REPOST: Fail Better- Health Justice Lessons from NS's Deinstitutionalization & Prison Abolition Mvts

Welcome everybody. My name is Matthew Herder and it's my pleasure to welcome you here and introduce our speaker, the final speaker for our seminar series this year at the Health Justice Institute here at Delhazi. Um, DAL operates on the unseated territories of the Mikmma, the Wisay, and the Besco Doati peoples. These sovereign nations hold inherent rights as the original peoples and keepers of these lands, and we each carry collective obligations under the peace and friendship treaties. Section 35 of the Constitution Act 1982 recognizes and affirms Aboriginal and treaty rights in Canada. We also recognize that African Nova Scotians are distinct people whose histories, legacies, and contributions have enriched that part of MCMI known as Nova Scotia for over 400 years. Um, it's really a pleasure for me um as a colleague, as a friend, as someone who greatly admires Sheila's work. She really doesn't need much of an introduction. She asked me not to really do one to to give more time for the presentation and discussion. But I just want to say on a personal note and a note that I think extends to everyone here and beyond, uh, Sheila is a a rare scholar whose work is both expansive in terms of the material and issues she engages with, but so grounded at the same time in personal relationships in a deeply human way with people in the community experiencing marginalization. Uh, forms and I can think of no better person um even if it fails to play with her title for a bit to think about this turn that we're really excited about taking continuing and expanding upon at the health justice institute around uh really leaning into and making our work uh community centered community led in allyship with many community- based actors and so it's really exciting to hear Sheila sort of expand on that vision here today share some of her work and talk about what this shift at the Health Justice Institute might look like in in conversation with you. So, Sheila, >> thank you. Thank you, Matt. Let's see. Oh, there we go. So, really happy to and grateful to uh be able to speak with you today. Um, so when I stepped in as Health Justice Institute director in July, I inherited a question uh which is this question. What does it mean to stand for health justice and work for health justice in these troubled times? Times of war, climate crisis, accelerating material inequality, the rise of authoritarianism, and with it a retraction at the highest levels of power uh from even the facade of commitment to global health, climate justice, medical science, human rights. I ask this question not rhetorically uh or idly but with purpose. As someone working here and now at this university directing the Health Justice Institute, which spans faculties of law, health, medicine, and dentistry, what should we do to support health justice in these times? My remarks today offer a preliminary and partial response reflecting my scholarly and advocacy focus on decarceration and deinstitutionalization projects anchored in health justice or equitable access to the social determinance of health. My aim is to draw from those examples and take stock of related themes in my research and to propose one small way that I and we at the Health Justice Institute might contribute in a way that seeks to honor and amplify community embedded insights about health injustice and justice in a world of increasingly remote and abstract legal and health professionalism and knowledge production. a world and I include in this the world of our students increasingly starved for human connection and purpose. So I preface my remarks with acknowledgement of our locatedness in MCMagi honoring the Wabanaki traditions of stewardship and connection to and on these lands is fundamental to health justice amidst generations of colonialism including colonialist university dealings. I'll start, here's the plan, with two case studies centering deinstitutionalization and decarceration and intended to distill insights and questions on what it means to pursue community engaged health justice in the here and now. Then I'll trace a path through my community-engaged research and service, a story of hope and of progressively failing better. As I say, I highlight a few examples I describe as efforts to amplify subjugated knowledge and connect that knowledge to the wider project of health justice. And I conclude by describing an initiative that Professor Herder and I and others at the HJI are launching, community health justice partnerships. What this is, what it might be is something that I invite you to imagine with us as we explore new ways of connecting legal with health professionals, individual problems with social structural determinance, individualized with systemic advocacy, heart with mind, and the university with the wider community in the service of health justice. So, let's start with what is health justice. The health justice institute changed our name. Oh, changed our name uh to uh health justice from health law institute a few years ago to signal a deepened commitment to interdisciplinarity and to recognize that law has frequently been a source of injustice corrosive to health particularly for communities subordinated by colonial racist heteronormative and abbleist inequality. At the same time, our name change picks up on a scholarly and social movement trend reflected here on this slide where health justice is defined as both a framework for health and policy, health law and policy scholarship and a social movement. On this approach, as a research framework, health justice engages the role of law and policy in creating and potentially dismantling subordination in health care and public health. Here the normative anchor is intersectional substantive equality. A concern to red address inequitable access to social determinance of health on grounds of race, indigenity, gender and gender identity and disability. That imperative may be traced to international law on the right to health and the social, economic and cultural rights that underpin it as well as anti-discrimination law. The same imperative of intersectional substantive equality drives the health justice movement which seeks to overcome and remediate inequitable access to the social determinance of health. As defined, health justice is a big tent. It encompasses scholarly inquiry as well as social movement advocacy on say climate justice, indigenous justice, reproductive justice, justice and access to essential medicines and more. Its strategies, both scholarly and movement-based, are similarly capacious. Health justice scholarship tends to be deeply interdisciplinary, connecting legal analysis to quantitative and qualitative empirical inquiry. Further, while it does not narrow to a single research method, it is closely aligned with action research involving community-led design and pursuit of research questions engaging live problems those communities seek to solve. drawing scholarly and movement aspirations together to support those directly affected by health inequalities to create and sustain the conditions of health and justice. My work in recent years has focused on one corner of health justice, namely how coercive control across both justice-based and care institutions interacts with inequitable access to the social determinants of health. I situate that work in light of social determinance research. For instance, affirming the birectional relationship of psychosocial disability with poverty, homelessness, and other forms of social exclusion. Further, I and others explore how disability institutionalization, segregating people in congregate spaces and depriving them of choice and control, is constituted by deprivation of the social determinance of health. For its part, criminal law incarceration is not only over representative of people with disabilities, but also of people with disabling social characteristics, including poverty, homelessness, childhood trauma, and involvement in child welfare systems. Indigenous people and people of African descent are also, as you know, grossly over represented in prisons and jails. In short, the social determinants of disability, disability institutionalization, and criminal law incarceration overlap in significant ways. The common foundation