The Role of Mental Illness in Court

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

Copyright © 2012 Pearson Canada Inc.
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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

Fitness Standard Unfit to stand trial if unable to: Understand nature or object of proceedings Understand possible consequences of the proceedings Communicate with counsel Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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) Copyright © 2012 Pearson Canada Inc. Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Psychological assessment? – social workers, psychologists Why not use only psychologists for psychological assessments? – expensive, a lot of criminals don’t necessarily need psychological assistance but more someone who can help them with their integration in society (finding appartment etc…) Group interventions – anger management, drugs and alcohol, domestic violence, criminal thinking group May require input by social worker, psychologists, Only standardized test for assessment of mental disorder for criminals – Rogers Criminal Responsibility Assessment Scales Absolute discharge = free to go, no conditions Capping is to protect the crinimally not-responisble and you cant have longer than if you would have went to job Psychiatric facility – people are placed in those when they are considered to be a threat to society Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

Information for Review Boards
Charge information Trial transcript Criminal history Risk assessment Clinical history Psychological testing Hospital’s recommendation Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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) Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Non insane – outside of the person Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

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 Psychopaths who have completed 2/3 of their sentence more likely to be released when they go in front of parole board Copyright © 2012 Pearson Canada Inc.

Treatment Options Facilities for treatment include: Psychiatric institutions Hospitals Assisted housing units Two key treatment options for psychotic symptoms: Antipsychotic drugs Behaviour therapy To determine whether a problem has a chance to be violent when you start a new couple: Police check, Alcohol abuse Copyright © 2012 Pearson Canada Inc.

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 Copyright © 2012 Pearson Canada Inc.

The Role of Mental Illness in Court

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