Psychiatric Survivors/Consumers Die and Nothing Is Done: An Examination of the Discriminatory Nature of the Ontario Coroner’s Act

  • Tracy Mack York University
Keywords: Mad people, Ontario Coroners Act, psychiatric and correctional facilities, government accountability, mandatory and discretionary inquests


Through a critical examination of the Ontario Coroners Act, this paper reveals the expansive loopholes within the legislation disallowing public inquests in regards to the deaths of Mad people held in police custody, psychiatric hospitals and correctional facilities. The lethal abuses and rights violations occurring within the system are neither oversights nor technicalities, but rather are a result of the standard procedures and applications of the Coroners Act.  An in-depth investigation of cases mandated under the legislation, further demonstrates how these deaths are attended to with a level of ambiguity, along with an expansive and arbitrary interpretation of the Coroners Act, providing ample leeway to disregard holding open, public, and transparent inquests, is evidence that these deaths remain improperly investigated, if they are at all. Legislative change to the Coroners Act is urgently required in order to have these deaths seriously investigated and to prevent the continuation of psychiatric consumers/survivors dying suspiciously under the control of the state.