Not Criminally Responsible Due to Mental Disorder

Whenever the media highlights a particularly violent and random crime, questions arise about the perpetrator’s mental state. It seems hard to imagine that anyone in their right mind would inflict violence on a stranger.

After the question is raised, the inevitable public discussion occurs about our country’s laws and whether the perpetrator should be held criminally responsible for his or her actions.

A lot of misinformation tends to circulate about the nature and prevalence of mental illness and exactly what our laws state when it comes to being found not criminally responsible due to a mental disorder.

Common misconceptions include: that most not criminally responsible on account of a mental disorder cases involve serious personal violence; that the verdict is used too frequently; and perhaps that people often fake a mental illness to avoid punishment only to be released into the community after a brief hospitalization.

While this may be understandable given the complexity of the law and mental illness, it is disconcerting when our government enacts policies reflecting misinformation rather than science in this area.

Our current government advocates a tough on crime approach and last year introduced a bill making changes to the law as it relates to people being found not criminally responsible. The bill (C-54, later re-named C-14) recognizes public safety as paramount in decisions, and creates a new category of high-risk accused found not criminally responsible, which limits that person’s access to community treatment supports and the discharge options available to a review board.

Contrary to some rhetoric, the verdict of not criminally responsible due to mental disorder is quite rare. Only 1.8 in 1,000 criminal cases come to this conclusion.

Data released in the National Trajectory Project and published recently in the Canadian Journal of Psychiatry provides a longitudinal look at 1800 cases from Quebec, Ontario and BC where this verdict was found and gives valuable information about the verdict, the people, their histories and their long-term outcomes.

A few of the interesting findings show 51 percent had no prior criminal convictions, and 72 percent had at least one prior mental health hospitalization. When offences occurred against people, the most common targets were family members followed by police and mental health workers. Strangers were the target in 22 percent of cases.

Three quarters of the sample group was on government assistance at the time of their crime and 10 percent were homeless. Psychotic symptoms were the most common diagnosis and a third of the sample also had a co-occurring substance abuse problem.

This review also showed women were less likely to have a criminal history, less likely to offend against strangers, had fewer risk factors for recidivism so less likely to re-offend when back in the community.

Recidivism is one of the more interesting factors to consider, as it is often the rationale used to support a tough on crime policy. This review found a 16% recidivism rate at three-year follow up and some differences between provinces. People whose offense was a serious violent offence had the lowest three-year recidivism rate for any type of re-offense.

An informed debate would have considered some of these facts – most who are found not criminally responsible have not committed offences involving serious violence, the level of violence tells us nothing about the risk of recidivism and most are already known to the civic mental health system. Since recidivism rates are lower than those seen for people being released from prison, the review boards seem to be doing a good job.

It would also be interesting to see what impact the new legislation has on the outcomes for this group.

In my opinion, it is not helpful to have mentally ill people in jail where they have limited access to proper treatment and supports.

 

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