of criminal law incarceration and disability institutionalization in lack of access to housing, income, and other social determinants of health may be more constructively stated as a thesis about the health and justice protective factors conducive to health justice. disability justice, race and indigenous justice. This further cashes out as a question, namely, how might we advance decarceration and deinstitutionalization by promoting equitable access to the social determinance of health to adequate housing, food, income, the social bases of self-respect in a manner reflective of intersectional substantive equality. So, I offer a few touchstones from which I draw inspiration in answering that question before turning to my case studies. I start with the social movements and community-based organizations in our backyard that make it their business to pursue equitable access to the social determinance of health and resist healthing institutionalization and incarceration every day. I'll come back to these grassroots players in the space of decarceration and deinstitutionalization as I go through uh and I'm co-chair of one of them with Renford Frier my co-chair that's East Coast Prison Justice Society Sonia's here who is our amazing staff answering our phone line um not answering it right now but uh relatedly I draw inspiration from Andrea Richie and others elaboration of a black feminist practice of emergent transformative ative justice strategies in troubled times. Richie analogizes emergent strategies to coordinate organic microprocesses like mushrooms detoxifying soil after disasters and argues that even small moves to animate justice at the level of our relations to ourselves and those immediately around us can have transformative effects over time. Emergent strategies stand in contrast to mass movements and hierarchical or linear strategies embracing creativity, imagination, experimentation, also grace, kindness, and care to guide resistance to the violence and war endemic to white supremacist and colonialist capitalism. In a related vein, I'm inspired by an idea resurfacing in critical theory circles, that of prefiguring justice, described by Algra Mloud as the imagining and generating of alternative institutions and relations based on equity, mutual aid, and self-determination. Originating in 1960s anarchos syndicist critiques of statist Marxism, the idea is to act as if the revolution has already happened and shape one's legal and social relations in ways that reflect movement goals. Examples include local exchange trading systems and buy nothing groups, bypassing money markets while fostering social connection through direct trade and mutual aid. Another example in our midst is African Nova Scotia's community land trusts. My case studies and the community health partnerships I will speak to aspire to this ethos of instilling values and norms resistant to oppressive social and institutional structures through quote local efforts to imagine and manifest just relations in the here and now. My last touchstone is abolition remedies an idea advanced in legal scholarship in the last 7 10 years or so after being wellseed in social and political theory. This encompasses first the idea of non-reformist reforms popularized by black feminist prison abolitionist Miriam Cabba. This means resisting reformist reforms premised on what is possible within the existing order. Wins that carry bigger losses like a win on prison overcrowding resulting in new jails. Non-reformist reforms focus on what should be made possible to achieve deep social transformation like reducing high rates of pre-trial incarceration by promoting new ways of supporting freedom in community. Second, grounded preventative justice is a term Allegra Mloud uses to describe redirecting resources from carceral institutions to the means of advancing and protecting just community membership like free and voluntary community-based health care, education, and safe and affordable housing. Third is the need to link up macrolevel strategies, say systemic legal remedies in the vein of the disability rights coalition case about to be explored with micro strategies like individualized habius corpus applications that creatively anticipate and protect against incursions on transformative systemic change. With that, I turn to my two case studies which elaborate my earlier claim that decarceration and deinstitutionalization are both grounded in equitable access to the social determinance of health while also advancing a further claim that Nova Scotia is a good spot for creative prefiguration of the worlds we want. Perhaps in part because we're so darn small. Um, I was engaged with both these happenings in a tangential though intense way alongside many others as a law prof, co-chair of East Coast Prison Justice, facilitator of an intellectual disability action research collective, My Home, My Rights. However, my remarks are rooted mainly in published documents and uh uh commentary. So, first is Nova Scotia's CO 19 rapid decarceration. On the one side there, this describes a fiveweek period at the start of the pandemic in March, April 2020 when the provincial jail population in Nova Scotia was reduced by nearly 50% in about four weeks, the highest proportion released in the country. And the second is the disability rights coalition remedy, a June 2023 human rights tribunal settlement order obliging Nova Scotia to remediate systemic discrimination within 5 years by closing all large disability institutions, including supported residences with more than four people and introducing individualized disability support funding. This is an extraordinary deinstitutionaliz deinstitutionalization order complete with reporting requirements, benchmarks, external expert oversight and more putting Nova Scotia on the global map as a leading example of law and social movement coordination. So starting with the rapid decarceration, my colleague who's here, Adelina F10A, there's Adelina uh writes a wonderful article in the DAO law journal in the middle there 2021 article that by uh July 2020, most country and says this in the article that in July 2020, most countries had failed to adequately heed early calls of international human rights and health groups to protect prisoners against CO 19. such that by that time across 36 countries over 100,000 incarcerated people had been infected and over 1,500 were dead. Recommendations from international organizations focused on decarceration and providing housing and health supports on the outside as well as public health measures inside with monitoring for infringement of residual liberties. This was easier said than done. Canada's federal prisons administered by Correctional Services Canada rejected calls to decarcerate although the rate of infection was over 10 times higher than in the community and over 77 times higher among federally sentenced women. All of which had dis disproportionate effects on people with disabilities inside. Disproportionate effects were of course also felt in disability institutions where residents experienced harsh isolation and sometimes elevated rates of CO 19 infection and death. Returning to that March 2020 weekend when COVID came down, the concern arose here in Nova Scotia among prisoner justice advocates that those incarcerated in the provincial jails would be forgotten despite what we knew about their disproportionate vulnerability to infection given overcrowding and over representation of pre-existing chronic disease. Beyond Professor if Tenny's article placing Nova Scotia's rapid decarceration in a wider context of national and global public health measures. This slide features two publications by Ash Avery who at the time of CO's inception was ED of a group supporting justice involved women and non-binary folks Coverdale Justice Society. Uh she's now ed of Feed Nova Scotia. One of these is her Master of Arts thesis and the other an article co-authored with former prisoner and social justice leader, present social justice leader Sarah Tessier. Both reflecting on work on the front lines of release planning and support during this period. Avery's thesis, Frameworks for Freedom, recounts an array of creative measures taken by community organizations, some in collaboration with government and some as improvised mutual aid. East Coast Prison Justice was part of a coalition