The MJLH’s 7th Annual Colloquium: Dr. Archibald Kaiser on Mental Health Courts

Posted By Stephanie Hewson

Dr. Archibald Kaiser is a panellist at this Saturday’s Colloquium on the Not Criminally Responsible Reform Act. Dr. Kaiser is a professor at Dalhousie University in the Faculty of Law and an Assistant Professor in the Department of Psychiatry. Dr. Kaiser’s work focuses on the intersection of mental disability law with the criminal justice system.

Dr. Kaiser recently examined the “proliferation of mental health courts” across Canada. Mental health courts exist in most major urban centres in Canada as a means of diverting people with mental health issues out of the regular justice system, towards a “therapeutic conception of justice.” While Dr. Kaiser recognizes the commitment of lawyers, judges, social workers and mental health workers who staff mental health courts, he raises serious concerns about their role in perpetuating historical stigma, segregation and paternalism towards people with mental health issues.

Dr. Kaiser criticizes the coercive nature of the criminal justice system, even in the form of specialized courts, as a means of forcing treatment, including medication, on the accused. He writes that “mental health courts acquire the mantle of beneficence, but they function as another source of social control without addressing foundational issues.” Instead, Dr. Kaiser advocates for a rights-based approach to disability that focuses on self-determination, access to services and social inclusion.

The new Not Criminally Responsible Reform Act promises Canadians that “public safety comes first” on decisions about accused people found not criminally responsible or unfit to stand trial – indicating the continuation of segregation and social control, rather than movement towards disability rights and social inclusion. The MJLH is eager to hear directly from Dr. Kaiser on the implications of the Act on the future of mental health in Canada.

For more information on the MJLH Colloquium, and to read up on our other distinguished speakers, click here.

La vie après la non-responsabilité criminelle : le débat entre la sécurité publique et le stigmate des maladies mentales

Posted By Chris Laliberté

En juillet 2008, Tim McLean monte à bord d’un autobus Greyhound où il subit une mort tragique et monstrueuse. Le pays est bouleversé après que Vince Li, un passager souffrant de schizophrénie non diagnostiquée, poignarde et décapite McLean dans une acte ayant ni provocation, ni raison d’être. La Cour du Banc de la Reine du Manitoba jugea M. Li non criminellement responsable, et il est condamné à la détention dans un hôpital en conformité avec l’article 672.54(c) du Code criminel du Canada.

En 2014, M. Li gagne le droit aux sorties sans garde suite à son progrès. Son psychiatre explique que M. Li n’est plus violent et ne souffre plus de délires. Il prend des médicaments quotidiennement et comprend que sans ceux-ci il entendrait toujours des voix. Il semble que, dans le cas de M. Li comme avec plusieurs autres, cette tragédie aurait pu être évitée si de meilleurs mécanismes afin de détecter et traiter les maladies telles la schizophrénie avaient été en place.

Les nouvelles dispositions du projet de loi C-14, ayant comme objectif d’améliorer la sécurité du publique, menacent la possibilité de réhabilitation des agresseurs NRC. Les modifications mettent en place des restrictions plus sévères pour les contrevenants « à haut risque » : un accusé à haut risque doit être tenu sous garde dans un hôpital, et une commission d’examen ne peut le libérer que lorsqu’un tribunal révoque cette désignation; une commission d’examen peut prolonger, jusqu’à trois ans, la période entre les audiences de révision; les sorties sans escorte dans la collectivité sont interdites et les sorties avec escorte ne seront autorisées que pour des raisons médicales et s’il existe des mesures suffisantes pour assurer la sécurité du public. Un accusé peut être considéré « à haute risque » si un tribunal :

1) « est convaincu qu’il y a une probabilité marquée que l’accusé usera de violence de façon qu’il pourrait mettre en danger la vie ou la sécurité d’une autre personne » et

2) « est d’avis que les actes à l’origine de l’infraction étaient d’une nature si brutale qu’il y a un risque de préjudice grave — physique ou psychologique — pour une autre personne ».

