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Evolving systems of care: Individuals found not criminally responsible on account of mental disorder in custody of civil and forensic psychiatric services

Published online by Cambridge University Press:  16 April 2020

A.G. Crocker  and
G. Côté
A.G. Crocker*
Affiliation:
McGill University and Douglas Mental Health University Institute, 6875, LaSalle boulevard, Montréal, QuébecH4H 1R3, Canada
G. Côté
Affiliation:
McGill University and Douglas Mental Health University Institute, 6875, LaSalle boulevard, Montréal, QuébecH4H 1R3, Canada
*
*Corresponding author. Tel.: +(514) 761-6131 ext. 3361; fax: +(514) 762-3049. E-mail address: Anne.Crocker@mcgill.ca (A.G. Crocker), E-mail address: cote_gilles@ssss.gouv.qc.ca (G. Côté).
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Abstract

Following psychiatric deinstitutionalization and changes in involuntary civil commitment laws, many individuals with severe mental disorders have been receiving mental health services through the back door, that is, the criminal justice system. Significant changes to the section of Criminal Code of Canada dealing with individuals with mental disorders have led to significant annual increases in the number of individuals declared Not criminally responsible on account of mental disorder (NCRMD), many of whom are directed to civil psychiatric settings. The goal of the present study was to describe the psychosociocriminological and risk characteristics of individuals found NCRMD remanded to civil psychiatric hospitals (CPH) compared to a forensic psychiatric hospital (FPH). This study was conducted between October 2004 and August 2006 in the sole FPH of the province of Québec and two large CPH in the Montréal metropolitan area. The final sample for the current study consisted of 96 men: 60 from the FPH and 36 from the two CPH. Results indicate that individuals in both settings have similar psychosociocriminal profiles, including PCL-R scores, but that individuals in CPH have higher scores in the Risk subscale of the HCR-20 than do their counterparts in the FPH. This difference is due to a higher score on two items: exposure to destabilizing factors and noncompliance with remediation attempts. Results are discussed in terms of the need for civil psychiatric settings to implement risk assessment and management programs into their services, and the need for further research into forensic mental health services.

Keywords

Mentally disordered offenderRisk assessment and managementMental health servicesCivil psychiatryForensic psychiatry
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 6 , September 2009 , pp. 356 - 364
Copyright
Copyright © Elsevier Masson SAS 2009

