Au Canada, on a constaté un nombre grandissant de personnes ayant des problèmes de santé mentale et qui ont des démêlés avec la justice. La dynamique d'exclusion engendrée par cette intervention pour ces personnes - difficultés d'accéder à des soins et des services, détérioration des conditions de vie, accélération de la judiciarisation avec des retours multiples en prison -, ainsi que l'épuisement des ressources - consultations répétées en urgence psychiatrique, demandes accrues de services auprès des ressources communautaires -, ont montré la nécessité d'examiner la politique de déjudiciarisation. Cette dernière vise l'usage de mesures non pénales ou, lorsque ce n'est pas possible, la diminution ou l'absence de recours à l'incarcération, selon la nature ou la gravité du problème à régler. Cet article documente des pratiques de déjudiciarisation à travers l'exploration d'un nouveau programme d'intervention : l'Urgence psychosociale-justice de Montréal (UPSJ). Après un examen de la thèse de la criminalisation de la maladie mentale, le texte présente quelques résultats préliminaires des 19 premiers mois de fonctionnement du service. En conclusion, s'il apparaît évident que l'UPSJ joue un rôle clé en amont en évitant des entrées dans le système pénal, elle soulève la question de la capacité du milieu à répondre aux besoins d'intervention et de prise en charge des populations ciblées.A growing numbers of people who suffer from mental health problems have been found to run into trouble with the criminal justice system. The exclusion dynamic created by intervention targeted at these people - difficult medical care and access to services, deteriorating living conditions, the acceleration of judicial processing along with multiple prison experiences - as well as increasing ressource limitations - repeated psychiatric emergency ward consultations, growing service demands on community ressources - have both demonstrated the need to examine policies that would divert people from the criminal judicial system. Such policies aim to promote the use of non judicial measures, or when this is not possible, lessen or put an end to incarceration practices, depending on the nature and seriousness of the problem. This article researches judicial diversion practices through the exploration of a new intervention program: l'Urgence psychosociale-justice de Montréal (UPSJ). After reviewing the mental illness criminalization thesis, the text goes on to present preliminary results of the service's first 19 months of functioning. In conclusion, although the UPSJ obviously plays a key role in reducing entries into the criminal justice system, its very existence also raises the issue of the environment's capacity to answer the target population's intervention and caretaking needs
This article discusses how pre-trial detention has become an important instrument in the treatment of the accused whose mental state has been questioned during the judicial process. This study is part of a major research trend centered on the hypothesis of criminalization of the mental illness. This hypothesis has been defined as a shift of groups of the population from the mental health system to the criminal justice system. First, the authors examine how the Criminal Code's dispositions and those regarding mental disorder, which have been revised in February 1992, can be associated with the Court's decisions regarding the release of the accused during the legal process. Then, the authors continue to look into the question concerning the articulation of dual decisional logic (judicial and psychiatric) by studying approximately 1 000 cases heard before the Criminal and Penal Chamber of the Québec Court in Montréal in 1992-1993, in which the mental illness issue was raised. This analysis will try to demonstrate a link between pre-trial detention and mental health problems. It will also show that, despite the adoption of the principle of presumption against custody during assessment orders regarding mental disorder, the Court practices are changing slowly and the new dispositions are rarely used.
Les comportements suicidaires chez les personnes présentant une déficience intellectuelle ou un trouble du spectre de l’autisme sont peu reconnus et ont été peu étudiés, ce qui limite le développement d’interventions adéquates. Cet article propose une analyse des connaissances et des besoins dans ce domaine, à partir d’une synthèse des connaissances scientifiques et un forum de consultation d’experts en recherche et en clinique. Les résultats montrent qu’il est important de reconnaître l’existence des comportements suicidaires chez ces personnes, de développer les connaissances sur les liens entre permanence de la mort, perception du temps, communication et suicidalité chez ces personnes et d’analyser le besoin de développer ou d’adapter des stratégies d’estimation du risque.Suicidal behavior in people with intellectual disability or autism spectrum disorder is not sufficiently recognized and has been scarcely studied, which limits the development of appropriate interventions. This article proposes an analysis of current knowledge and needs in this area, based on a literature review and a consultation with a group of clinical and research experts. Results show that it is important to recognize the existence of suicidal behavior in these people, to develop our understanding of the links between perception of death, time perception, communication and suicidality among these people and analyze the need to develop or adapt risk assessment strategies
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