Page - 443 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

443Weighing Public Health and Mental Health Responses to Non-Compliance… All who are at risk of likely serious bodily harm or physical impairment due to mental illness have an equal claim on the resources of psychiatric hospitals. However, in some cases the risk may be more likely or imminent, such as with an acutely suicidal person. Another consideration is that the use of involuntary hospitalization to protect a person from contracting or transmitting the virus could consume psychiatric hospital resources needed for such emergencies. In the case of known or suspected infection, people who dis- regard public health directives may face harsher penalties such as detention, court orders, contempt of court proceedings, or potential imprisonment for offences under public health legislation. Would it be appropriate to use these kinds of enforcement measures in the case of people whose abilities to understand, to exercise appropri- ate judgment, and/or to evaluate risk, are affected by mental illness? During a pandemic, perhaps a broader concept of risk should be employed to permit a mental health response rather than a public health response where these harsher public health measures would be applicable. It is true that mechanisms exist to divert a person with mental illness from prosecution to treatment, such as special- ized mental health courts. This might be an alternative means to address the issue other than proceeding initially with involuntary hospitalization. The intersection of mental health and public health laws brings tensions to the fore between protecting the health, liberty, and equal- ity interests of people whose ability to protect themselves from infec- tion is affected by mental illness, protecting other vulnerable people from infection, and pursuing the public health goal of containing the virus. Not all people will agree on how best to address these risks. A woman with lived experience of schizophrenia recently expressed her concern about how she might have fared during the current pandemic while homeless and unwell.24 She indicated that, in the past, she had been unwilling while ill to accept help, and wished that intervention had come earlier in her case. Others may disagree. from-covid-19>; Lisa-Marie Gervais & Marco Bélair-Cirino, “Éclosion de cas de COVID-19 à l’Institut psychiatrique Douglas”, Le Devoir (30 April 2020), online: <www.ledevoir.com/societe/sante/577982/eclosion-de-covid-19-a-l-institut- psychiatrique-douglas>. 24. Bethany Yeiser, “Homeless with COVID-19: What will happen to the homeless during this pandemic?” Psychology  Today (11 April 2020), online: <www.psychol- ogytoday.com/ca/blog/recovery-road/202004/homeless-covid-19>.