Chapter 8 - The role of mental illness in court

Question 1

Elements that must be present for criminal guilt

Answer 1

• Actus reus
• Mens rea
• Must be found beyond a reasonable doubt for guilty verdict to be reached

Question 2

Unfit to stand trial

Answer 2

An inability to conduct a defence at any stage of the proceedings on account of a mental disorder.

Question 3

Fitness stand

Answer 3

• Whether defendant is mute of malice (intentionality)
• Whether the defendant can plead to the indictment
• Whether the defendant has sufficient cognitive capacity to understand proceedings

Question 4

Fitness Standard

Answer 4

• Understand the nature or object of the proceedings
• Understand the possible consequences of the proceedings
• Being able to communicate with counsel

Question 5

Characteristics of Unfit Defendants

Answer 5

• Unemployed and living alone
• Never married
• Older females belonging to a minority group with fewer marital resources
• 4 times more likely to meet criteria for a psychotic disorder
• Less likely to have substance abuse problems

Question 6

When someone is deemed unfit to stand trial:

Answer 6

• Proceedings are halted until defendant is deemed fit
  (usually 45 days after)
  -Attempt to restore defendant’s fitness
  (most common method is through medication)
  -If the person is still unfit, the court can stay proceedings according to Bill-10

Question 7

Bill C-10

Answer 7

Court can stay proceedings if:

• Accused is unlikely to ever become fit
• Accused does not pose a significant threat to safety of the public
• It is in the interests of the proper administration of justice

Question 8

Mental State At Time of Offence

Answer 8

• Insanity: is not being sound of mind, and being mentally deranged and irrational.
• Legally speaking, insanity removes responsibility of performing an act because of uncontrollable impulses and delusions

Question 9

Legislative Changes ( Bill C-30) 1992

Answer 9

Insanity term was changed to “ not criminally responsible on account of mental disorder” (NCRMD)

Wording of the standard was altered

Review boards were created

Question 10

A Bigger change (1999)

Answer 10

Case: Winko v. British Columbia

1. Supreme Court stated that a defendant who is NCRMD should only be detained if they pose a threat to society
2. If there is no threat to society, then they should receive an absolute discharge

Question 11

Raising the Issue of Insanity

Answer 11

Very few defendants use the insanity defence and very few succeed ( approximately 25% of those that try)

There are 2 situations in which the Crown may raise insanity:

1. Following a guilty verdict
2. If the defence states the defendant has a mental illness

Question 12

Defendants Found NCRMD

Answer 12

3 Dispositions 
1. Absolute discharge 
2. Conditional discharge
3. Psychiatric facility 
Dispositions are made by the review board and they are made within 90 days.

Question 13

Information useful for Review Boards

Answer 13

1. Charge information
2. Trial transcript
3. Criminal history
4. Risk Assessment
5. Clinical history
6. Psychological testing
7. Hospital’s recommendation

Question 14

Four main criteria when deciding a disposition

Answer 14

1. Public safety
2. Mental state of the defendant
3. Reintegration of defendant into society
4. Other needs of the defendant

Question 15

Automatism

Answer 15

Definition: Unconscious, involuntary behaviour

The person committing the act is not aware of what they’re doing.

The Canadian Criminal Code does not address automatism as a defence.

Question 16

2 Forms of automatism

Answer 16

Insane and noninsane

Question 17

To address defences of automatism

Answer 17

1. Judge decides whether evidence exists that behaviour was involuntary
2. Judge decides if condition is a mental disorder or sane automatism

Question 18

Defences of noninsane automatism

Answer 18

• A physical blow
• Physical ailments (stroke)
• Hypoglycemia(low blood sugar)
• Carbon monoxide poisoning
• Sleepwalking
• Involuntary intoxication
• Psychological blow from extraordinary external event

Question 19

NCRMD vs. Automatism

Answer 19

Verdict outcome differs
NCRMD verdict may result in defendant being sent to mental health facility

Noninsane automatism results in a not guilty verdict

Insane automatism results in NCRMD verdict

Question 20

Intoxication as a defence

Answer 20

Intoxication is not recognized as a defence for violent crimes

Question 21

High Rates of Mental Illness

Answer 21

• Individuals with a mental health illness are likely arrested more often
• Individuals with a mental illness are more likely to get caught
• Individuals with a mental illness are more likely to plead guilty

Question 22

Rates of Psychiatric Disorders

Answer 22

Substance abuse - 87% 
Antisocial personality disorder - 57% 
Affective disorder - 23% 
Anxiety/ somatoform disorders - 16% 
Schizophrenia - 2%

Question 23

Dealing with Mentally Ill Offenders

Answer 23

Police has 2 choices:

1. Mental health system
2. Criminal justice system

Biases may exist in the conditional release of mentally ill offenders

Question 24

Treatment

Answer 24

Goals:
1. Reduce symptoms
2. Decreased length of stay in the facility
3. No need for re-admittance to hospital
Overarching goal is reintegration.

Question 25

Treatment Options

Answer 25

Facility for treatment include:
Psychiatric institutions
Hospitals
Assisted housing units

Two key treatments for psychotic symptoms
Antipsychotic drugs
Behaviour therapy

Question 26

Mental Health Courts

Answer 26

Objectives
Divert accused charged with minor to moderately serious criminal offences

Facilitate a defendant’s fitness to stand trial evaluation

Ensure treatment for a defendant’s mental disorders

Decrease likelihood of repeat offences