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The authors present a rare case of a family in which both the mother, and four decades later the son, committed second-degree murder while suffering from major mental illnesses. The mother had successfully used a mental disorder defence and it was likely that the son who had raised the defence would have qualified also. The mother has a history of adverse childhood experiences. The son had also experienced various severe childhood adversities, though there were no functional impairments, personality dysfunction, suicidality or violent crimes until the onset of treatment-resistant schizoaffective disorder around age 18. His earlier comorbidities included sport-related traumatic brain injuries, sickle cell trait, severe burns, and tardive dyskinesia. His comorbidities around the material time included occasional cannabis use and dementia pugilistica. While awaiting court ruling on criminal responsibility, additional stressors triggered significant deterioration of his schizoaffective disorder and the court found him unfit to stand trial. During rehabilitation, he was severely injured by another accused, which subsequently led to his demise. This case is the first report of intergenerational mental disorder defence and involved almost every facet of criminal forensic psychiatry, which highlights the need for further research on the association between intergenerational ACEs and intergenerational risk for criminal behaviour from a comprehensive and longitudinal perspective. [ABSTRACT FROM AUTHOR]

Although mental illness has a demonstrated link with violence, the prevalence of targeted (planned and goal‐directed) violence perpetrated by individuals with mental illness and its association with psychiatric symptoms is relatively unexplored. File information was compared for all 293 individuals found not criminally responsible due to mental illness in British Columbia between 2001 and 2005, of whom 19% had committed targeted violence. Most individuals with targeted offenses displayed at least one warning behavior before their offense (93%); all displayed delusions and approximately one third exhibited hallucinations. Compared to individuals who perpetrated non‐targeted offenses, the individuals with targeted offenses displayed greater proportions of threats/criminal harassment, had female victims, displayed a psychotic disorder and/or personality disorder, and displayed delusions during the offense. This implies that severe psychiatric disorders do not preclude the perpetration of planned violence and suggests that exploring symptoms of mental illness that may be proximally indicative of targeted violence is important in preventing future acts. [ABSTRACT FROM AUTHOR]

Since 1999, Gladue principles have been applied in a variety of contexts within the Canadian criminal justice system. Some of these contexts, like bail hearings, have been thoroughly discussed by courts and academics. Others have not. To supplement the ongoing discussion of how Gladue can be used in new and unique ways, this paper analyzes the application of Gladue principles to NCRMD and fitness disposition hearings under s. 672.54 of the Criminal Code. To date, only one appellate court has held that Gladue principles apply to NCRMD and fitness disposition hearings. However, according to the Ontario Court of Appeal, that application is limited. While relevant to the rehabilitation and reintegration of an Indigenous accused, Gladue principles are not relevant when assessing their dangerousness or mental condition. This paper argues that the current approach by the Ontario Court of Appeal is inappropriate, inconsistently applied, and should not be adopted by Courts and review boards across the country since it ignores the benefits a full Gladue analysis can have during s. 672.54 disposition hearings. [ABSTRACT FROM AUTHOR]

Background: The public often perceives the insanity defense as a "get out of jail free card". Conversely, several studies demonstrate the substantial control imposed upon these defendants. This study compares Review Boards decisions regarding people found not criminally responsible on account of mental disorder (NCRMD) to criminal courts decisions regarding convicted offenders for similar offenses in Canada. Method: Detention, using logistic regression, and duration under detention and supervision, using Cox regression, were compared between a cohort of 1794 individuals found NCRMD in three Canadian provinces (Quebec, Ontario, and British Columbia) between 2000 and 2005 followed until 2008 from the National Trajectory Project and a national sample of 3,20,919 Canadians convicted of criminal offense from Statistics Canada's Criminal Court Survey. Results: Individuals found NCRMD are 3.8 times (95% CI 3.4–4.3) more likely to be detained than convicted offenders as well as 4.8 times (95% CI 4.5–5.3) and 2.9 times (95% CI 2.6–3.1) less likely to be released from detention and supervision, respectively. One year after the verdict, 73% of the NCRMD accused were still under legal supervision and 42% were still in detention, whereas these proportions were, respectively, 41 and 1% for their convicted counterparts. Interaction effects show that sex, age, jurisdiction, number of offenses, and severity of crimes committed have a differential impact on decisions applied to NCRMD accused compared to convicted persons. Conclusion: Contrary to popular perceptions, the insanity defense is not a loophole. Differences as to factors influencing the trajectories of the two samples confirm that Review Boards are able to distance their practices from the criminal courts and can set aside, at least in part, the principles of proportionality and punitiveness governing the traditional sentencing practices. [ABSTRACT FROM AUTHOR]

