mental illness

Supporting residents struggling with mental illness

Wednesday, June 8, 2022
By Lisa Feldstein and Tess Chambers

Mental illness is more prevalent than it may appear. Studies suggest that almost one in five Ontarians have been affected by a psychiatric disorder.

As it is a legal duty under the Ontario Human Rights Code for organizations and institutions to be “accessible, inclusive, discrimination and harassment-free environments,” there are some things to consider when dealing with residents who may be suffering from a mental illness.

Take notes

Document anything that may seem out of the ordinary about a resident. This may include rapid weight loss, decline in hygiene, wearing inappropriate clothes for the weather, acting in a threatening or intimidating manner, behaving out of character, illogical or disorganized speech, statements that demonstrate potential paranoia, or actions that harmed or could have harmed the resident or others.

Documents may later be supplied to police, hospitals or used in court if necessary. Ensure that documents are kept private and confidential and are not used as a means to stigmatize or discriminate against individuals.

When meeting with a resident, taking notes is essential as the individual may have a different recollection of what transpired. For this reason, it may be useful to have a witness present, if possible. As a witness can create an uncomfortable power imbalance, it can be useful to meet in a room where everyone feels safe (e.g. equal access to exits, door open).

Request emergency contacts

It is prudent to request all individuals to supply an emergency contact when they become a resident. This helps a matter proceed in the event any resident becomes ill or injured. If a resident has a serious mental health issue, it is likely the emergency contact is well aware.

The emergency contact may also be able to intervene in ways that a condo manager cannot, such as transporting the person to seek medical care, liaising with a psychiatrist, or taking legal action to become a guardian.

If there is no emergency contact and it is suspected that the person has a serious mental illness, it is possible to call the Office of the Public Guardian and Trustee (PGT). The PGT is part of the Ontario Ministry of the Attorney General and plays a role in caring for individuals found to be mentally incapable. The PGT keeps a register of all guardians of property and guardians of the person. Upon request, the PGT will disclose if an individual has a guardian. This information can be used by condo managers to identify a resident’s guardian and determine next steps. Notably, many people with a serious mental health issue do not have a guardian.

Accept the challenge and get creative

Sometimes, it can be cheaper and less stressful to simply accept challenging behaviour for what it is, and focus on developing a solution, rather than try to change the behaviour itself.

With many mental illnesses, a request to modify conduct is simply not going to result in meaningful change. Though no fault of their own, the individual may lack the ability to comprehend or act upon the request. Lack of insight is often part of the illness; it may be unrealistic and unreasonable to expect a person suffering from a serious mental illness to change. Medication, however, can lead to dramatic improvements for some individuals.

Here are some examples:

  • If a person is covering their windows with tinfoil due to paranoia, it may be worth considering whether to let this go rather than insist the tinfoil be removed (provided there is no safety concern).
  • If noise is an issue, soundproofing may be an option.
  • If hoarding is a problem and creating an odour that disturbs residents, it may be logical to offer occasional cleaning services.

Condo managers are not expected to serve as mental health professionals and, therefore, addressing paranoia or other manifestations of a mental illness is not realistic. Focusing on what can be controlled is often the path of least resistance.

Have an emergency plan

Just because someone has a mental illness does not mean that they will become violent. It is much more likely for people with mental illness to become victims of violence instead of the perpetrators. However, creating an emergency plan is never a bad idea.

If someone has been threatened or harmed, calling police can be prudent, or necessary, to ensure everyone’s safety.

However, the police may have no information about the resident. It can, therefore, be important to share knowledge or suspicion of a mental illness with the dispatcher when calling 911, and the first responders who arrive on scene. This may help diffuse the situation and result in a more positive outcome.

This is also where those documents of unusual behaviour come in handy. It can be helpful to review one’s notes before speaking with first responders. Additionally, providing a copy or summary of notes to police may help police decide to exercise their authority under section 17 of the Mental Health Act, which allows them to transport a person to hospital for a psychiatric evaluation. Managers may wish to keep a printout of this section in a binder with the rest of the emergency plan as a reminder to advocate for this option rather than a criminal charge.

Keep calm and be kind

The duty to accommodate includes performing those duties in a manner that respects the dignity of the person. Human dignity includes inherent worth as a human being, and autonomy is harmed when people are ignored or devalued.

Disruptive residents with mental illness are rarely trying to be difficult. Most likely, they are experiencing difficult times themselves. We don’t blame people with physical disabilities or illnesses for their conditions, yet there is a stigma with mental illness that is difficult to overcome and often results in poor treatment by others.

This article does not constitute legal advice. When in doubt, consult a lawyer.

Lisa Feldstein is a health and fertility lawyer at Lisa Feldstein Law Office PC. She specializes in matters relating to consent, capacity and substitute decision-making. Her practice is focused on serving family caregivers and helping clients build families through third party reproduction. She can be contacted at lisa@lisafeldstein.ca.

Tess Chambers is a summer law student with CAMH. At the time of writing this article she was a second-year law student at the University of Ottawa.

This article originally appeared in last year’s August issue of CondoBusiness magazine.

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