English Mental Health Reform: Lessons from Ontario?

Abstract

Reforms in areas related to mental disability are under debate in England to an extent unprecedented for almost half a century. The Law Commission’s proposals on incapacity, following further consultation from the Lord Chancellor’s Department, have now largely been accepted in principle by the government for legislative enactment at some time in the undetermined future. A joint green paper from the Home Office and the Department of Health has established a policy agenda concerning the governance of people with serious personality disorders. Proposals by an expert committee chaired by Professor Genevra Richardson on mental health reform have likewise been followed up by a government green paper, and the two green papers have in turn resulted in a joint white paper on reform of the Mental Health Act 1983. All this takes place as the Human Rights Act 1998 takes effect, with its guarantees relating to liberty and security of the person, standards for hearings, respect for private and family life, and protection from inhuman or degrading treatment. Throughout the development of the reforms, a number of similar themes have recurred, involving civil rights, the provision of appropriate legal processes, anti-discrimination, the respect for people with capacity, the extension of controls into the community, and the safety both of people with mental disabilities and of the public as a whole.

At least in the public arena, most of the debate has focussed on the English situation. The premise of this paper is that the situation in the rest of the world may have something to teach us. The paper examines the law of Ontario. While it focuses primarily on those issues related to the Richardson Report and its subsequent government response, Ontario legislation divides issues somewhat differently to English law, and thus overlap with the other reform proposals is inevitable.