USING AND ABUSING POWER

CLIENT INTERACTIONS WITH PEOPLE IN POSITIONS OF AUTHORITY

Dr. Crystal Dieleman Dalhousie University Dr. Jean Hughes Halifax, Canada Robin Campbell Valerie Hodge

Understanding how social determinants of health affect the criminalization of people with mental health problems

THE TEAM

• Dr. Crystal Dieleman (Principal Investigator), School of Occupational Therapy, Dalhousie University, Canada

• Dr. Jean Hughes (Co-Principal Investigator), School of Nursing, Dalhousie University, Canada

• Archie Kaiser, Schulich School of Law, Dalhousie University

• Dr. Linda Bayers, Self Help Connection, Nova Scotia, Canada

• Gail Gardiner, Elizabeth Fry Society of Mainland Nova Scotia, Canada

• Joan Jessome, Nova Scotia General Employees Union

• Robin Campbell, Project Coordinator, Hope Not Jail

• Valerie Hodge, Research Assistant, Hope Not Jail

• Dan Peladeau, Research Assistant, Hope Not Jail

METHODS

Community based action research

• Semi-structured interviews with individuals who have mental health problems and involvement in the criminal justice system

• Semi-structured interviews with family members of such individuals

• Focus groups with key stakeholders from multiple sectors

• Stakeholder forum for consideration , and development , of strategic action plans

PARTICIPANTS

Individuals (n=33) with mental health problems who have been involved with the criminal justice system

- 18 men

- 15 women

- ~age 35 years (19-60)

FINDINGS

INTERACTIONS WITH PEOPLE IN POSITIONS OF AUTHORITY

People who are providing/have provided a service to individuals. People who hold an official role in the community, including those

who use their power to help others and those who abuse their power.

Stigma & Discrimination

Lack of human compassion

Unethical behaviour

Feeling trapped

Champions

FEELING STIGMATIZED AND/OR DISCRIMINATED AGAINST

Individuals reported feeling discriminated and stigmatized against by both health professionals and criminal justice professionals.

Individuals felt that they were being judged because of their mental illness and their involvement in the justice system. There were

feelings of being misunderstood and dismissed by people in positions of authority. Individuals felt defeated and like they did not

have a voice.

FEELING STIGMATIZED AND/OR DISCRIMINATED AGAINST

“I was freaking right out and I went suicidal… and so when they put me in jail, I was in the hole for the week… I was like ‘Can I see a

doctor’ because obviously I need help if I cut myself. And they’re like, ‘no, no, deal with it.’ So they wouldn’t let me see a doctor or

nothing.”

“I got put in jail… and I was like, I need to talk to a doctor because I’m suicidal. And they’re like ‘no, no, you have to deal with it’. So they put me in this room, so I popped out my [glasses] lens and

scraped ‘fuck it’ on my arm. Then they tied me up to this chair for 2 hours. And I couldn’t move. Like, I was strapped to a chair.”

FEELING STIGMATIZED AND/OR DISCRIMINATED AGAINST

“and the psychiatrist… I was living on the streets. I was fleeing an abusing relationship. And he knew that. And he was like, “You’re just

looking for attention. You just think this is a…” Literally, he said, “You just think this is a warm roof over your head.”

LACK OF HUMAN COMPASSION

Along with feelings of being misunderstood or dismissed, one of the most common negative experiences by individuals was the lack of

human compassion they felt from people in positions of authority in all professions. They felt as though professionals would not listen to

them and felt they had no control over what was happening to them. They feel like no one cares, the professionals do not help and no one

listens.

LACK OF HUMAN COMPASSION

I found them… They’re not nice. They [police] don’t understand. And I mean it’s not excusable. You know, I did what I did. I did break

into… Like I did trespass and everything. But they take it at face value. And they treat people the same. They would treat me the

same as somebody who didn’t have a mental health issue. Which is part of their job, I understand. But I can’t handle that anxiety. And so when I was arrested for the first time, I started shaking and I started

like having an anxiety attack. And they told me just to suck it up and stop looking for attention. So you know, like at that point, I was… They treat everybody at face value, and they shouldn’t.

LACK OF HUMAN COMPASSION

“So I mean it was a really stressful experience just to be in there, to be honest. It’s a mental hospital so you’re basically treated like a criminal even though you didn’t do anything wrong. You have no

rights. You’re not even allowed to go outside to have a cigarette. And you’re told when to eat and you’re told, you know, you have to take

this medication. And you don't know what it is. You don't know what it’s going to do to you but you have to take it or else they’ll force you

to take it, and give you, you know, the injection against your will.”