of nonprofits including Coverdale, Ephry Mainland, Wellness Within, eventually the North End Health Clinic, Direction 180, and more. jointly drafting communications and in the first three weeks of the pandemic meeting with top officials including deputy ministers of justice, community services, and municipal affairs to promote expedited bail reviews, conditional release, accelerated health and income and housing supports, intersection intersectoral bail support planning, and more. The unity of purpose was moving and tireless. That said, there were missteps. I and others found ourselves repeatedly describing because it was effective provincial prisons and prisoners as quote unquote vectors of contagion requiring release for the greater good. Among the most radical developments of the period was a homegrown expression of mutual aid whereby Ephry Coverdale and John Howard came together in unprecedented fashion to co-create supported housing for those exiting rapidly exiting the jails. Avery describes the initiative called JEC as anchored in harm reductive, trauma-informed, feminist, and anti-opressive theories and practices. Harm reduction supports were provided by North End Clinic staff and formerly incarcerated peer mentors, including dedicated indigenous, African Nova Scotian, and queer peer supports. Clients were assigned a caseworker for navigating longerterm houser housing and health needs. Halifax library staff were on site renewing pre-existing relationships with those who previously had found shelter and community in the library. JEC quickly became a go-to for police rather than the lockup or drunk tank. None of the over 40 people supported over the five months it ran breached their conditions of release. However, federal funding dried up after a few months and government, specifically community services, took over placement and case management absent harm reduction and other supports. Avery observes that while federal funding for nonprofit supported housing later expanded, the harm reduction approach, which had which had protected against breaching and reincarceration was not replicated. She adds that the province has since invested in technological over community-led, including indigenousled bail supports. By the fall of 2021, the Nova Scotia jail population had crept back up to pre2020 levels and incarcerated people were subject to harsher conditions than ever, including prolonged lockdowns seriously impairing physical and mental health. In some, Nova Scotia's rapid COVID decarceration prefigured abolition in the style of grounded preventive justice, but all too fleetingly. Unlike the rapid deinstitutionalization story, my second decarceral case study, the disability rights coalition case features litigation as a key driver in coordination with gradually intensified social movement advocacy. That said, the lines blur a bit given the sustained social justice engagement of the lawyers leading this case uh on the right there. Um so poverty lawyers Vince Calderhead poverty lawyer Vince Calderhead represented the individual and represents the individual complainants although all but all but one have died. Uh the original one of the original complaintants was Beth Mlan there. Uh and also on this side are other uh social movement actors. So disability rights coalition spokespeople Vicky Lavac uh and Lita Jarvis. Um so there's Spence. Back to the lawyers. Claire McNeel of DAO legal aid uh representing the disability rights coalition. Now it's Kran Mc uh now Katran McNeel yes is representing. Not to be forgotten is Dalaw's Diane Patche who contributed to the launch of the complaint in 2014 including through co-design of the first iteration of the systemic remedy. The groundbreaking remedy I already described requiring deinstitutionalization within five years originated in a statutory human rights complaint brought by Mlan and two others who had lived for over 10 years in a hospital ward reserved for people with concurrent psychiatric disorders and intellectual disability. Why? Why over 10 years in a clangy, bangy, terrible, you know, emergent uh psych ward? Because according to the province, there were no appropriate community spaces for them. The DRC joined to say the core problem was not individual. It was systemic. Many were similarly wasting away in highsecurity institutions or on weight lists for appropriate residential supports and living in inappropriate spaces in community. The analytical core of the case was discrimination, lack of equitable access to social assistance. That is in Nova Scotia, non-disabled people are formally entitled to social assistance without delay should one meet income criteria. Yet, if one is disabled and owed assistance through disability support, one was placed on decades long wait lists or in a controlling institution. In 2021, the Nova Scotia Court of Appeal ruled that this was systemic discrimination. After the Supreme Court of Canada refused leave, the province and DRC entered in to the historic settlement remedy that I've described, featuring timelines and benchmarks for closing Nova Scotia's disability institutions and adopting a rights respecting system of individualized supports by 2028. To be clear, advocacy for deinstitutionalization had been pressed by Nova Scotia disability advocates and families since at least the 1980s. Report after report had exposed injustice, yet government did not budge. It was litigation that consolidated and activated a movement that at that point had no political clout. And it was litigation plus litigation amplified social movement advocacy that moved government to eventually accept the settlement and recently to walk back from proposed disability support cuts. How the remedy is unfolding is a matter of public record given the reporting requirements. However, there remains need for vigilance. In January, the DRC released comments on the province's progress at the halfway point. It recognized significant changes to the disability support system, yet called out a failure to meet benchmarks on release from the largest institutions and creation of community-based supports. On the side of hope and potential interconnection between deinstitutionalization and decarceration, Emma Halpern, ED of Ephry Mainland, shared recently that a year or two ago after a session at DAL on the DRC remedy, she i.e. E Fry reached out to the disability support program and this led to a new supported housing initiative through which eight women with complex mental health challenges, addictions, childhood trauma and criminalization who'd cycled for years between prisons, involuntary hospitalization and homelessness now live independently in their own apartments with staff who provide care and community completely removed from the hospitals and criminal legal system. that in our small world of Nova Scotia health justice is earth shaking. So what takeaways might these case studies offer? For me, there are at least two. First, the transformative power of community-led justice strategies. The rapid COVID decarceration story in particular reminds of the importance of building relationships of trust over time among nonprofits, with marginalized constituencies and with government to support mobilization of services to the most marginalized in times of emergency and also at the best of times. Second, the transformative power of creative lawyering. There is in the law and society literature a well-developed critique that litigation sucks the radical pretent potential from social movements. Yet a competing increasingly robust literature focuses on creative community connected lawyering designing and pursuing legal remedies with social movements in ways that stay attuned to the goals of system transformation. Benefits of such alliances include strengthened public narratives about movement goals and struggle, coalition building effects, and instilling rights consciousness and empowerment among those long treated as lacking agency. So just as Nova Scotia's CO 19 rapid decarceration is exemplary of creative community organizing, facilitating equitable access to the social determinance of health. So the DRC case is exemplary of creative social movement lawyering, strengthening social movements by anchoring them in legal authority. Yet these examples also suggest the vulnerability of deep transformative change to the