Quebec tragedies put mental health in spotlight, but expert warns of stigma

In the wake of the tragedies, Quebec Premier François Legault and other politicians have stressed the need for better mental health care and even raised the spectre of involuntary treatment.

Emmanuelle Bernheim, a University of Ottawa law professor and the Canada Research Chair in mental health and access to justice, said the rush to connect violence with mental health is based on a “false association.” Research, she said, does not show that people with a mental illness are more likely than others to be violent.

If anything they tend to be victims of crimes, she said. However, the stereotype persists — perhaps because people have a need to make sense of tragedies, Bernheim added.

“I think it’s saying something about how we cannot handle that kind of behaviour,” she said in a recent interview.

Legault described Breau’s death last week as “another violent tragedy,” adding, “It is clear that there are mental health problems.” He promised to ensure that patients who pose a risk are treated quickly.

In Amqui, after a man driving a pickup truck drove down the sidewalk, killing three pedestrians and injuring eight, Legault urged Quebecers to intervene when someone close to them shows “worrying signs.” The premier also suggested that those who don’t accept treatment may need to be forced into it.

Bernheim said she considers the premier’s comments “problematic” because they can create distrust of people with mental illnesses. Furthermore, she noted that requests for involuntary admissions and forced treatment for mental health have already increased drastically in recent years.

Citing government data, she said involuntary admissions rose by nearly 30 per cent between 2015 and 2020, and forced treatment rose 45 per cent.

“To say we’re going to treat people against their will, we’ll hospitalize them against their will and it will be fixed, the current practices show that’s not the case at all,” she said, pointing out that such tragedies continue to occur.

While mental health has been raised as contributing factors in several of the Quebec tragedies, Bernheim notes that there are major differences between them.

On Feb. 8, a driver with the Laval transit corporation was arrested after the bus he was driving turned down the driveway of a daycare in Laval and plowed into the front of the building, killing two young children. Pierre Ny St-Amand, 51, who is facing two first-degree murder charges, is undergoing a psychiatric evaluation to assess whether he was legally insane at the time of the alleged attack.

Steeve Gagnon, the man accused of deliberately driving his truck into pedestrians in Amqui, was arraigned Wednesday on three counts of first-degree murder.

While witnesses have described concerning behaviour from both suspects, Bernheim notes that neither had a history of violent crime and nothing indicates that they were being treated for mental illness.

The man accused of fatally stabbing Breau is a different story. Isaac Brouillard Lessard, whom police shot dead after he allegedly stabbed the officer, had a history of mental health issues and had been found not criminally responsible at least five times for past offences. The province’s mental health review board found in March 2022 that Brouillard Lessard posed a “significant risk to public safety,” but the board determined that the risk could be adequately controlled if he were properly monitored.

In that case, Bernheim said, other options may have been available.

Since Breau’s killing, the union representing provincial police officers has said it planned to submit a petition to the legislature for improvements to the supervision of violent people who are released from custody, and for police officers to have access to patient data from the mental health review board.

Bernheim said this could lead to all people conditionally discharged being “flagged,” without reason, for being violent, or to a situation where they would be sorted into categories, “which raises the question of how and by whom it would be made.”

“The rhetoric of the past few days is helping to create associations between mental illness and violence, and between non-criminally responsible people and violence, without any scientific basis,” she said.

She stressed that the factors that lead to crime are complex and difficult to predict but go far beyond mental health — a term she said that is poorly defined and understood.

While Bernheim said she doesn’t have the answer, she suggested people look at societal factors for crime, including widening inequality, a lack of social services and isolation.

“We know that a lot of people are really alone; they have nobody,” she said. “How can they get help or support if they need it, if they have nobody, in a context where services are really difficult to get?”

This report by The Canadian Press was first published April 9, 2023.

Morgan Lowrie, The Canadian Press

by Canadian Press

Quebec tragedies put mental health in spotlight, but expert warns of stigma

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