Remoteness and its impact on the potential for mental health initiatives in criminal courts in Nunavut, Canada

ABSTRACT

Remoteness in the isolated communities of Nunavut, Canada adversely affects access to mental health services. Mental health initiatives in criminal courts exist in many cities to offer healthcare alternatives to regular criminal court processing for people affected by mental illness. These initiatives do not exist in Nunavut. A qualitative multiple-case study in 3 Nunavut communities involving 55 semi-structured interviews and 3 focus groups explored perceptions by health, justice and community stakeholders of the potential for criminal court mental health initiatives in the territory. Findings suggest remoteness is perceived to hinder mental healthcare support for court responses to people affected by mental illness, creating delay in psychiatric assessments and treatment. While communication technologies, such as tele-mental health, are considered an effective solution by most health professionals, many justice-sector participants are sceptical because of perceived limits to accessibility, reliability and therapeutic value. These perceptions suggest remoteness is a significant hurdle facing future criminal court mental health initiatives in Nunavut. Additionally, remoteness is viewed as affecting decisions by lawyers to bypass legislated mental health avenues, possibly resulting in more people with mental illness facing criminal justice sanctions without assessment and treatment.

KEYWORDS:

• Nunavut
• Arctic
• Canada
• remote
• mental health
• criminal justice
• assessment
• treatment
• tele-mental health
• videoconferencing

Acknowledgements

The authors thank the Nunavut communities of Iqaluit, Arviat and Qikiqtarjuaq and participants in this study and also Peter Christie. Funding for this research was provided by the Social Science and Humanities Research Council of Canada: [Grant Number 767-2011-1882], Canadian Institutes of Health Research: [Grant Number 201311FRF-322597-241577], Canadian Federation of University Women, Nunavut Law Foundation, Canadian Polar Commission, Aboriginal Affairs and Northern Development Canada, and Queen’s University.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding for this research was provided by the Social Science and Humanities Research Council of Canada: [Grant Number 767-2011-1882], Canadian Institutes of Health Research: [Grant Number 201311FRF-322597-241577], Canadian Federation of University Women, Nunavut Law Foundation, Canadian Polar Commission, Aboriginal Affairs and Northern Development Canada, and Queen’s University.