BackgroundThe public often perceives the insanity defense as a “get out of jail free card”. Conversely, several studies demonstrate the substantial control imposed upon these defendants. This study compares Review Boards decisions regarding people found not criminally responsible on account of mental disorder (NCRMD) to criminal courts decisions regarding convicted offenders for similar offenses in Canada.MethodDetention, using logistic regression, and duration under detention and supervision, using Cox regression, were compared between a cohort of 1794 individuals found NCRMD in three Canadian provinces (Quebec, Ontario, and British Columbia) between 2000 and 2005 followed until 2008 from the National Trajectory Project and a national sample of 3,20,919 Canadians convicted of criminal offense from Statistics Canada's Criminal Court Survey.ResultsIndividuals found NCRMD are 3.8 times (95% CI 3.4–4.3) more likely to be detained than convicted offenders as well as 4.8 times (95% CI 4.5–5.3) and 2.9 times (95% CI 2.6–3.1) less likely to be released from detention and supervision, respectively. One year after the verdict, 73% of the NCRMD accused were still under legal supervision and 42% were still in detention, whereas these proportions were, respectively, 41 and 1% for their convicted counterparts. Interaction effects show that sex, age, jurisdiction, number of offenses, and severity of crimes committed have a differential impact on decisions applied to NCRMD accused compared to convicted persons.ConclusionContrary to popular perceptions, the insanity defense is not a loophole. Differences as to factors influencing the trajectories of the two samples confirm that Review Boards are able to distance their practices from the criminal courts and can set aside, at least in part, the principles of proportionality and punitiveness governing the traditional sentencing practices.

This article presents an analysis of social media posts by laypersons regarding a finding of Not Criminally Responsible on Account of Mental Disorder (NCRMD) for Matthew de Grood after a high-profile trial in 2016 in Canada. From trial to verdict, a total of 4,991 tweets relating to the case were harvested from Twitter. Qualitative content analysis of 365 tweets by laypersons revealed three themes – largely equating the insanity defense to a legal loophole: (1) The case exemplified a misappropriation of the legal defense (e.g., due to privilege, due to the seriousness of the offence); (2) The perception existed that the NCRMD defence is a miscarriage of justice; (3) Many comments reflected a search for answers and justice. These embodied the ABCs of NCRMD: advocating, blaming, and clarifying. A need for public education about the forensic psychiatric system is evident; misconceptions about the insanity defence appeared pervasive. Further research could focus on the efficacy of knowledge translation over new media channels, such as Twitter. [ABSTRACT FROM AUTHOR]

In a 25-year Australian cohort of men and women found Not Guilty by reason of Mental Illness (NGMI forensic patients; N = 477), we aimed to: establish the sociodemographic, clinical and forensic characteristics of the sample, comparing men and women; to establish rates of post-release reoffending, including for men and women separately; and to test associations between individual characteristics and post-release re-offending in the full sample. Post-release re-offending was considered in terms of officially-recorded charges, proven offenses, violent offenses, and any offending within the first 12 months of release. Women (13.8%) were found to differ significantly from men on a number of key characteristics but, although women had a higher rate of proven offending in the early post-release period, sex was not a predictor of post-release offending overall. Post-release re-offending rates were low (6.3% committed proven offenses in the first 12 months following release) and the only independent predictor of re-offending was a clinically-recorded diagnosis of co-morbid personality disorder (i.e. co-morbid with a primary psychosis diagnosis). The differences identified between male and female NGMI forensic patients, including the differences in re-offending in the early post-release period, have implications for the development of forensic services and interventions, in both inpatient and community settings. [ABSTRACT FROM AUTHOR]

This study identified factors that predicted which of 713 clinically documented incidents of aggression—threats to kill, assault, or sexual assault—committed by 404 forensic psychiatric patients were linked to court findings of guilt. Individuals had, on average, 1.7 aggressive incidents and were found guilty of an average of 0.3 offenses against persons during the study period. Aggressive incidents were mostly assaults, followed by uttering death threats, and sexual assaults. The victims of aggressive incidents were mainly other patients or staff, but some incidents involved family members or friends (16%) and strangers (14%). Most of the aggressive incidents (84%) did not lead to findings of guilt. Incidents of aggression linked to court findings were significantly associated with province; personality disorder; fewer prior aggressive incidents; and incidents involving strangers compared to staff or co-patients or to family or friends. These findings have implications for research in terms of understanding how criminal records underestimate histories of aggression. These findings also point to the need for the development of more consistent policies and procedures for responding to patient aggression, including when it is necessary or productive to report to police. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the criminal justice system's folk-psychological understanding of people and behavior. The attempt of this paper is to explore some of the complex literature focused on the criminal justice system in order to provide a concise account of its foundational beliefs about responsibility and the human condition. Although the effectiveness of the criminal justice system is a topic of contention, many scholars and legal actors agree that this institution is in part designed to impact people's decisions and behavior. The law's understanding of how people think and on what basis they act is thus of fundamental importance. This paper explores three areas where the law is willing to lessen prescription of criminal responsibility or finds a person not guilty despite their having engaged in apparently wrongful conduct. First, the law's default understanding that people are rational agents is tempered by its acknowledgment of the human condition. Second, the law recognizes that some people who engage in wrongful conduct fall outside the ambit of criminal law. Third, the law embraces a more nuanced view of blame when determining appropriate punishment, taking into account the impact that an unfair social structure has on individual responsibility. [ABSTRACT FROM AUTHOR]