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References

Arboleda-Florez, J.Crisanti, A.Holley, H.L.The effects of changes in the law concerning mentally disordered offenders: The Alberta experience with Bill C-30. Canadian Journal of Psychiatry 1995;40:225–233CrossRefGoogle ScholarPubMed
Arboleda-Florez, J.Nussbaum, D.Ohayon, M.M.Roesch, R.Research on the impact of the 1992 criminal code amendments on remands for fitness to stand trial and criminal responsibilityEaves, D.Ogloff, J.R.P.Roesch, R.Mental disorders and the criminal code: Legal background and contemporary perspectives Burnaby, BCMental Health, Law, and Policy Institute, Simon Fraser University 2000 101–160Google Scholar
Balachandra, K.Swaminath, S.Litman, L.C.Impact of Winko on absolute discharges. The journal of the American Academy of Psychiatry and the Law 2004;32:173–177Google ScholarPubMed
Bassuk, E.L.Gerson, S.Deinstitutionalization and mental health services. Scientific American 1978;238:46–53CrossRefGoogle ScholarPubMed
Canadian Charter of Rights and Freedoms. Constitution Act B; 1982.Google Scholar
Canadian Criminal Code. L.R.C. C-46; 1992.Google Scholar
Cardinal, C.Côté, G.La clientèle psychiatrie-justice au Centre de détention Rivières-des-Prairies et à l’Institut Philippe-Pinel de Montréal MontréalCentre de Recherche de l’Institut Philippe Pinel de Montréal 2003Google Scholar
Cohen, J.A power primer. Psychological Bulletin 1992;112:155–159CrossRefGoogle ScholarPubMed
Crocker AG, St-Onge B, Caulet M, Ohayon MM. Implementation of Bill C-30 in the Province of Québec: Progress report. A Report submitted to the Federal department of Justice Canada. 1995.Google Scholar
Desmarais, S.Hucker, S.J.DeFreitas, K.A.A Canadian example of insanity defense reform: Accused found not criminally responsible before and after the Winko decision. International Journal of Forensic Mental Health 2008;7:1–14CrossRefGoogle Scholar
Drake, R.E.McLaughlin, P.Pepper, B.Minkoff, K.Dual diagnosis of major mental illness and substance disorder: An overview. New Directions for Mental Health Services 1991;50:3–12Google Scholar
Drake, R.E.Osher, F.C.Noordsy, D.L.Hurlbut, S.C.Teague, G.B.Beaudett, M.S.Diagnosis of alcohol use disorders in schizophrenia. Schizophrenia Bulletin 1990;16:57–67CrossRefGoogle Scholar
Drake, R.E.Wallach, M.A.Substance abuse among the chronic mentally ill. Hospital Community Psychiatry 1989;40:1041–1046Google ScholarPubMed
Dubreucq, J.-L.Joyal, C.C.Millaud, F.Risk of violence and serious mental disorders. Annales Medico-Psychologiques 2005;163:852–865CrossRefGoogle Scholar
First MB, Gibbon M, Spitzer RL, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I). New York: Biometrics Research Department; 2001.Google Scholar
First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.W.Lorna, B.Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). (Version 2. 0) New YorkBiometrics Research Department 1996Google Scholar
Hare, R.D.The Hare psychopathy checklist-revised TorontoMulti-Health Systems 1991Google Scholar
Hare, R.D.The Hare psychopathy checklist-revised (3rd edition) TorontoMulti-Health Systems 2003Google Scholar
Hare, R.D.Jutai, J.W.Criminal history of the male psychopath: Some preliminary dataVan Dusen, K.T.Mednick, S.A.Studies of crime and delinquency Boston, MAKluwer Nijhoff Publishing 1983 225–236CrossRefGoogle Scholar
Hare, R.D.McPherson, L.M.Violent and aggressive behavior by criminal psychopaths. International Journal of Law and Psychiatry 1984;7:35–50CrossRefGoogle ScholarPubMed
Hart, A.Psychopathy and violenceHays, J.R.Roberts, T.K.Soloways, K.S.Violoence and the violent individual Jamaica, NYSpectrum 1981 53–74Google Scholar
Hart, S.D.Dempster, R.J.Impulsivity and psychopathyWebster, C.D.Jackson, M.A.Umpulsivity: Theory, assessment, and treatment New York, NYGuilford 1997 212–232Google Scholar
Hodgins, S.Alderton, J.Cree, A.Aboud, A.Mak, T.Aggressive behaviour, victimisation and crime among severely mentally ill patients requiring hospitalisation. British Journal of Psychiatry 2007;191:343–350CrossRefGoogle Scholar
Hodgins, S.Müller-Isberner, R.Allaire, J.-F.Attempting to understand the increase in the number of forensic beds in Europe: A multi-site study of patients in forensic and general psychiatric services. International Journal of Forensic Mental Health 2006;5:173–1984CrossRefGoogle Scholar
Hodgins, S.Müller-Isberner, R.Freese, R.Tiihonen, J.Repo-Tiihonen, E.Eronen, M.et al.A comparison of general adult and forensic patients with schizophrenia living in the community. International Journal of Forensic Mental Health 2007;6:CrossRefGoogle Scholar
Hodgins, S, Toupin, J, Fiset, S, Moisan, D. Soins communautaires pour patients souffrant de troubles mentaux graves et ayant une histoire d’actes illégaux: Une comparaison de l’efficacité des soins spécialisés et non-spécialisés. Montréal : Rapport de recherche soumis au Conseil québécois de la recherche sociale; 1998.Google Scholar
Kiesler, C.A.McGuire, T.Mechanic, D.Mosher, L.R.Nelson, S.H.Newman, F.L.et al.Federal mental health policy making: An assessment of deinstitutionalization. American Psychologist 1983;38:1292–1297CrossRefGoogle Scholar
Latimer, J.The Review Board Systems in Canada: Overview of Results from the Mentally Disordered Accused Data Collection Study OttawaDepartment of Justice Canada 2006Google Scholar
