

During a ride to the jail to find his ID, he talked about his relatives in Cambridge Bay, including his three children, citing their ages and birthdays.

At one point he took off his hat to reveal his bandaged head. He said he was punched the night before at the Salvation Army. He hit his head on a pay phone during the fall and had to be taken to hospital for stitches. He showed a note from the hospital reminding him to come back in two weeks to have his stitches removed.

Then he showed a wound on his abdomen. He was stabbed on the streets last fall and had to be medevaced to Edmonton.

'He really needed to be in a hospital, not a jail'

In an attempt to get him into care, Peter Harte, a lawyer in Yellowknife who knew the man when they both lived in Cambridge Bay, applied for a court-ordered psychiatric assessment while he was still in jail.

Harte took the unusual step after seeing the man banging his head on the glass of the prisoner's box and attempting to choke himself while in court.

"It's a tragedy that you find somebody in the situation that he's in and nobody can do anything about it, that nobody really sees an alternative."

Harte said he was hoping the assessment could lead to the man getting psychiatric care. Instead, he was sent back to the North Slave Correctional Centre.

"He was safe. But he really needed to be in a hospital, not a jail," said Harte.

Courts, jails substitute for treatment

Lydia Bardak, executive director of Yellowknife's John Howard Society, applauds the justice system for establishing wellness courts, in an attempt to adapt to its role as mental health care provider.

Wellness courts offer counselling and programming as an alternative to jail for those with mental health and addictions issues. But Bardak says police, the courts and jails will never be a substitute for proper mental health care.

"The court is well aware that it's not an appropriate place for people with disabilities, so they're trying to come up with their own court solutions. But the criminal justice system is still a blunt instrument," said Bardak.

"You often hear people who maybe don't know as much about the system saying, 'Oh, the jail just has a revolving door. They go in and out and in and out.' Yeah, because of the lack of other appropriate services, that's exactly what happens."

Bardak says homelessness contributes to mental illness and mental illness contributes to homelessness. She says people on the streets who are suffering from psychological problems and brain injuries should be treated the same way as those who are physically disabled.

"We're talking about some of the most severely, chronically and multiply disabled people. And that's who's on the streets of Yellowknife. Oh yeah, and some of them [struggle with] substance abuse. But these are people with very serious disabilities."

Bardak says she's never seen a mental health care worker in Yellowknife's day shelter, where many of the city's homeless converge.

Uncertain future

As part of his sentence, the Cambridge Bay man is on probation for the next year and must report regularly to a probation officer. If he doesn't take his medication he is required to report to the officer every day.

Harte is certain the man will wind up back in trouble, and then in jail. 

"The police end up being put in a position where they're dealing with a very difficult individual when he's off his medication and out of control and intoxicated and he ends up having to be put in jail for his own safety."

CBC asked the health department about its efforts to reach out to those with mental health issues who are living on Yellowknife's streets. An official referred CBC to a department web page providing instructions on how to get help.

No one from the territory's health department or Yellowknife Health and Social Services was available to talk about their efforts to help homeless people with mental illness.