social, political, and economic structures that make prisons and disability institutions as well as poverty and homelessness seem necessary. Leat Ben Moshe and others have shown that both deinstitutionalization and decarceration are chronically vulnerable to neoliberal imperatives of cost savings, retracting or reneging on community-based supports while playing up the need for coercive containment of the dangerous or incapable few. From this follows a few questions, namely how can transformative reforms like these health and disability justice wins be sustained? More pointedly, from where I stand, how can universities promote health justice, a a health justice teaching, research, and service ecology that respects and fosters the leadership of communities lacking equitable access to social power? More pointedly still, how can we at the Health Justice Institute contribute to such work? acknowledging that much is already being done through such critical vehicles as Dell housy legal aid and Dell's social work, family medicine and dental clinics. So here my remarks turn to method taking stock of a tr a strand in my scholarship that helps contextualize the vision of community health justice partnerships that I'll close with. And from there I or sometimes we gradually surface justice insights bringing the story into relationship with systemic analysis about how health and disability injustice is produced and sustained and how the conditions of that injustice might be transformed. So the method might be described as an effort at narrative justice. Distinct but related is a project in some of my work of seeking to expose and unseat epistemic injustice. A term some of you would be familiar with. It's in the literature. Epistemic like around knowing injustice. And this is the assertion of expert authority and institutional power to deny what individuals and communities know about their own lives as a means of countering epistemic injustice. narrative method or narrative justice seeks to activate the power of individuals and communities to shape and control the stories through which their identities and capacities are constructed. Narrative justice includes but is not reducible to the powerful tradition of counter stories in critical race, indigenous and disability theory. A tradition harnessing the power of stories to surface embody justice insights rooted in marginalized and resistant subject positions. Narrative justice might also include deep listening in clinical law, mindful engagement intended to disrupt tendencies of legal and other professionals to impose their narratives on those they serve, and also as a means for the professional to check in on their nervous system responses. Troubling narrative justice is the question of whether or how those who are not members of a given justice-seeking community might enter into narrative justice engagement without exploitation, extraction, or hurtful distortion of other stories. Who can tell or retell health justice stories in situations of asymmetrical power is a central question for social movement lawyers just as it is for interdisciplinary health justice educators, students and researchers. So with all that with all that trouble in mind, let me turn to some stories from my career as a legal schol scholar such as it is a career of progressively failing better at critical community-engaged scholarly practice. I take this route on the way to introducing the HJI's community health justice partnerships. Our plan for interdisciplinary community-based education rooted in narrative justice and slow justice in deep listening as both method and ethos including listening across profound differences in identity, background and communication styles in the hope we might work together to connect individual problems to structural conditions and collective strategies. So again, my method, such as it is in a thick strand of my scholarship, has been to dig into an individual's story, perhaps paradoxically, to redirect attention from the individual viewed as the site or source of drama or crisis or disruption to the social or institutional structures that precipitate or exacerbate crisis and coercive social responses thereto. I'll start with my earliest work on the Supreme Court of Canada's 2003 decision in Starson and sees read narrowly. Starson was about legal capacity to make decisions about psychiatric treatment. Starson's doctors had determined that his rejection of both the diagnosis they assigned him schizopeffective disorder and their proposed treatment reflected a lack of insight on Starson's part and inability to appreciate he was ill. The Supreme Court overturned that based on a sympathetic reading of Starson's asserted preference for his untreated over his treated condition and an unsympathetic reading of the doctor's testimony that Starson's preferences were symptoms, not reasons. At first, I was interested in Starson as a story about law's vindication of value pluralism. But over time, what interested me more was a more complicated story pieced together through tribunal transcripts, court decisions, other documents about how decisionmaking capacity is shaped in relationship and undermined by coercive systems. For instance, I brought out how Starson's first encounter with police and hospital staff had escalated rapidly to restraint and forcible injection, an all too common pattern which in his case set in motion a lifetime of adversarial struggle. Further, I focused on passages in the Supreme Court judgment largely overlooked in the case law and commentary emphasizing the duty to address environmental factors that impair decision-making such as lack of information, emotional upset or sedating medication. In this way, I suggested that the court or more deeply starson's story, the court decision or more deeply starson's story be read through the lens of reasonable accommodation, urging a shift in focus in the law and legal capacity from capacity as a function of a healthy or broken brain to capacity as a relational achievement grounded in respect and trust, critical social determinants of health and justice. So, it took me a decade to get Starson out of my system and wake up to the fact that I'd been working on de ideas, sympathetic to and yet in utter isolation from the wider disability justice community, including disability rights advocates and organizations representing people with psychosocial and intellectual disabilities in the negotiation and drafting of the UN Convention on the Rights of Persons with Disabilities or CRPD. It took local disability rights leader Steven Estie to come around proposing joint public education sessions at DAL for me to wake up to the importance of this treaty engaging the radical abolitionist aspirations of global disability advocates in resistance to guardianship institutionalization and involuntary treatment and in favor of supported community inclusion. Yet, as I relate in a 2013 article, those radical aspirations at the CRPD negotiations precipitated sharp divides between grassroots disability justice movements and psychiatric and legal expertise. divides centered on the CRPD's article 12 engaging equality and legal capacity and article 14 on liberty and on who decides the legitimacy of state laws authorizing guardianship, substitute decision-making and psychiatric detention. That rift and attendant worries about delegitimization of international law forms an important backdrop to my others work on health and disability justice and underlines the importance of shared deliberation or connected up knowing. This image looks ahead to my failing better post arson through work with an interdisciplinary group to create and pilot service user-led art and story-based supported decision-making workshops which we presented for staff and residents in Nova Scotia's remaining large uh and largest disability institutions. In some way that was the co culmination of my earlier work on legal capacity as a relational achievement. But returning to those expert subject divides, I was invited in 2016 to participate in a co-authoring project connecting lived expertise and experience of disability injustice to rightsbased law and policy reform under the CRPD. For this, I was paired with Rousi Stanniv, who a few years before had won a landmark European Court of Human Rights case against Bulgaria, establishing his 10-year