Il est nécessaire, dans tous les procès criminels, de tenir compte de la sécurité publique ainsi que des droits de la victime. Mais il faut aussi, comme l’explique David Butt, comprendre que les cas d’un agresseur qui souffre d’une maladie mentale nous présentent avec deux victimes. Ce qui se présente autrement comme une situation assez simple– quelqu’un commet un crime pour lequel il doit être puni- se complique quand une maladie mentale entre en jeu. Le désir de soigner ceux qui souffrent de maladies mentales entre en conflit avec le désir de condamner ceux qui commettent des actes répréhensibles.

Suite à l’adoption du projet de loi C-14, il est possible que Vince Li ainsi qu’autres contrevenants NRC se trouvent dépouillé des privilèges qu’ils ont gagné suite à des années d’effort. Pourquoi traiter ces maladies si un niveau déraisonnable de prudence interdit leur réintégration dans la société? Comment balancer les peurs légitimes du publique, qui a droit à la sécurité de corps et de l’esprit, avec le but de réhabilitation et traitement pour les contrevenants NRC?

Ces questions difficiles, parmi plusieurs d’autres concernant le projet de loi C-14, seront adressées par notre panel lors du septième colloque de la RDSM intitulé « Loi sur la réforme de la non-responsabilité criminelle : le droit et la santé mentale ». Tous sont invités à participer au à la discussion ce samedi, le 21 février dès 9h30 à la faculté de droit de l’université McGill.

Pour plus de renseignements à propos du Colloque, cliquez ici.

The Sleepwalking Defence and Implications of the Not Criminally Responsible Reform Act

Posted By Lana McCrea

The National Post reported on February 17, 2015 that a man on trial for sexually assaulting his seven-year-old daughter in December 2010 was found not criminally responsible. The judge ruled that he was sleepwalking and therefore in a state of automatism. The man was accused of entering his daughter’s bed after his wife kicked him out of their bed for having spent the night drinking. He allegedly tried to remove his daughter’s underwear and held her down as he touched her. Dr. Colin Shapiro testified that the man suffered from parasomnia, a type of sleep disorder that can include ‘sleep sex’.

R v Parks (1992) established that sleepwalking can be classified as automatism resulting in the verdict of not guilty. In that case, the defendant drove 25 kilometers to the home of his in-laws and stabbed his father-in-law to death, seriously injuring his mother-in-law.

In Canada v Campbell (2000), George Campbell was found not criminally responsible by reason of mental disorder after he attacked a woman in her bed where she had been sleeping with him. He was charged with attempted murder, assault with a weapon, aggravated assault, choking, and uttering a death threat. The judge ruled that he had been sleepwalking and therefore the defence of automatism applied. On October 14, 2014, CBC News reported that Phyllis John was attacked by the same George Campbell. She claimed that she “didn’t realize her new boyfriend was the ‘sleepwalker’” at first.

One important aspect of the Not Criminally Responsible Reform Act is that it creates a high-risk designation. Upon being designated as such by a court, the accused would be held in custody at a hospital and could not be released by a review board until the designation was revoked by a court. The designation has other important consequences that may help safeguard victims from future acts by those held not criminally responsible. Sleepwalking is just one of many manifestations of the automatism defence which may be affected by the new legislation.

The McGill Journal of Law and Health will discuss some of these important developments and what their implications may be at its Colloquium on February 21st, 2015.

For more information on the MJLH Colloquium, and to read up on our other distinguished speakers, click here.

Interested in sleepwalking and neuroscience? See MJLH Online Editor Jey Kumarasamy’s recent blog post, here.

The MJLH’s 7th Annual Colloquium: What is the Mental Health Unit for Women Serving a Federal Sentence?

Posted By Lauren Hanon

The McGill Journal of Law and Health is hosting its 7th annual Colloquium this coming Saturday, February 21st. The topic of this year’s colloquium is: “The Not Criminally Responsible Reform Act: Mental Health and the Law.” With many great speakers and participants lined up, one notable contributor this year is Dr. Renée Fugère. Fugère is the Executive Director of the Philippe-Pinel Institute of Montreal, a hospital and center for research and teaching.