This study sought to examine the potential impact of defendant gender and mental illness type on Canadian juror decision making by manipulating the gender (man, woman) and mental illness (substance abuse disorder, schizophrenia, bipolar, depression) of the defendant in a second-degree murder case involving an insanity plea. Participants read a trial transcript that included definitions of second-degree murder and the not criminally on account of mental disorder (NCRMD) defense. Participants then provided a verdict (guilty or NCRMD) and completed various scales measuring attributional judgments, perceptions of the defendant, and perceived dangerousness. Contrary to expectations, NCRMD was chosen over a guilty verdict in the majority of cases. Findings also indicated that participant decisions and perceptions regarding defendants diagnosed with substance abuse disorder differed from the other mental illness groups. The gender of the defendant had an influence on participants' perceptions of internal attributions, and the perceived stability of criminal behaviors. Results suggest that perceptions of mental illness influence verdicts in NCRMD cases, and that defendant gender plays a role in participants' perceptions of defendants. These findings contribute to the scarce literature on mental illness in the Canadian court system. Future research should examine the interaction between juror gender, defendant gender, and mental illness in insanity cases. [ABSTRACT FROM AUTHOR]

Beyond the legal definition of criminal insanity, the verdict of "not criminally responsible on account of mental disorder" (NCRMD) is a social construction. This study explores the differences between individuals who raise the mental disorder defence and are found NCRMD and those who raise this defence and are found guilty. Files of individuals assessed for criminal responsibility over a two-year period on a remand unit at a forensic psychiatric hospital were examined. Approximately one quarter (N = 36) of these individuals were found NCRMD, and the remaining 102 individuals were found guilty. The study examines differences between these groups along various dimensions such as demographic characteristics, offence characteristics, victim characteristics, criminal and psychiatric history, and psychiatric opinion. The results indicate that the most salient factors that distinguish between the two groups are factors related to psychiatric opinion (e.g., diagnosis of a psychotic disorder or recommendations psychiatrists make in reports to the court). The article concludes with a discussion of the impact of psychiatric opinion on the determination of criminal insanity and the apparent forensication of legal and mental health systems. [ABSTRACT FROM AUTHOR]

Three studies examined the psychometric properties of a new scale, the Forensic Stigma Scale (FSS), designed to measure public stigma of forensic patients. In Study 1, the initial item pool was derived to measure three components of stigma (stereotypes, prejudice, discrimination). An EFA (n = 218) identified a two-factor model with 12 items. In Study 2, this two-factor solution was confirmed using CFA with a separate sample (n = 326) which had good-excellent fit indices. All 12 items loaded (> 0.40) on the two latent factors (Dangerousness/Unpredictability [7 items] and Responsibility/Blame [5 items]) identified in the EFA. In Study 3, using the combined samples from the previous two studies, the 12-item FSS showed promising internal consistency reliability (0.75-0.80) and demonstrated satisfactory-good criterion validity; the scale was moderately correlated with a similar construct and was able to differentiate individuals who did and did not have specific education on forensic psychology. IRT analyses demonstrated that both subscales had discrimination parameters in the moderate-high range (α = 1.03 to 2.54), though the threshold parameters (bi) on the Dangerousness/Unpredictability subscale showed better distribution across trait levels. Overall, the 12-item FSS demonstrates strong psychometric properties, especially the Dangerousness/Unpredictability subscale. The scale may provide clinical and empirical uses for measuring public stigma of forensic patients. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses the results of the National Trajectory Project of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada.

The Canadian forensic mental health system was transformed following the two landmark Supreme Court of Canada cases of Regina v. Swain (1991) and Winko v. British Columbia (1999). The Swain decision led to the creation of a new forensic mental health system that moved towards balancing the needs of the patient with the safety of the public. The Winko decision ruled that review boards had to release all persons who did not pose a significant threat to the safety of the public, even persons whose threat level was uncertain. In this article, the authors conducted 20-year pre-post analyses for incoming not criminally responsible persons following the Swain decision and absolute discharges following Winko. The results indicated that there was a statistically significant increase of new/incoming NCRMD cases post- Swain and a statistically significant increase of absolute discharges post- Winko. [ABSTRACT FROM AUTHOR]