Focus On

Group urges better strategies to address plight of criminal defendants with dementia

Friday, September 21, 2018 @ 2:16 PM | By John Chunn

Sept. 21 is World Alzheimer’s Day.

To mark the occasion, the Dementia Justice Society of Canada has launched its Strategy Tracker, an annual update that monitors national and subnational dementia strategies in Canada and across the globe to track whether they address the plight of criminal defendants with dementia — an often forgotten and overlooked population.

At the national level, only two countries — Cuba and England — directly address this vulnerable group in their dementia strategies. The United States mentions educating legal professionals, but it is not explicitly in relation to criminal defendants. With the exception of some references to driving and public safety, another 20 strategies do not address criminal justice at all.

Canada’s national dementia strategy is under development; however, the Public Health Agency of Canada recently released its final report from the National Dementia Strategy Conference, which was hosted by the Ginette Petitpas Taylor, federal minister of Health, in Ottawa on May 14-15, 2018. The report identifies a handful of cross-cutting issues, including human rights, particularly in the context of criminal justice:

“Participants emphasized the application of a human rights lens to the national dementia strategy and the integration of principles of equity, diversity and inclusion throughout. They also signalled the importance of aligning with global and national charters of rights for people living with dementia, particularly with respect to criminal justice.”

Most people with dementia will not come into conflict with the law. However, it is well-established that some of the behavioural symptoms associated with dementia (e.g., aggression, disinhibition, forgetfulness) may lead to involvement with the criminal justice system. In other cases, a convicted individual may have dementia while in prison or on parole.

As such, it is important that strategies address the plight of criminal defendants with dementia. Not only is it the right thing to do, but it also aligns with the World Health Organization’s (WHO) suggestion that countries develop national strategies that are comprehensive and multisectoral. In its recently released publication, Towards a Dementia Plan: A WHO Guide, the WHO outlines a number of non-health sector roles, including by the justice system: (1) mechanisms to protect the human and civic rights and freedoms of people with dementia, their carers and families; (2) treatment and rehabilitation of people with dementia in prisons; and (3) diversion of people with dementia from the judicial system.

Regarding strategy leadership and governance, the WHO states:

“[T]o avoid a health-centric perspective, some countries [have chosen] to establish a national commission or council, typically convened by the ministry of health, representing multiple sectors (e.g. education, housing, justice, environment, social welfare).”

As Canada continues to develop its national plan, Dementia Justice again urges the federal government to expand the mandate of the strategy’s advisory board beyond health. As the organization has previously cautioned, the National Strategy for Alzheimer’s Disease and Other Dementias Act currently limits the board to advising on the health care of persons with dementia. This narrow scope is at odds with the legislative commitment to build a comprehensive strategy that addresses all aspects of dementia.

At the subnational level, a handful of U.S. state plans address criminal justice, particularly in relation to shoplifting, gun ownership and prisons. In Germany, Bavaria’s strategy mentions judge and police training. In Canada, only two provinces — Newfoundland & Labrador and Quebec — make direct reference to police or the justice system.