institutionalization in a remote facility at the instigation of a guardian as an illegal deprivation of liberty and cruel and unusual treatment. Rusei and I met three times on this Irish-led project in Galway and remotely many other times. Working together was as challenging as it was energizing. The distances geographic, economic, linguistic were vast. Further, even after his legal victory, Rusei remained under a cfg gas guardianship while cycling through institutions. This became a major focus of our chapter. If this is what happens to a human rights hero, what good are human rights? Our collaboration supported by Russy's longtime lawyer and interpreter Aneta Goenova who's pictured there became an exploration in bridging those distances including through art making storytelling and what I reflect on in our chapter as gifting ways of recognizing and exchanging value outside dominant market norms. On this slide is a drawing Ry made one afternoon of its stories, absurd and sad and crazy and air guitar and bouncing on the bed. And it depicts an image that Russy said he had drawn repeatedly with a stick in the road as he walked to and from the institution every day looking for a little day work or conversation and looking to get away from the drugging and torper of that place which I have a picture of. I went and visited later and it really is a horror haunted horror place. I find the figures that he drew transfixingly ambiguous locked in a position of domination, subordination, or maybe it's a dance. It's a little like our writing project. I am an emotional person. Maybe this is why I do this stuff. This this next sentence is like that uh Russy died. Yeah. from so-called natural causes uh hastened by years of abuse and social neglect just before our chapter was finalized. The final form of the chapter centers Russy's entries in a journal addressed to me and my responses placing his experience in dialogue with human rights law and its limits. It was tragic that Russie did not live to enjoy his authorship and our book launch party and so much more the sustained freedom and reciprocity and love that he so hungered for. So my work on starson was on starson. My work with Russy was in relationship however imperfect and partial and complete. I had failed uh better. So um this part gets fun. Co-authoring with Rissy motivated me to become more engaged with disability justice and deinstitutionalization at home. This led to more community embedded advocacy lending my legal analytical and research and listening capacities to movement goals. Eventually, I obtained SHK partnership engage funding to co-launch with inclusion Nova Scotia the action research collective my home my rights led by people with intellectual disabilities in paid researcher roles. The collective used creative methods to define and explore a research question that core members chose how can we use human rights so that people with intellectual disabilities are included and respected in community. So core members made and found art to guide conversation on human rights and what they mean in members lives. We advocated around themes that came up in those conversations, particularly closing institutions and creating inclusive communities. We made a multimedia art show and exhibited it at the Halifax Central and Alternegate libraries. That was so great. Uh we made videos based on members stories with scripts co-drafted and improvised by members. The videos are available on the DRC website and inclusion Nova Scotia websites and they've been licensed to NSCC to train disability support workers on human rights practice. We give presentations to local nonprofits on what distinguishes support from control or denial of agency. Uh core members presented at international conferences. And believe me, finding the money for that, that's a whole talk in itself. Uh oh, I've got some people who helped with this here. It's great. um in Gent Belgium where we also exhibited the art show at the UN in New York where we co-hosted a side event on inclusive advocacy and human rights consciousness raising and most recently in Dublin and York uh York UK we co-hosted a workshop on using art to support peer monitoring of human rights in disability services something I'll come back to although my I'm having to speed up these are examples of the collective's photo portraiture co-designed by members and photography for David Simmons and juxtaposed in our art show with member statements to express how each is the author of their story about human rights at home and in the community. The most important project outcome is how each member has since asserted leadership at home and in the community. Simon Snder and Connor Corey are now president and vice president of People First Halifax. Simon and Chantel Meister co-designed and led the artsbased supported decision-making curriculum I described and are sought after speakers. Shantel just texted me last night to say she's speaking at White Point. Getting 500 bucks for that or something. Uh, EA EA SD was not only a youth delegate at the UN and Eay uh speaks through um letterboard and his own sign system. Uh this is this is Eay here. Uh yeah, he was a youth delegate at the UN and also lead plaintiff in a class action on institutionalization which recently settled for $33 million. Melly Thompson and Jan Walters have asserted themselves as disability justice leaders in the organizations that support them. So there are other stories I'd like to tell of community-gaged co-creation and mobilization of knowledge and justice. Instead, I'll just point to the ecology of local organizations working every day to connect individuals to social determinance of health and justice preventive of incarceration and institutionalization. The legal clinics and nonprofits doing anti-poverty work, prison justice work, work resisting and redressing colonial, racist, tetronormative, and abbleist discrimination. A more pointed example of community-led justice advocacy. And thank you Sonia for posting this. Sonia's gone. She had to go answer the phones. Uh, sorry. Uh, this says, "I turned to what the HGI might do, including to better support community action research. Here's a recent report by Randolph Riley. Anticipated at last year's Black Justice Strategy Panel for the seminary seminar series at which he spoke. Randy's African Nova Scotian roots and experience of federal and provincial incarceration prior to the overturning of his conviction position him as an expert on systemic discrimination affecting persons of African descent. An expertise deepened and sharpened in this report which presents and contextualizes FOP data on disproportionate isolation of persons of African descent in Nova Scotia's jails. We just released this. You can find it on our website. So finally I arrive at the vision for health community health justice partnerships at Dell's Health Justice Institute. A response partial but hopeful to the question with which I began which is how can we help support and sustain health justice in these times. How can we foster and ensure fidelity to social movement wins like the rapid decarceration and disability deinstitutionalization examples I've described? And how can we do so in ways responsive to distinct communities health justice priorities? Linking individual injustice to systemic remedies while also supporting students and advocates to sustain health justice work amidst so much suffering and violence both fast and slow. So the community health justice partnership initiative we're launching is rooted in an established model of health justice advocacy called medical legal partnerships or MLPS. Yale Cannon has spoken about this previously in the series as did Tess Sheldon just a few weeks ago. This describes a deeply interdisciplinary way of advancing health justice by integrating lawyers onto health care teams to address what's called healthharming legal needs through individualized and systemic advocacy. Here health harming legal needs means barriers to accessing the social determinants of health such as income, housing or employment security. And I could go into the history but I'm going to skip that right now. love to talk about it if you want to talk about it in the questions. A growing body of research confirms the benefits of MLPS including reduced emergency room visits and hospitalizations, increased