Examining the high-risk accused designation for individuals found not criminally responsible on account of mental disorder.

Abstract

In 2014, the Canadian government amended the Criminal Code, allowing courts to designate some individuals found not criminally responsible on account of mental disorder (NCRMD) as high-risk accused (HRA). As a result, individuals found HRA face significant new restrictions for transitioning through the forensic system. This study examined the relevance of the HRA designation by simulating the retrospective application of the legislative criteria to the National Trajectory Project (NTP) sample of 1,800 persons found NCRMD between 2000 and 2005 in Quebec, Ontario, and British Columbia, followed until 2008. Focusing on all individuals who had committed a serious contact offense (part of the first HRA criterion) in the NTP sample, we selected variables from the NTP database based on the remaining legislative criteria. We found that an HRA designation could apply to up to 1 in 4 individuals found NCRMD. The HRA group had been under the supervision of the Review Board for a longer period of time than had the non-HRA group. The HRA group reoffended at rates similar to those for the non-HRA group. Our results suggest that the HRA criteria do not identify a subgroup of persons found NCRMD who present an elevated risk of harm to others. Moreover, the findings suggest that NCRMD-accused with serious personal index offenses were already conservatively managed by the Review Boards. As such, a HRA designation based largely on offense severity is likely to miss its mark in terms of improving public safety.

Alberta not criminally responsible project: Rates of persons found NCRMD and absolute discharges in Alberta following the Not Criminally Responsible Reform Act

“…Moreover, there was no statistically significant difference between the HRA and non-HRA group for violent offenses against the person (hazard ratio [HR] = .95, 95% confidence interval [CI] .69, 1.31, p = .757). Despite the HRA group having slightly higher recidivism rates than the non-HRA group, Goossens et al, (2019) reported that the HRA group spent considerably more time under the supervision of the Review Board than the non-HRA group. Indeed, individuals in the HRA group were nearly two times less likely to receive an absolute discharge (HR = .51, 95% CI .44, .58, p < .001).…”

“…There is a need for a large-scale longitudinal study in Alberta comparing general and violent recidivism rates between persons found NCRMD who committed particularly brutal index offenses with NCRMD persons who did not commit "brutal index offenses." This study, like Goossens et al (2019), could help provide practitioners, researchers, and policy makers the data to help determine institutional best practices for the forensic mental health system. This research could help inform Review Boards across Canada.…”

“…The HRA designation can be applied to individuals found NCRMD following a particularly serious personal injury offense or if they posed a substantial likelihood of committing future violence (Grantham, 2014). Once an individual is designated as HRA, they are barred from entering the community for rehabilitative purposes (e.g., day passes), even escorted supervised privileges, until a Superior Court lifts the HRA designation (Goossens et al, 2019). Moreover, persons found HRA cannot be conditionally or absolutely discharged by the provincial/territorial Review Boards unless a superior court first retracts their HRA designation.…”

Legal, medical and epidemiological characteristics of persons exempt from criminal liability in the National Prison Institute of Peru, 2014-2019

“…Entre las variables clínicas del estudio realizado se destacó la predominancia de los trastornos del espectro de la esquizofrenia (67,0%), aunque los trastornos mentales orgánicos, el retraso mental y las patologías asociadas al consumo de drogas ilegales también resultaron de importancia. Así, la prevalencia de la esquizofrenia en la muestra estudiada (57,5%) fue similar a lo reportado en el estudio colombiano con el 63,0% 6 , pero significativamente superior a los hallazgos de la investigación sueca (33,6%) 30 e inferior a los del estudio canadiense (77,9%) 32 . El estudio llevado a cabo en Turquía mostró la prevalencia de esquizofrenia de 42,5%, siendo esta por debajo del presente estudio, pero la prevalencia de trastornos afectivos (19,5%) fue significativamente superior 33 .…”

“…El único establecimiento penitenciario que cuenta con el servicio de hospitalización psiquiátrica en el Perú es el EP Lurigancho, sin embargo, sus condiciones de atención psiquiátrica no cumplen con las normas técnicas para la atención de salud, según el reporte del Ministerio de Salud 39 . Es importante precisar que, en el Perú, no se cuenta con un adecuado sistema psiquiátrico forense en comparación con otros países [26][27][29][30][31][32]40 .…”