LACK OF HUMAN COMPASSION

“…there’s not enough mental health facilities. They put too many people in jail that don’t belong there. And when they’re in there, you

know, the guards make fun of them and laugh at them, and try to ostracize them so they can be buddy, buddy with the solid cons, the

cons. Conning somebody to make fun of you.”

UNETHICAL BEHAVIOUR

Individuals report unethical behavior and being physically harmed by service providers, including some examples of extreme harm.

UNETHICAL BEHAVIOUR

“And then a cop came up to me and threw me down on the ground like face first because I had pulled the fire alarm and woke

everybody up, and everybody was coming out of the building. And I don't know, I was not treated very well. He like pushed me down on the ground face first. Like it’s a good thing I put my hands there to catch myself because I would have like cracked my nose and broke my nose. They were really like rough with me. And threw me in the

back of the paddy wagon and took me to the hospital.”

UNETHICAL BEHAVIOUR

“My psychiatrist, he basically, to be honest, he doesn’t do his job. He sees me about every 4 to 5 months, and he renews my

medication for the following year. As in like he renews it for an entire year ahead. Which I think is kind of ridiculous because, you

know, there’s no way to tell, you know, what I’m going to need in the next year. And he’s just not there. When I go to see him, I see him

for maybe 5 minutes at the most, and that’s it.”

UNETHICAL BEHAVIOUR

“There was one police officer, they were going to send me to local jail for the weekend. And I managed to get myself out by blowing him in the bathroom… And it seems like that stuff happens more after other police officers, the crooked ones, found out I had done

that. I got that offer a few more times.”

FEELING TRAPPED

Some individuals felt bullied by the law or health professionals such as feeling as though their cases were being sabotaged or that they

were being punished.

FEELING TRAPPED

“I didn’t like the psychiatric support that I received either. My psychiatrist would not let me go. Like I was in the clutches of

psychiatry. I was trying to get away. I had to get lawyers. She was even writing me letters and calling me at home, and saying, “Come in to see me. You need to be on medication. You have a 97% chance

of relapse if you don’t take these medications for the rest of your life,” the medications that were like killing me.”

FEELING TRAPPED

“I find that the lawyers at like Legal Aid, they are free. I find that's just like they're all working against… Like they all know what's going on. And us, we're just like on the sidelines, I guess. And they're just

debating what they want to do with us. So it's like we're kind of pawns in the game, sort of. So you're not really an active part of

your…I feel like that it's an… like they're all inside jobs. Like they all just work together pretty much. If I had a choice to get a paid lawyer or one given to me, because I know they're going to work for them

before they would work for me. You know what I mean?”

CHAMPIONS & HUMAN COMPASSION

Human compassion was the most common theme for positive experiences for individuals. These people in positions of authority such as judges, lawyers, sheriffs, guards, paramedics, and doctors

treated individuals “humanely” and “like a person”. These tended to be small gestures within the scope of individuals jobs.

Individuals would mention that one person who made a difference in their life. They felt it was the one person who made a difference and made me feel like a human being. These people tended to go above

and beyond the scope of the job.

CHAMPIONS & HUMAN COMPASSION

“The judge changed my life. So doing that, you know. I still see them this many years later… If it weren't for him, my whole life would have been different. I would have probably been dead by

now. He took me in.”

CHAMPIONS & HUMAN COMPASSION

“And the good things that have come in the past 13 years is I've managed to get involved with a psychiatrist who has been an

extremely great outlet for me. And it's been also a very normalizing process where I realized that I am not a freak of nature and that I

have nothing to be ashamed of, and that I just continue on with my medication.”

CHAMPIONS & HUMAN COMPASSION

“I actually had one good police officer. And that, I'll say, he was actually the… I think not the chief of police but he had a good

position. And I remember I smoked then when the incident had took place. And I gave my report of… Like I was out of it and I was giving my whatever report on paper to 2 officers. And the man, he said, "Do

you smoke?" He goes, "You must be dying for a cigarette." He put me in a cell and he gave me one. He goes, "Don't tell anyone," and

he gave me… Like that gesture meant so much to me.”

TAKE HOME MESSAGES

• We stigmatize and discriminate against our clients

• We display ignorance and lack of compassion for our fellow human beings

• Positive experiences are the exception and are specific to particular individuals rather than services, professions, or sectors

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