access to social benefits, and enhanced disciplinary collaboration to promote these ends. All of which have produced cost savings to health care systems. Further, MLPS have contributed upstream population health benefits through systemic advocacy. for instance, changing policies and practices uh to uh reduce delays in accessing important social benefits. And there's lots of great literature out there. I'll skip these detailed slides on activities and impacts of MLPS which I provide simply to show that there are detailed schematics on point. Basic components of the model include community consultation, education and empowerment, interprofessional, community co-led collaboration and research, and individualized and systemic advocacy. So, some interesting slides coming, but I'm not going to I don't want to dwell on it now. Yale Cannon adds the important argument that medical legal partnerships should identify racism as a specific expression of social structural injustice rather than take a singular poverty orientation or or if not we risk reinforcing race injustice. This requires education and advocacy surfacing and challenging systemic racism and I would add systemic racism and abbleism as these intersect with colonial injustice in health and related social systems. Canon adds that MLP should extend into criminal law settings where mass incarceration is itself a healtharming legal problem producing related legal needs associated with specific remedies like habius corpus compassionate release parole and with that I finally turn to the community health justice partnerships we're launching at the health justice institute so what we envision reflects our engagement with other health justice partnership initiatives like Yale Cannons and Tess Sheldon's Sheldon's Windsor Law mental health justice partnership model bringing law students into collaboration with the empowerment council at CAMH as well as drawing on our own local connections and capacities. Like medical legal partnerships, the model we're building starts with the recognition that inequitable access to the social determinance of health leads to poor health outcomes. To that we add the MLP commitment to interdisciplinary collaboration to address those inequities. Finally, to Canon's point, our nent model seeks to recognize that carceral settings, including prisons and disability institutions, express and exacerbate health justice inequalities in ways that systematically and disproportionately do harm on grounds of race, indigenity, as well as disability. Further, in advancing community health justice rather than medical legal partnerships, we recognize that medicine and law have themselves been barriers to health and disability justice. We aim to co-create and implement this model in collaboration not only with health clinicians, but also with community justice workers in nonprofits and other embedded experts able to inform individualized and systemic advocacy. So the se here's the calendar description. The seed of the initiative is a practicum course starting this fall. And I'll add, and this is big news, so wake up now. You're starting to fall asleep. So am I. We're in the process of hiring a chair in community health justice partnerships who will help refine and lead the course and related initiatives. So here's the calendar description which describes community health justice partnerships as community centric initiatives bringing together health care professionals community justice workers lawyers and students for cross- sectoral collaboration and problem solving to address health inequities arising from unequal access to the SDHs right income housing employment and related denial of rights and agency in health justice and community services and it continues this fullear course so we have a full year, all the time in the world to slow down and reflect and connect. We'll bring together law students and students from DAL's faculty of health for classroom based learning and community service responsive to intersecting discrimination which creates and perpetuates poverty, criminalization, and other health harming injustices. It's social work that we have our eye on to start. Social work students really excited about that. The practicum sites are envisioned as four-fold with more to come. contingent on further conversations following the arrival of the chair. These include an indigenous health justice site focused on Jordan's principal work. That would be work assisting indigenous children and youth and families denied disability and other social supports. My colleague, Professor Naomi Metallik and alumni David Taylor are well positioned to advise on such cases. Both were integral to the caring society litigation. Second, a disability health justice site at the arts forward drop-in run by or co-run by Prescott Group and Club Inclusion where disability support and access there too, including supported decision-making may be is of interest. Again, we'll make this up with the groups involved. a prison health justice site engaging east coast prison justice path legal and ephry clients affected by health disability and prison justice issues from compassionate release needs to restraints and seclusion and a family medicine health justice site where for instance assistance to newcomers seeking individual and family supports may anchor our engagement to be clear this will not be a full-ervice clinic consultation and legal education will not require lawyer supervision or law firm in infrastructure. But in contrast, individualized client relationship building and advocacy will be contingent on and supported through partnerships with law firms and legal aid clinics external to the HJI. The aim is to add value to those firms and to community organizations and to communities we engage through responsive public education, assistance with complex cases, potentially leveling up to test case litigation, and the community engaged interdisciplinary acculturation of legal and health professionals along the way and investment in health justice futures. We further promoted the practicum as reflecting a commitment to narrative justice, supporting people with healtharming legal needs to tell their stories in the way that's right for them, including by offering more expansive or creative opportunities to do that than there's space for in a traditional legal service relationship. This is complemented by a commitment to slow justice, taking the time to listen and work collaboratively toward holistic, sustainable change. To this end, we'll work with partnered sites to identify a maximum number of clients per interdisciplinary student pair. Students will be paired up law and social work at these sites. Uh and ensure that clients who enter into retainers with partnered law firms or clinics and undertake supervisory roles uh that those clients will meet with students for a period appropriate to their needs, potentially weeks or months. So in short, we intend the practicum to center holistic learning, deep listening, including through narrative and arts-based engagement aimed at connecting individual problems to systemic causes and solutions. And I'm going to leave qu leave questions around evaluation. I wasn't going to go into it, but we're really excited to engage the question of how we will measure success of this initiative in ways responsive to and inclusive of the expertise of those communities served. Um and I close with this gesture to what else may fall under the umbrella of community health justice partnerships at the institute. Um possibly one is an initiative I'm exploring with an international network of academics and self- advocates which involves mobilizing disability support service users as artsbased consciousness raisers and monitors of respect for human rights in disability services. And that idea was something trial in 2003 2023 at a workshop where advocates celebrated the disability rights leadership of Steven SD and it also builds on the work my home my rights did with inclusion Ireland this past spring and I really am going to um stop now is it really it's five after right that's not too bad I'm not the worst. Um so I began by asking what we should do to advance health justice in these troubled times. My two case studies on radical decarceration and deinstitutionalization in Nova Scotia remind us that sustainable health