The Federal Government has announced the Not Criminally Responsible Reform Act
that proposes changes to the ‘Not Criminally Responsible
on Account of Mental Disorder (NCR)’ process.
If passed, this Act will represent a shift in how Canada views and treats a vulnerable
minority of people with mental illness.
NCR is a historical and important legal defense. It recognizes that in some situations mental
illness results in a criminal act. The
bar is high for using this defense. In Ontario, only .001% of
people charged with a Criminal Code violation are judged NCR. When the defense is used though, media
coverage can be prominent and emotional responses are common.
The Bill has three major elements:
- Victim rights to
information and involvement in the process are increased.
- A ‘high risk’
patient group is created. This group is
subject to more controls and less frequent review of their condition by the
- The issues that Review
Boards must balance in evaluating those accused and NCR are changed and public
safety is deemed paramount.
Here are some facts. Public safety is already a critical part of decision making in this
situation. As well, high-risk patients are
already detained in high secure forensic units until a clinical assessment and
a Review Board decision deem them fit for a medium secure unit. Currently, NCR
individuals already receive treatment and rehabilitation for their mental
illness, and rates of recidivism are very low.
Three high profile cases have driven these reforms. These
tragic examples have caused terrible suffering to the victims. However, none of these instances involved a decision
that resulted in a compromise of public safety.
So, has the new legislation even addressed the right
Does an NCR system that de-emphasizes treatment and
rehabilitation in favor of punishment help anyone? More restrictive processes will detain
individuals longer and in higher secure units than is necessary. Considering
that these individuals have been found NCR because of a mental illness, is this
approach effective, necessary or fair?
Forensic mental health should not be punitive - keeping
people in hospital for three years without review shifts the focus from
recovery to incarceration. At CAMH, we want
forensic patients to be active in their treatment and rehabilitation. We want them to take responsibility for
recovery and have the comprehensive and coordinated care that enables them to be
faithful to their treatment plans after discharge.
Many of the changes in the Act were understandably driven by
the experiences of victims of mentally ill offenders. I’m deeply respectful of the impact of their
suffering and agree that their needs must be given careful consideration. I also recognize the importance of public
safety. What’s missing is a robust
discussion of the need to balance the rights of all parties involved.
We need to do all we can to make sure that this takes place
in the coming weeks.