The Role of Mental Illness Flashcards
Are competent or those unfit to stand trail more likely to have violent charges?
Competent defendants
What percentage of cases argue insanity defense?
about 1%
What are the criteria for criminal guilt to be established
- Actus reus: A wrongful deed
- Mens rea: Criminal intent
Def: Insanity
Impairment of mental or emotional functioning that affects perceptions, beliefs, and motivations at the time of the offense
Rogers Criminal Responsibility Assessment Scales (R-CRAS)
First standardized assessment scales for criminal responsibility
- Patient Reliability: likely to lie, memory or recall issues
- Organicity: Biological effects contributing to mental state, genetic disability, TBI, intellectual disability
- Psychopathology: Psychiatric disorders, any mental disorder, symptoms relevant
- Cognitive Control: Awareness of criminal behaviour, capacity for planning and understanding repercussions
- Behavioral Control: Degree to be held responsible to behaviour
Each scale has 30 items scored between 0 and 6 - do not rely solely on cut-off scores, the clinician will make the final call
What happens to someone found NCRMD?
ABSOLUTE DISCHARGE: Defendant released into community without restrictions to behaviour
CONDITIONAL DISCHARGE: Defendant is released, however, carries certain conditions that they mut meet
- Failure to meet conditions may result in incarceration or being admitted to a psychiatric facility
PSYCHIATIC FACILITY: sent directly to psychiatric facility and held until judge believes they are ready for discharge
- Don’t have to comply with treatment
- If they can’t make decisions for themselves doctors makes decisions
The Case of Jeffery Arenburg
- Had paranoid psychosis and a history of hospitalizations
- Thinks thoughts are being broadcasted by TV or radio
- In august 1995, sat outside in parking lot at media broadcasting (JOH in ottawa) & killed first person to come out - Brain smith (former hockey player and sportscaster
- Found NCRMD and released to high security psychiatric institution
- Conditional release in 2003 under care of brother - went to college and graduated in 2005
Brain’s Law passed in 2000
- Have to check in to metal health caregiver regularly upon release
- Could have to be up to date with meds if released
- Could be held in psychiatric facility even if danger wasn’t imminent
Unfit to stand trail
Inability to conduct a defense at any stage of the proceedings on account of a person’s mental illness or disorder
- Doesn’t mean impaired during crime
- Reassess fitness after 45 days to see if become fit then reassess annually
- Offender stays in psychiatric institute in the meantime
What makes a defendant unfit to stand trail?
Unable on account of mental disorder to conduct a defense at any stage of the proceedings before a verdict is rendered or to instruct counsel to do so, and, in particular, unable on account of mental disorder to
1. Understand the nature or object of the proceedings
2. understand the possible consequences of the proceedings
3. Communicate with counsel
Fitness tests today
Semi-structured interview used to determine if individual is fit to stand trial
- Fitness interview test - revised (1998) * most commonly used
- Competency to stand trail assessment instrument (1973)
- Competency screening test (1971)
- Interdisciplinary fitness test (1984)
- MacArthur Competence Assessment Tool - Criminal Adjudication (1992)
Automatism
Unconscious, involuntary behaviour such that the person committing the act is not aware of what they are doing
Noninsane Automatism
Behavior occurs due to an external factor
- Verdict of not guilty
Insane automatism
Behavior occurs due to a mental disorder
- Found NCRMD
How is automatism determine in court
- Not specifically addressed in Criminal Code of Canada
- Judges must make their own judgement
- Factors to be considered: Psychiatric assessments, severity of triggering event, history of automatic behavior
External events leading to noninsane automatism
- A physical bow (eg to the head)
- Physical ailments (stroke)
- Hypoglycemia
- Carbon monoxide poisoning
- Sleepwalking
- Involuntary intoxication
- Psychological blow from extraordinary external event
Automatism and intoxication
- If intoxication is voluntary, the act is considered voluntary
- May be more lenient for non-violent offenses
- Protocol used to be the opposite
What % of males in Edmonton Remand Centre had a lifetime prevalence of psychiatric disorders?
92%
- 43% when substance abuse was not included
- Next more prevalent was anti-social personality disorder
Prevalence of mental disorders among male offenders admitted to a correctional facility in Canada between 2021 and 2014
- 0.5 drug dependance
- 0.45 antisocial personality disorder
- 0.3 anxiety disorder
Why are mental health disorder rates so high for offenders?
- Individuals with mental illness may be disproportionately arrested
- Individuals with mental illness may be more likely to get caught (less aware of surroundings)
- Individuals with mental illness may be more likely to plead guilty (can’t fully understand consequences, can’t afford defense)
Baillargeon et al. (2009) - Are people with mental illness violent?
- Offenders without disorder - 23%
- Offenders with disorder - 28%
Fazel et al. (2014) - Are people with mental illness violent? - sibling match study
- 24,947 patients with schizophrenia vs. matched sample of unaffected siblings
- Within 5 years a diagnosis 10.7% of men and 2.7% of women violent offence
- Odds of being convicted were higher for patients with schizophrenia
- Similar between groups when accounting for pervious violent history and substance use
Fazel & Grann (2006) - Schizophrenia or psychosis violent conviction rates
- Patients with schizophrenia or psychosis are more likely to have violent conviction over general population
- Those with schizophrenia are more likely than those with other psychoses
- Peak age around 15-24 years (onset), decline after 40 years of age
Are offenders with mental illness likely to reoffend?
Some have found that mental disorder has not been found to be predictive of recidivism
Among NCRMD in ON, BC, QC, after 3 years:
- 17% recidivism rate
- Lower than general offender and inmates with mental health disorders
Def: Recidivism
The tendency of a convicted criminal to reoffend