justice demands a joined up ecology engaging grassroots organizations, lawyers, and allied social movement supporters. I argue there's a critical need for university-based actors to engage our tripart tight responsibilities of teaching, research, and service to advance health justice, including but not limited to the projects of deinstitutionalization and decarceration. So the community health justice partnership vision that I shared is one way of activating our capacities to promote and sustain equitable access to the social determinance of health in a way that's responsive to community priorities. So really finishing I hope to have you know convinced you through my reflections on progressively failing better in the co-creation and mobilization of knowledge uh that there's a need for narrative justice for slow justice arts-based other deep listening practices as we seek to do health justice you know not just identify health harming needs but prefigure uh that I was GOING TO SAY SORRY, I HAD THAT AHEM THING. THE JUST relationships we want. That's what we're prefiguring. Sorry, didn't want to leave you hanging. Yeah, questions. I do have a song. I could play it at the very end if no one has a question, but we need not go right to the song. >> We have time. Question. >> I wasn't going to sing it. I'm honestly not gonna sing the song because I I actually love singing but I'm not very good at it. >> Yeah, >> please. >> Uh so some colleagues and I hosted a symposium of folks who work in community based organizations in healthare talk about moral injuries. >> Oh yeah, >> Dr. Lisa Barrett, our beloved keynote talking about how >> seeing the swing back after the institutionalization caused so much injury. and I can share because it was a public >> and many healthare workers suffered like serious lifeanging occur >> um as a result of seeing the possibility of justice and the possibility being taken away. >> Yeah. >> But I'm also thinking that the possibility of greater justice within those systems would also add to positive mental health and wellbeing of workers in community based organizations and healthare workers. >> Yeah. So I'm wondering if there's any plan to not just evaluate the program but also to evaluate the benefits added to small CBOS that might actually be able to do more work on the front line and to reduce structural violence and like the impacts of austerity organization. >> Yeah, I'm going to go back to that evaluation slide because I went over it really fast and this is a paper which is actually really interesting to me and I need to spend more time with it but it opens up this question how should we measure because measuring these things is really hard. These partnerships have been around for a like decades and they've been measured all kinds of ways, but sometimes the measure is not a great measure. Like it's not clear there's a causal effect. It's not clear they've sort of isolated the thing they're measuring properly, but it's also not clear that they're measuring what really matters like to especially to as you say the communities and organizations most affected. And so this piece is exactly about that like somehow measuring the extent to which this kind of systemic moving from the individual to the structure work shifts power toward the impacted communities. And in order to sort of measure that, they go into it a bit. I think you'd have to have a process where you're co-designing like even the questions you're going to ask you. I love the idea of this being a big like action research piece from the ground up so that those participating are thinking about how to measure it thinking as they even go of what questions need to be asked. But uh just to go back to your earlier piece on on moral injury, I'm really glad you centered that. I'm not protect I've used this language like deep listening and stuff because I I hope that I'm like just as a person okay at that. I'm sometimes really bad. Like I'm actually a terrible interrupter. I keep trying not to but like I have an idea. I have an idea. You know, like I want to say my thing. I feel like I need the deep training of deep listening. I'm not the one who does that clinical training. Our Dal Glade, they do a session in deep listening. Niha Charia here is working on mindful holistic teaching and lawyer practice. And I think in our ADR she addresses that. Anyway, I think it's a really interesting piece and I'm holding great hopes that the chair that we're bringing in is well, whoever they are, they are going to center that in this year-long process with a very small group. It's eight law and eight starting social work working together and thinking about how do we slow down and listen not just to the person but my understanding of deep listening uh and some of these techniques is that it's at least intended to help you be aware of your own em emotional response and try and find ways to put that in a place that allow you to keep doing the work because burnout is so real and uh and I'm glad you mentioned that and Lisa Barrett was so incredible and integ integral to those early days when I met is Lisa right here. Oh my god, you are there. You were look at you like you're so such a rock star. I don't know. I think Lisa Barrett was sort of talking to absolutely everybody and was sort of inside us. But certainly um lent her expertise and insights to us even just like on the side when we were trying to sort of figure out what was happening. So, so that is part of what I mean by our community being a place that yes, you can feel the the great weight and harm, but I'm so elevated by how people put their backs into building and keeping those relationships. It just it's staggeringly beautiful to me. Uh, and I think it can be sustained. So, I don't know how to answer apart from that. That's great questions. Yeah. Anything else? Hi. >> Um, when you're thinking about partnerships and um nonreformist reforms. Can you comment a little bit on like reconciling an abolition abolitionist sort of philosophy with having to partner with say like the prisons or the correctional authorities in order to do this work or to do research? >> Yeah, I think that's really interesting. There was one point in there where I was saying that, you know, in order to create this ecology, there's got to be all this relationship building. And I said included government in there and I thought should I keep that in? Should I take that out? Um but the just the brute fact of it when I think back to what we learned from that time on say the COVID rapid it was essential to have those lines of communication. They were changing policies on the fly and and doing work. I mean, and in the justice sector, you know, provincial court judge sitting over the weekend, that first weekend out to do bail reviews, there were many people with power who who did things that were absolutely essential. So it's true there's a whole not just literature but a close study of of how movements have risen and fall fallen and part of it is about this kind of capture like government captures the wave and then it's kind of the story in part of the when I told um uh but I don't think we can just isolate and so east coast right works with corrections long we spent a long time to just sort of build this relationship where we could have a phone line from inside the provincial jails And that partly involved I think establishing this common background understanding even if we're adversarial in some level we're on all on the same page about something and in co it was clear it was public health like you know Karen Hudson who was deputy minister of justice at the time met with some of us. It was Easter weekend. It was a Saturday on the phone. There were a few people meeting and deputy minister of justice, community services and municipal affairs was there and she said, "This is a time, I know it sounds like a cliche, but at the time I just wanted to write, this is a time we all have to row together." She was deputy minister of justice and made things happen. So, I guess I'm just saying I'm not going to throw anybody out, but you've got to always work with caution, I think, and care about whether your values are still aligning. Yeah. Yeah. It's a good question though. Anything else? >> Um, thank you. First of all, it's just such a privilege to see the art of this work and how it's all