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Assuring Treatment for the Mentally Ill


Mentally-ill patients and their fellow citizens are well served by new Ontario law which expands the definition of patients who must undergo treatment before being released.

Originally published in the London Free Press. Republished with the permission of the author.


Rory Leishman

 Author Notes

Freelance journalist, author of a weekly national affairs column for The London Free Press and Sun Media Newspapers in London, Ontario. Mr. Leishman's work also appears in various other journals, and he operates his own web site where others of his essays can be viewed. He can be reached via e-mail at rleishman@home.com.

 Essay - 4/28/2000

For Alana Kainz, persistence has paid off. Thanks in no small measure to her efforts, Ontario Health Minister Elizabeth Witmer introduced legislation on Tuesday to help assure that people who suffer from an acute mental illness can finally get the treatment they desperately need.

Kainz is the widow of Brian Smith, a popular Ottawa-area sportscaster who was shot to death in 1995 by a paranoid schizophrenic. The killer was found not criminally responsible by reason of mental illness and ordered to remain confined indefinitely in a psychiatric hospital.

Prior to the shooting, Smith's killer had been repeatedly picked up by the police and turned over to mental health authorities. Time and again, he had to be released back into the community under terms of the mental health act, because there was no compelling evidence that he posed an imminent and serious threat to himself or others.

This is an all-too-typical conundrum. From 1994 to 1997, a 60-year-old Hamilton woman afflicted with paranoid schizophrenia was a well-known target of complaints to the police about minor assaults. Medical authorities could not require her to undergo treatment or confine her to a mental hospital until after she had stabbed to death a two-year old neighbour, Zachary Antidormi, in the deranged belief that she could free her own dead son's soul from the lad's body.

Notwithstanding the frequency of these horrors, the great majority of schizophrenics are not dangerous to others. With competent medical care, most people with a severe mental illness are able to live peacefully in the community.

The tragedy is that many thousands of others do not respond well to treatment or refuse to take their medications. All too many have been discharged from mental hospitals and abandoned to wander helplessly in the streets.

Richard Patten, the Liberal MPP and former correctional services minister, has estimated that up to 20 per cent of the prisoners in Ontario jails suffer from a mental illness. Close to 30 per cent of the homeless are mentally ill and about 10 per cent of schizophrenics commit suicide.

Such an appalling toll of suffering and death is not necessary and should not be tolerated in a civilized society. To safeguard the lives and well-being of the mentally ill, a coroner's jury that examined the Smith killing called upon the health ministry to end the practice of allowing people with a severe mental illness to subsist helplessly in the community without competent medical care.

Following the inquest, Kainz vowed to be "a thorn in the ministry's side" until the jury's recommendations were adopted. She has been true to her word. On Tuesday, she and the parents of Zachary Antidormi were on hand at Queen's Park, when Witmer disclosed plans to expand the criteria for committal in the mental health act to protect people with a serious mental illness who are liable to suffer serious harm if they do not get treatment.

In addition, the legislation will authorize physicians to require a patient who has been involuntarily confined in a mental hospital to take medication after discharge into the community. Patients who refuse to abide by such a community treatment order could be recommitted to a hospital.

As expected, some lawyers and patients' rights groups like the Canadian Mental Health Association contend that the legislation violates human rights, by coercing the mentally ill into undergoing treatment, even if they pose no imminent peril to others. Such arguments are poppycock.

It makes no sense to insist that a mentally incompetent person has a right to forgo potentially life-saving medical care. Besides, Witmer's bill includes reasonable safeguards for patients, including the rights to legal counsel and to appeal treatment orders to the courts.

Patten has long advocated the kind of compassionate and enlightened reforms to care for the mentally ill proposed in Witmer's bill. Her legislation also has solid backing from the Chief Coroner of Ontario, the Schizophrenia Society of Ontario and numerous other medical experts and associations dedicated to helping the mentally ill and their families.

Kainz is simply relieved. She hopes the legislation will spare others the loss of a loved one. "I made a bedside promise," she recalls, "and I said that I would do whatever it took to make sure that this didn't happen to another person. And I believe today that promise is fulfilled."

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