Date Presented 03/27/20
Nova Scotia, Canada, established its first problem-solving court in 2009 in response to an over-representation of people with mental illness in prisons. This research project examines the ideological foundations of the Nova Scotian problem-solving court programs. Findings indicate that the ideological foundations of these programs are consistent with the values and principles underpinning OT, making OTs a critical presence on these multidisciplinary teams.
Primary Author and Speaker: Crystal Dieleman
Additional Authors and Speakers: Lisa Jaegers
Contributing Authors: Niki Kiepek
PURPOSE: Effectiveness of mental health court programs is largely explored in in relation to outcome measures of criminal recidivism and criminogenic needs. However, Canada & Ray (2016) emphasize the need for a greater understanding of the processes or mechanisms that facilitate change and success. Our research attends to identification of jurisdictional and operational differences that are not typically described in the literature, but essential to establish formative evaluations about the unique features and functions of mental health court programs in relation to participant experiences. Examination of participant outcomes has been examined in relation to team structure, model of service, and functions (e.g., having a specialized docket, voluntary diversion to the specialized docket, intensive and highly monitored treatment, consistent status hearings before a judge, and rewards and sanctions to encourage compliance with the court mandate) (Canada & Ray, 2016; Council of State Governments Justice Center, 2008). Our research extends beyond this to understand …
DESIGN & METHODS: The findings are presented from a qualitative, community driven study guided by principles of recovery, participatory research, and critical theory. This data is part of a larger mixed methods project. In 2019, interviews and focus groups were conducted with team members of four problem solving courts in Nova Scotia, including an OT and OT student involved with the teams. Broadly understood as wellness court programs, the teams addressed client concerns related to mental illness, opioid and alcohol addictions, and other wellness considerations, to gain an initial understanding about the history and ideological foundations of the program and day to day operations. Questions included: “What prompted the establishment of this program in your community?”, “What things need to be in place for a successful program?” and “Since its inception, how has your program evolved, expanded, or changed? Why?” Teams were asked to share program documents to illuminate history, structure, and/or operations.
RESULTS: Preliminary findings indicate that team members are motivated by empathy and compassion for the struggles experienced by people who face the court system. Frustration is expressed about the limitations of traditional, adversarial court processes to effectively respond to the needs of people living with mental health and addiction concerns. Principles of recovery-oriented practices, restorative justice, and therapeutic jurisprudence emerged as prominent themes. Ideological tensions inherent in providing supportive, recovery-oriented services within a traditionally adversarial system were also evident.
CONCLUSIONS: The ideological foundations of the problem solving court programs in Nova Scotia, Canada are consistent with the values and principles of occupational therapy, including emphasis on client choice, client’s autonomy to make decisions about their own lives, positive risk taking, peoples’ capacity for change, and opportunities to envision future possibilities. As change agents, occupational therapists have the potential to enable individual and social levels of change by bringing our professional skills into court settings which share many foundational values of the profession.
IMPACT STATEMENT: This project encourages occupational therapists to envision their roles beyond formal health care systems and examine the potential to address non-sanctioned occupations within the context of clients with life experiences that are differ notably from their own.
References
Canada, K. & Ray, B. (2016). Mental Health Court participants’ perspectives of success: What key outcomes are we missing? International Journal of Forensic Mental Health, 15(4), 352-361.
Canadian Association of Occupational Therapists, (2012). Profile of Practice of Occupational Therapists in Canada. Ottawa: CAOT.
Council of State Governments Justice Center. (2008). Mental health courts: A primer for policymakers and practitioner. Criminal Justice/Mental Health Consensus Project. New York, NY: Author.
Ferrazzi, P. (2019): Occupational Therapy and Criminal Court Mental Health Initiatives: An Important Emerging Practice Setting, Occupational Therapy in Mental Health. Occupational Therapy in Mental Health. doi: 10.1080/0164212X.2019.1571467
