By: Jeffrey Bradley, Lindsay Jennings, & Alexander McClelland

Today, Tracking (In)Justice releases a Fact Sheet: deaths of people labelled with schizophrenia in custody in Canada.  Since the year 2001, Tracking (In)Justice has documented a minimum of 14 people in custody by police, in jails, prisons, mental health facilities, or immigration detention across Canada who were diagnosed with schizophrenia and who died after a use of force incident.   

Download the Fact Sheet: deaths of people labelled with schizophrenia in custody in Canada.

Since 2001, Tracking (In)Justice has documented a minimum of 14 deaths of people in custody across Canada where force was used on individuals with a mention or diagnosis of schizophrenia. Out of the 14 people who experienced these types of force with a mental health diagnosis of schizophrenia and died in custody, 3 were in remand custody, 4 were in police custody, 6 were in a mental health facility, and 1 was in immigration detention. Most of these tragic incidents involved police, guards, and mental health staff using force against people experiencing mental health crises.  

Due to a lack of data being collected or reported by government institutions on the use of force against individuals with mental health issues by police, prison guards, and mental health staff. Our research cannot conclude that the use of force led directly to the individual’s medical cause of death. However, we can demonstrate a relationship between mental health, crisis, and the use of excessive force with deaths in custody.

The criminalization of people with mental health issues

People with serious mental health needs are disproportionately represented in the criminal legal system. Estimates show that rates of mental illnesses are 4 to 7 times more common in prison than in the community [1], with around 2-5% of men incarcerated in Canadian prisons being labelled with a psychotic disorder such as schizophrenia [2].

Additionally, people who are labelled with schizophrenia are more likely to be on antipsychotics (that they may not have access to inside), which increases risk of cardiovascular events. [3]

Most people with this label never commit a violent crime, rather lack of mental health services in communities means hyper-incarceration of vulnerable people who need support. This is known as the criminalization of people with mental health issues.

Instead of care people face violence

When in custody, instead of receiving specialized care, preventative approaches, or de-escalation of crises, police, prisons, and jail officers exert force to manage complex problems. The use of force can be physical handling, restraint equipment, medical sedating drugs, and weapons, including tasers, pepper spray, or batons, and guns.

In 2015, the John Howard Society of Ontario released a report entitled Unlocking Change: Decriminalizing Mental Health Issues in Ontario [4], which called for a reset on how we think about and respond to people with mental health issues when they interface with the justice system. The report challenged policymakers to interrupt the reliance on punitive measures and redirect resources to upstream, preventative solutions. It stated, “When the healthcare system fails to treat mental illness, the criminal justice system punishes the symptoms.” [5]

Hard to track

There is a lack of data being collected or reported by government institutions on the use of force against individuals with mental health issues by police, prison guards, and mental health staff. There is currently no system which reports on the use of force within prisons, jails, or by police, against people living with or labelled with mental health diagnoses.

In many provinces, there is no requirement that deaths of people in mental health custody in seclusion or following chemical restraint are publicly reported, nor that there be an inquest into those deaths. As a result, we do not have a concrete understanding of how many deaths occur, where, when, or why.

Calls to end use of force

Howard Hyde, a man with schizophrenia who was in a psychotic state, was tasered by police multiple times on November 22, 2007, while awaiting a mental health assessment. Thirty hours later, instead of receiving a mental health assessment, he was hit with the stun gun, and died while being restrained by jail guards. His death was ruled accidental. Hyde’s death inquest resulted in multiple recommendations, including a call for an end to the use of force towards people experiencing mental health crises. [6]

Our findings

Since 2001, Tracking (In)Justice has documented a minimum of 14 deaths of people in custody across Canada where force was used on individuals with a mention or diagnosis of schizophrenia.

Out of the 14 people who experienced these types of force with a mental health diagnosis of schizophrenia and died in custody, 3 were in remand custody, 4 were in police custody, 6 were in a mental health facility, and 1 was in immigration detention.

Most of these tragic incidents involved police, guards, and mental health staff using force against people experiencing mental health crises.

Our research cannot conclude that the use of force led directly to the individual’s medical cause of death. However, we can demonstrate a relationship between mental health, crisis, and the use of excessive force with deaths in custody.

We have only included people with formal diagnosis in our findings. Furthermore, incarcerated people experiencing psychosis may not have access to a formal diagnosis. As a result, our findings may not include people who died while restrained who are labelled with schizophrenia in settings outside of custody.

Read more in the Fact Sheet: deaths of people labelled with schizophrenia in custody in Canada.

References

1: Simpson, S. (2023). Mental Illness and the Prison System. The Centre for Addiction and Mental Health. https://www.camh.ca/en/camh-news-and-stories/mental-illness-and-the-prison-system#:~:text=Mental%20illness%20rates%20are%20about,prison%20than%20in%20the%20community.

2: Pednault, C. I., Perley-Robertson, B., Mularczyk, K. P. , & Prevost, H. (2003). Approaches to Addressing Serious Mental Illness in the Canadian Criminal Justice System. Public Safety Canada. https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2023-r001/index-en.aspx

3: Li XQ, Tang XR, Li LL. (2021). Antipsychotics cardiotoxicity: What’s known and what’s next. World Journal of Psychiatry, 11(10):736-753.

4: John Howard Society of Ontario. (2021). Broken Record: The Continued Criminalization of Mental Health Issues. https://johnhoward.on.ca/wp-content/uploads/2021/01/Broken-Record.pdf

5: John Howard Society of Ontario. (2015). Unlocking Change: Decriminalizing Mental Health Issues in Ontario. http://www.johnhoward.on.ca/wp-content/uploads/2015/07/Unlocking-Change-Final-August-2015.pdf

6: Government of Nova Scotia. (2011). Building Bridges: Improving Care In Custody for People Living With Mental Illness. https://novascotia.ca/just/global_docs/Building_Bridges_Hyde_Report.pdf