One of Fugère’s current projects with the Institute is the Mental Health Unit for Women Serving a Federal Sentence. The services offered to women serving a federal sentence by the Unit include psychiatric care and treatment through individual and collective therapeutic strategies. The treatment for each patient is aimed at addressing her specific and individual mental health needs, and offering women the type of necessary care that prisons simply do not seem capable of. The program thus seems extremely promising for any woman suffering from mental health issues who is serving a federal sentence.

How does a female detainee access the program?

There are two requirements for a female detainee to be admitted into the program: 1) the institution in which she is detained must request that she be assessed by the Philippe-Pinel Institute; 2) the needs of the female detainee, in terms of psychiatric care, must be too much for the institution itself to handle. There is also a voluntary aspect of this program for women who suffer from a severe personality disorder.

Is the program large enough to accommodate all women suffering from mental illness?

The program has approximately 15 beds and accepts women from across Canada. A detainee may stay for a maximum of 12 months.

A question that immediately pops up is whether this is enough for women suffering from mental health issues who are serving sentences. If not, are there other similar programs elsewhere in Canada? How many are there and how many women do they serve?

Other questions that I hope to see answered at the Colloquium this Saturday include: What quality of care do women receive within their institution before they would qualify for such a program? What does it mean for women to serve a federal sentence and be suffering from mental illness at the same time?

If you too would like to find out more about Dr. Fugère’s wonderful initiative, be sure to join us this Saturday, February 21st at the MJLH’s 7th annual Colloquium.

For more information on the MJLH Colloquium, and to read up on our other distinguished speakers, click here.

The MJLH’s 7th Annual Colloquium: Come listen to Justice Schneider on Bill C-14

Posted By Sabrina Mach

The adoption of Bill C-14, the Not Criminally Responsible Reform Act, has been met with much criticism. Amongst those skeptical about the Act’s effectiveness is the Honorable Mr. Justice Richard D Schneider, Justice of the Ontario Court of Justice and Chair of the Ontario Review Board. During the Standing Senate Committee meeting to consider Bill C-14, Justice Schneider explained his skepticism towards the bill and highlighted that his biggest concern with the reform was the addition of the “high-risk offender” provisions.

Important change brought by Bill C-14

With the new reform, accused persons who are found not criminally responsible (NCR) but who the Court believes will pose a higher risk of committing future acts of violence will be held for up to three years in custody in a hospital, and will not be released by a review board until the high-risk designation is revoked by the court. Prior to the bill, review boards were given more freedom; they could order the NCR individual to remain in the hospital, they could order a conditional or complete discharge, etc.

Given that he sits on the Ontario Review Board, it is not surprising that Justice Schneider would be critical of the reform, since the “high-risk offender” provisions encroach on the review board’s ability to assess NCR individuals. However, the criticisms that Justice Schneider raised during the Senate Committee run much deeper than simple encroachment of power.

Criticisms of the high-risk offender provisions

First, Justice Schneider argues that high-risk offender provisions are not applicable to most accused in Canada. They only address a small group of highly mediatized outliers, such as Vincent Li, Guy Turcotte and Allan Schoenborn.

Second, Justice Schneider asserts that changes should not be made to a system that is not broken. Evidence clearly demonstrates that the previous review board scheme worked extremely well and greatly reduced the probability of recidivism.

Finally, Justice Schneider emphasizes that the Bill C-14 might actually make things worse for the mentally disordered, not better. Given that those classified as NCR high-risk offenders run the chance of being locked up in a secure psychiatric facility for up to three years with no review, some mentally disordered individuals might choose not to raise the defense of NCR. The problem with not raising this defense, however, is that these individuals will end up in prison, which will prevent them from receiving proper treatment or assistance for their disorder, and thus increase their chances of recidivism.

Conclusion

Justice Schneider raises numerous compelling criticisms regarding Bill C-14. One of the main reasons why his arguments are so persuasive is because they are influenced by personal experience. Being the Chair of the Ontario Review Board as well as a former defense lawyer for the mentally ill, Justice Schneider is an expert in his field. It will be very interesting to hear him speak at the MJLH’s Colloquium on Saturday, February 21st, 2015.

For more information on the MJLH Colloquium, and to read up on our other distinguished speakers, click here.