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

2. Copyright © 2012 Pearson Canada Inc.8 -2 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

3. Copyright © 2012 Pearson Canada Inc.8 -3 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

4. Copyright © 2012 Pearson Canada Inc.8 -4 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

5. Copyright © 2012 Pearson Canada Inc.8 -5 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

6. Copyright © 2012 Pearson Canada Inc.8 -6 Fitness Standard Unfit to stand trial if unable to: –Understand nature or object of proceedings –Understand possible consequences of the proceedings –Communicate with counsel

7. Copyright © 2012 Pearson Canada Inc.8 -7 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

8. Copyright © 2012 Pearson Canada Inc.8 -8 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.

9. 8 -9 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

10. Copyright © 2012 Pearson Canada Inc.8 -10 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

11. Copyright © 2012 Pearson Canada Inc.8 -11 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

12. Copyright © 2012 Pearson Canada Inc.8 -12 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

13. Copyright © 2012 Pearson Canada Inc.8 -13 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

14. Copyright © 2012 Pearson Canada Inc.8 -14 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

15. Copyright © 2012 Pearson Canada Inc.8 -15 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

16. Copyright © 2012 Pearson Canada Inc.8 -16 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

17. Copyright © 2012 Pearson Canada Inc.8 -17 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

18. Copyright © 2012 Pearson Canada Inc.8 -18 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

19. Copyright © 2012 Pearson Canada Inc.8 -19 Information for Review Boards Charge information Trial transcript Criminal history Risk assessment Clinical history Psychological testing Hospital’s recommendation

20. Copyright © 2012 Pearson Canada Inc.8 -20 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

21. Copyright © 2012 Pearson Canada Inc.8 -21 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)

22. Copyright © 2012 Pearson Canada Inc.8 -22 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

23. Copyright © 2012 Pearson Canada Inc.8 -23 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

24. Copyright © 2012 Pearson Canada Inc.8 -24 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

25. Copyright © 2012 Pearson Canada Inc.8 -25 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

26. Copyright © 2012 Pearson Canada Inc.8 -26 Defendants With Mental Disorders Mental health issues may occur in defendants who do not receive an unfit finding or NCRMD verdict

27. Copyright © 2012 Pearson Canada Inc.8 -27 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

28. Copyright © 2012 Pearson Canada Inc.8 -28 Prevalence Rates of Psychiatric Disorders Type of Mental DisorderRate Substance abuse87% Antisocial personality disorder57% Affective disorder23% Anxiety/ somatoform disorders16% Schizophrenia2% Source: Bland et al., 1990

29. Copyright © 2012 Pearson Canada Inc.8 -29 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

30. Copyright © 2012 Pearson Canada Inc.8 -30 Treatment Goals include: –Symptom reduction –Decreased length of stay in the facility –No need for re-admittance to hospital Overarching goal is reintegration

31. Copyright © 2012 Pearson Canada Inc.8 -31 Treatment Options Facilities for treatment include: –Psychiatric institutions –Hospitals –Assisted housing units Two key treatment options for psychotic symptoms: –Antipsychotic drugs –Behaviour therapy

32. Copyright © 2012 Pearson Canada Inc.8 -32 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