Lecomte, Y.De la dynamique des politiques de désinstitutionnalisation au Québec [From the dynamics of deinstitutionalization politics in Québec]. Santé mentale au Québec. 1997;12:7–24CrossRefGoogle Scholar
Livingston, J.A.Wilson, D.Tien, G.Bond, L.A follow-up study of persons found not criminally responsible on account of mental disorder in British Columbia. Canadian Journal of Psychiatry 2003;48:408–415CrossRefGoogle Scholar
Ministère de la Santé et des Services Sociaux. Plan d’action en santé mentale 2005–2010: La force des liens. Québec: Gouvernement du Québec; 2005.Google Scholar
Mueser, K.T.Drake, R.E.Comorbidity: What have we learned and where are we going?. Clinical Psychology: Science and Practice 2007;14:64–69Google Scholar
Mueser, K.T.Drake, R.E.Clark, R.E.McHugo, G.J.Mercer-McFadden, C.Ackerson, T.H.Evaluating substance abuse in persons with severe mental illness Cambridge, MAHuman Services Research Institute 1995Google Scholar
Mueser, K.T.Yarnold, P.R.Bellack, A.S.Diagnostic and demographic correlates of substance abuse in schizophrenia and major affective disorder. Acta Psychiatrica Scandinavica 1991;85:48–55CrossRefGoogle Scholar
Mueser, K.T.Yarnold, P.R.Levinson, D.F.Singh, H.Bellack, A.S.Kee, K.et al.Prevalence of substance abuse in schizophrenia: Demographic and clinical correlates. Schizophrenia Bulletin 1990;16:31–56CrossRefGoogle ScholarPubMed
Mueser, K.T.Yarnold, P.R.Rosenberg, S.D.Swett, C.Miles, K.M.Hill, D.Substance use disorder in hospitalized severely mentally ill psychiatric patients: Prevalence, correlates, and subgroups. Schizophrenia Bulletin 2000;26:179–192CrossRefGoogle ScholarPubMed
Ohayon, M.M.Crocker, A.G.Impact of Bill C-30 in the province of QuébecEaves, D.Ogloff, J.R.P.Roesch, R.Mental disorders and the Criminal Code: Legal background and contemporary perspectives Burnaby, BCMental Health Law and Policy Institute, Simon Fraser University 2000 118–128Google Scholar
Ohayon, M.M.Crocker, A.G.St-Onge, B.Caulet, M.Fitness, responsibility and judicially ordered assessments. Canadian Journal of Psychiatry 1998;43:491–495CrossRefGoogle ScholarPubMed
Paquet, J.Crocker, A.G.Ohayon, M.M.Côté, G.La mise en application et les répercussions de la Loi C-30 : les personnes ayant reçu une ordonnance d’évaluation psychiatrique entre le 4 février 1992 et le 31 mars 1993 sous la responsabilité administrative de l’Institut Philippe-Pinel de Montréal. Rapport préliminaire soumis au ministère de la Justice du Canada MontréalCentre de recherche de l’Institut Philippe-Pinel de Montréal 1993Google Scholar
Pham, T.H.Évaluation psychométrique du questionnaire de la psychopathie de Hare auprès d’une population carcérale belge. L’Encephale 1998;24:435–441Google Scholar
Priebe, S.Badesconyi, A.Fioritti, A.Hansson, L.Reinhold, K.Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. British Medical Journal 2005;330:123–126CrossRefGoogle ScholarPubMed
Quinsey, V.L.Harris, G.T.Rice, M.E.Cormier, C.A.Violent offenders: Appraising and managing risk Washington, DCAmerican Psychological Association 1998CrossRefGoogle Scholar
Robertson, R.G.Gupton, T.McCabe, S.B.Bankier, R.G.Clinical and demographic variables related to fitness to stand trial assessments in Manitoba. Canadian Journal of Psychiatry 1997;42:191–195CrossRefGoogle Scholar
Roesch, R.Ogloff, J.R.P.Hart, S.D.The impact of Bill C-30 on remands and assessments of fitness to stand trial and criminal responsibility: A Report Department of Justice 1993Google Scholar
Roesch, R.Ogloff, J.R.P.Hart, S.D.Dempster, R.J.Zapf, P.A.Whittemore, K.E.The impact of Canadian criminal code changes on remands and assessments of fitness to stand trial and criminal responsibility in British Columbia. Canadian Journal of Psychiatry 1997;42:509–514CrossRefGoogle ScholarPubMed
Schneider, R.D.Forestell, M.MacGarvie, S.Statistical survey of provincial and territorial review boards 2002 Department of Justice CanadaGoogle Scholar
Haris, G.T.Rice, M.E.Seto, M.C.The criminogenic, clinical, and social problems of forensic and civil psychiatric patients. Law and Human Behavior 2004;28:577–586Google Scholar
SPSS Inc. Sample power. 2.0 ed: Author; 2003.Google Scholar
Sreenivasan, S.Kirkish, P.Eth, S.Mintz, J.Hwang, S.Van Gorp, W.et al.Predictors of recidivistic violence in criminally insane and civilly committed psychiatric inpatients. International Journal of Law and Psychiatry 1997;20:279–291CrossRefGoogle ScholarPubMed
Swain RV. 63C.C.C. (3d) 481; 1991.Google Scholar
Webster, C.D.Douglas, K.S.Eaves, D.Hart, S.D.HCR-20: Assessing risk for violence Version 2 VancouverMental Health Law and Policy Institute, Simon Fraser University 1997Google Scholar
White, P.A.Chant, D.C.Whiteford, H.A comparison of Australian men with psychotic disorders remanded for criminal offences and a community group of psychotic men who have offended. Australian and New Zealand Journal of Psychiatry 2007;40:260–265CrossRefGoogle Scholar
Williams, D.H.Bellis, E.C.Wellington, S.W.Deinstitutionalization and social policy: Historical perspectives and present dilemmas. American Journal of Orthopsychiatry 1980;50:54–64CrossRefGoogle ScholarPubMed
Winko v. British Columbia (Forensic Psychiatric Institute); June 17, 1999.Google Scholar
Zapf, P.A.Roesch, R.Fitness to stand trial: Characteristics of remands since the 1992 Criminal Code amendments. Canadian Journal of Psychiatry 1998;43:287–293CrossRefGoogle ScholarPubMed
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