building towards this initiative in many ways. I just wanted to invite you to say more about um epistmic injustice and the risks of it through this particular model because what I a little bit is this process of narative justice or justice spending time >> but are there any other ways that you envision through the the course or other related initiatives that the people the students for instance who will have expertise right they have to seed that to the actors that they're engaging with how How do they guard against, you know, reinforcing the fact that they're the experts and so on? >> Okay, a couple ex a couple responses. It's a great question. It's so important and it reminds me of something like a hope for this practicum, which I didn't mention uh but we've talked about it a little bit and sort of said maybe we're going to hold off. We're not going to do it right at the beginning, but later we're going to try for this, which is to reserve a couple seats for community members. And so that might be community justice workers, might be people affected, but but have a couple seats in the course for community members so that we're mixing that up. It was just hard bureaucratically to do that right away, but I love that like I'm so committed to and don't want to forget because you get all sort of bureaucratically encumbered. The other thing is I think of my co-chair with the East Coast, Renford Frier, who some people here probably have met because he's come in and talked in the prison law class and stuff. Ranford, my god, like he's so charismatic and so full of deep knowledge that people are just intimidated by him like they love him, but they're intimidated because he knows so much. And I think being confronted with people who have that deep knowledge is the best way of undercutting any kind of like let me tell you about the law. And that happens every time when we take the students into the Adelina and I have done this come into the provincial jails and it's this idea that the students are going to be telling people but we're always really careful to say it's never going to be like you lecturing about rights in jail like they have all topics and people go around the tables and and it's always really fun but what happens is you know the students sort of say pop and then the people are like that's not how it works. It's like law on the books versus law on the streets. And it happens so actively and naturally. And the students come away just realizing that they've got to ask questions. Like they really have to figure out what's going on. It's very disorienting in a beautiful way. And I assume that this we want to create something like that here. Yeah. >> Yeah. Yeah. Hi, Lisa. >> You're like an Oscar winner hiding in the back. I'll like >> bring it together. >> I just came from another venue in Vancouver. a couple weeks ago where we had 30 people sitting around to talk about the 2% of the world that don't get any societal presence including a lot of folks that you were talking about today and we came to a really long conversation about the weaponiz >> Oh yeah. So I'm interested in how you think um that discussion or that narrative that's in the world really not just you know Canada how that narrative might be something that is not that weaponiz >> yeah there's so much to sort of I mean I only scratched the surface in this idea of narrative justice but there's so many there's such danger to the way that stories and fixed you know ideas and concepts can be mobilized for the most sort of disastrous purposes and right now we're in a context as you folks know where an orientation to public even people who work in public health are asking themselves how can I rebrand what I do to public safety so I can get grant funding it's as simple as that and people are actively doing this like in droves and so this question of how we understand public safety becomes very like pragmatically important. Um, but it's also important from that bigger sort of social movement question of how you shift how you shift people's hearts in a way like people's hearts are full of fear. So public safety is about I am so I'm scared like and and public health is more like this capacious let's do something to all work together and I know it sounds really simplistic but I feel like some of that beautiful work even that L Jones led right around defunding the police it's very it's concrete it's like here's what we can do to build up actual public safety in ways that's responsive to the priorities to communities like what does safety mean to you what is a good life to you? Is it sort of living behind a little like all the locks and chains or is it something like creating good relationships with your neighbors? And we're in the camp here of the creating good relationships with your neighbor curiosity about people just reanimating that sense of curiosity, excitement, beautiful some of that stuff I think can be done through storytelling like you know people sort of expert there's experts in this stuff called social stories. We have someone on our board with East Co. Like I think there are some strategic ways to do that, but some of it is just I'm just I guess speaking back to you. I be what do you think? What do you think about that coming out of that conversation? What did you learn about that? I don't know. >> That we've got a lot to learn. >> Got a lot to learn. Um I'm sorry. You know what I'm going to do? Because I think this is a good segue. This is the craziest thing I've ever done which you're gonna love. Um, so I wanted to end this with this song because it's such a crazy way to end, but it's like, you know, the end of the I'm closing out the health justice seminar series for 2026, but you know, I'm partly just wanted to say no more business as usual. Let's do something a little bit different. So, this is Tona Mills. You can learn more about her on the East Coast Prison Justice website's modest memorial page, marking her recent death from cancer. She died too young. So much of her life was spent incarcerated. 10 years in federal prison, six of those in segregation. Six of those in segregation. Uh and another 13 in the forensic mental health system. Tona's name headlines a bill that Senator Kim Page is trying to pass in the upper chamber right now, which among other things would require CSC to move people with serious mental health conditions from prison to hospital or community settings, even better. And she was my friend. So, I first met Tona in 1997, although I didn't know it when I told her story in a law school essay on violations of the charter rights of a set of so-called high-risisk, high needs federally sentenced women placed in prolonged four-point restraints at NOVA institution and then isolated in Spring Hill Prison for men. And then I met Tona for real 20 years later. I was introduced to her by Kim Pate in 2019. We became friends in the fall, East Coast, this past fall, East Coast Prison Justice got a grant to bring Tona together with m musician Simone Schmidt, who is my new favorite person in the world, uh to translate Tona's poetry and other writing into a song cycle cycle. So, as Tona lay dying, uh this is a few weeks ago, about three, uh Simone played this piece. I'm going to play for you. I'll only play you like a minute and a half. I promise it's not like a 10-minute song. uh played this piece for Tona. It's one Simone had written a few years ago and Tona said she liked it and it's called Leaning Hard on my peripheral vision. Uh it sums up I get all teary but I'm going to make it sums up uh what I would like to express about deep listening community engagement uh sorry uh affirming dignity uh where it's been violated and affirming knowledge which has been denied uh and cultivating attentiveness not only to what's right in front of us but to what and who's at the margins uh on the way to health justice. And if this doesn't play, it's going to be like the most embarrassing time in my whole life. Hold on. There we go. Leaning hard. I'm up the river of vision. Crawling on the edges of my mind. Playing through the dragless condition. I can't divide. I got you on my side. The son with two tugs. He has gone. He is not leaving. You know, we must face this side to >> That's Simone Schmidt, otherwise known as Fiverr, who's an incredibly talented person. So, thanks, guys. That's it for us. Yeah. Bye.