Copyright © 2012 Pearson Canada Inc.8 -1 Chapter 8 The Role of Mental Illness in Court

Copyright © 2012 Pearson Canada Inc. 8 -1

Chapter 8

The Role of Mental Illness in Court


Learning Objectives

• Outline the fitness standard and legislation

• Contrast unfit and fit offenders

• Explain Canada’s insanity standard

• Describe automatism and case examples

• State explanations for high rates of mental illness in offender populations

• Explain treatment goals for offenders with mental disorders


Presumptions in Canada’s Legal System

• Elements that must be present for criminal guilt:

– Actus reus: A wrongful deed

– Mens rea: Criminal intent

• Must be found beyond a reasonable doubt for a guilty verdict to be reached


Fitness to Stand Trial

• “Fit” individuals charged with a crime are expected to understand the charges and proceedings, and help in preparing their defence

• Unfit to stand trial: An inability to conduct a defence at any stage of the proceedings on account of a mental disorder


R. v. Prichard (1836)

• Fitness standard:

– Whether the defendant is mute of malice (i.e., intentionality)

– Whether the defendant can plead to the indictment

– Whether the defendant has sufficient cognitive capacity to understand proceedings


Fitness Standard

• Unfit to stand trial if unable to:

– Understand nature or object of proceedings

– Understand possible consequences of the proceedings

– Communicate with counsel


Fitness Standard Changes

• R. v. Taylor (1992) specified the “best interest rule” was too strict a criterion

• Five-day limit for fitness evaluations with provisions, if necessary

• Issue of fitness may be raised at various stages of the proceedings


Fitness Instruments

• Fitness Interview Test Revised (FIT-R; Roesch et al., 1998)

• Competency Screening Test (CST)• Competency to Stand Trial Assessment

Instrument (CAI)• Interdisciplinary Fitness Interview (IFI)• MacArthur Competence Assessment Tool-

Criminal Adjudication (MacCAT-CA)

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Fit vs. Unfit Defendants

• Unfit defendants (e.g., Zapf & Roesch, 1998):– 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


Unfit to Stand Trial

• Proceedings halted until fit

– Reassessed within 45 days

• Attempt to restore defendant to fitness

– Most common method is medication

• If unlikely to become fit, court can stay proceedings according to Bill C-10


Bill C-10

• 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


Mental State at Time of Offence

• Insanity is not being of sound mind, and being mentally deranged and irrational (Sykes, 1982)

• Legally, insanity removes the responsibility of performing an act because of uncontrollable impulses or delusions


Influential Cases of the Insanity Standard

• James Hadfield in 1800• R. v. McNaughton (1843): Three critical

elements emerged from the verdict:– Defendant must be suffering from a

defect of reason/disease of the mind– Must not know the nature and quality of

act they are performing– Must not know that what he/she is doing

is wrong


Legislative Changes

• Bill C-30, enacted in 1992, the following changes were made to the insanity legislation:

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

– Wording of the standard was altered

– Review boards were created


A Further Change

• Winko v. British Columbia (1999)

– Supreme court stated that a defendant who is NCRMD should only be detained if they pose a threat to society

– If no threat to society then they should receive an absolute discharge


Raising the Issue of Insanity

• Few defendants use the insanity defence

– Approximately 25% succeed

• In Canada, only two situations in which the Crown may raise insanity:

– Following a guilty verdict

– If the defence states the defendant has a mental illness


Assessing Insanity

• Insanity defence requires a psychiatric assessment

• Rogers Criminal Responsibility Assessment Scales (R-CRAS; Rogers, 1984)

– First and only standardized assessment scale for criminal responsibility


Defendants Found NCRMD

• Three dispositions can be made:

– Absolute discharge

– Conditional discharge

– Psychiatric facility

• In Canada, dispositions are made by the court or a review board

– Court dispositions are reviewed by a board within 90 days


Information for Review Boards

• Charge information

• Trial transcript

• Criminal history

• Risk assessment

• Clinical history

• Psychological testing

• Hospital’s recommendation


Factors Affecting Dispositions

• Four main criteria considered when deciding a disposition:

– Public safety

– Mental state of the defendant

– Reintegration of defendant into society

– Other needs of the defendant


Automatism

• Automatism: Unconscious, involuntary behaviour; the person committing the act is not aware of what they are doing

• Canadian Criminal Code does not address automatism as a defence

• Kenneth Parks (R. v. Parks, 1992)


R. v. Stone (1999)

• Supreme Court stated there are two forms of automatism:

– Noninsane and insane

• To address defences of automatism:

– Judge decides whether evidence exists that behaviour was involuntary

– Judge decides if condition is a mental disorder (insane) or sane automatism


Defences of Noninsane Automatism

• A physical blow (e.g., blow to the head)• Physical ailments (e.g., stroke)• Hypoglycemia (e.g., low blood sugar)• Carbon monoxide poisoning• Sleepwalking• Involuntary intoxication• Psychological blow from extraordinary

external event


NCRMD versus Automatism

• 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 an NCRMD verdict


Intoxication as a Defence?

• R. v. Daviault (1994)

• In 1995, Bill-C-72 was passed

– Intoxication is not recognized as a defence for violent crimes


Defendants With Mental Disorders

• Mental health issues may occur in defendants who do not receive an unfit finding or NCRMD verdict


Explaining High Rates of Mental Illness

• Individuals with a mental 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


Prevalence Rates of Psychiatric Disorders

Type of Mental Disorder Rate

Substance abuse 87%

Antisocial personality disorder 57%

Affective disorder 23%

Anxiety/ somatoform disorders 16%

Schizophrenia 2%

Source: Bland et al., 1990


Dealing with Mentally Ill Offenders

• Police have two options:

– Mental health system

– Criminal justice system

• Biases may exist in the conditional release of mentally ill offenders

– Likely to be conditionally released as a result of mandatory supervision and to have their release suspended


Treatment

• Goals include:

– Symptom reduction

– Decreased length of stay in the facility

– No need for re-admittance to hospital

• Overarching goal is reintegration


Treatment Options

• Facilities for treatment include:– Psychiatric institutions– Hospitals– Assisted housing units

• Two key treatment options for psychotic symptoms:– Antipsychotic drugs– Behaviour therapy


Mental Health Courts

• 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

Documents

Copyright © 2012 Pearson Canada Inc.8 -1 Chapter 8 The Role of Mental Illness in Court