Dr. Eilion?ir Flynn:

I thank Ms Joyce for setting out all of these issues. From an international and comparative perspective, the UN Committee on the Right of Persons with Disabilities has been very clear on this point. Even though many countries are struggling to put into practice what the UN committee has asked for, it consistently asks for a dismantling of all coercive psychiatric treatment systems, including forensic systems but also on the civil side.

The perspective of the UN committee is that no one should undergo forced mental health treatment. Everyone who wants mental health treatment should have access to it but nobody should be forced to accept a treatment to which they do not consent. We do not force anyone to accept a physical treatment to which they do not consent. We need to achieve parity between physical and mental health care. If we are serious about parity this is what is required. It would require a massive structural change in how our mental health laws and the criminal justice system operate. Keeping this in mind, and acknowledging the scale of the challenge, it is nonetheless the goal we need to work towards.

There are plenty of examples we can draw on, particularly on tackling issues when they first emerge. There are examples of not only restorative justice projects but also transformative justice, where communities come together to figure out collectively how they want to tackle issues of interpersonal violence or other issues that arise in communities. Often communities create their own solutions because they are frustrated by the way in which law enforcement deals with these issues and the way in which it further marginalises, medicalises and creates more distress for people who are already in very difficult situations. We looked at examples of transformative justice work, such as Mia Mingus's project in California, which we mention in the research report. It is very positive. It has been informed and designed by disabled people and people with experience of emotional distress or mental health crisis. It is about coming up with a different way to respond when issues emerge that does not involve getting in contact with the criminal justice system in the beginning. This would solve many issues.

It is about an alternative way to look at things. Rather than diverting people out when they have already come in contact, if we could tackle the issues as they emerge and avoid this contact in the first place it might give a much better experience, not only for the person caught up in the centre of the situation but everyone impacted by it. People and families often call law enforcement where they have no alternative. They do not know what else to do in the situation. If we create alternatives that work and in which people have confidence, and if people can see the alternatives working and can see better outcomes, they will use them. This is what the international and comparative literature shows us.

The UN committee has made findings against other states, such as Australia. In a very famous case an indigenous man, Marlon Noble, was detained in a forensic setting and eventually released into the community but with conditions that were so restrictive the UN committee said they continued to amount to a deprivation of his liberty. This was all because he was unfit to stand trial. He never got to clear his name. He maintained his innocence throughout. He said it was something he had not been involved in. He was accused and got caught up in the system. We need to take seriously the mandate of the UN committee and the challenge it has set before all countries.

We can learn from our colleagues. In Australia the response was to have a number of very interesting pilot projects working with people, including indigenous people, who tend to get disproportionately caught up in the criminal justice system. This is also the case for people who have had various labels attached, such as a mental health diagnosis or foetal alcohol spectrum disorders, and the various experiences people have. It is about responding to these situations so that people do not end up coming into contact with the criminal justice system in the first place. This would be the best port of call for restructuring our entire system which, of course, is a huge challenge.