"No Safe Place to Call": Perspectives and Experiences of Access to Mental Health Services by People Found not Criminally Responsible on Account of a Mental Disorder.

Abstract

The growing role of the justice system in the care of individuals with mental illness has led to concerns about access to adequate and timely mental health services, particularly for persons with severe mental illness whose behaviors increase their risk of justice involvement. This study investigated the perceptions of people found not criminally responsible, their loved ones, peer support workers, and other mental health professionals and managers regarding access to effective and relevant mental health services. Semi-structured interviews and focus groups were conducted with 25 participants, and data analyses were carried out according using thematic analysis. The findings highlighted how past experiences of stigma, trauma, inefficiency, and discrimination within a hospital-centric system influenced service users' and caregivers' ability to seek and engage with care. Current access mechanisms, such as police intervention and emergency room visits, were described as unacceptable and often viewed as options of last resort. Consequently, service users frequently entered the healthcare system only when their needs had escalated in complexity, making them difficult to address within the scope of standard clinical practice. Implications for policy and service organization are discussed.