Forensic Mental Health and Corrections in Ontario

What are the three Divergent Pathways

1. Criminal Pathway

2. Unfit to Stand Trail

3. NCR Pathway

Explain the First Pathway: The Standard Criminal Justice System

• Explain the Findings, Setting, Objective and Exit Components

• The focus is Culpability and Time Based Sentencing

1. Court determined individual fit to stand trail and guilty

2. Provincial jail (short sentences/remand) or federal prison (two years +)

3. The objective is denunciation, deference and rehabilitation with in a correctional framework

4. Release is determined by expired of sentence or a parole board decision

Explain the Second Pathway: Unfit to stand Trail (UST)

• Explain the Definition, Action, Goal and Outcome Components

• Known as a pause in the legal process

1. Due to mental disorder, the accused acts against their own interest because they cannot understand the nature of the proceedings, the consequences or communicate with counsel

2. The legal process is paused and the individual is sent to a psychiatrist hospital under a “Treatment Order”

3. The goal is to restore them to fitness. The priority is stabilizing the patient so they can return to court

4. The outcome is once deemed fit, they return to court to face trial

Explain the Third Pathway: Not Criminally Responsible (NCR/NCRMD)

• Explain the Findings, Shift and Jurisdiction Components

• A Verdict of Not Criminally Responsible on Account of Mental Disorder

1. Terminology: Known as NCRMD (or NCR). Often termed NGMD (not guilty by a reason of mental disorder)

2. The court rules the accused committed the act but due to a mental disorder, they were incapable of appreciating the nature/quality of the act or know it was morally wrong ‘

3. Not an acquittal, but not a conviction. The individual is diverted from correction. to healthcare facilities

4. Authority over the individual and sentencing decision is transferred from the Courts to the Review Board

What is the Staircase to Recovery?

• Recovery is a stepping process based on clinical improvements and risk management

1. Secure Forensic Unit (High supervision)

2. Hospital Grounds Passes (Escorted → Unescorted)

3. Community Passes (Rehabilitation & Family Visits)

4. Conditional Discharge (Living with community with conditions)

5. Absolute Discharge (No further jurisdiction)

What is the LSI-OR

The Level of Service Inventory is a comprehensive, actuarial risk/needs assessment instrument used by Ontario correctional services to evaluate adult and older young offenders. It measures recidivism risk and criminogenic needs to guide case management, parole decisions, and program placement.

What are the 8 Items/Measurements on the LSI-OR

1. Criminal History (Static)

2. Education/employment

3. Family/Marital

4. Leisure/Recreation

5. Companions

6. Criminal Attitudes

7. Substance Abuse

8. Antisocial Patterns (Static)

What are the 6 structured risk assessment elements

1. predictors

2. probability

3. behaviour type

4. time at risk

5. risk targets

6. outcome severity

7. motivation

• they included motivation: underlying emotions, psychological, driver states that influence our choices and behaviours

What are the Gold Standard Statements of Assessment

IF (the following risk factors are present) PREDICTOR

THEN THERE IS (a low, moderate or high likelihood) PROBABILITY

FOR (specific behaviours) BEHAVIOUR TYPE

OVER (specific interval of time) TIME AT RISK

FOR (specified victims) RISK TARGETS

AT RISK FOR (specified type and severity of harm) OUTCOME SEVERITY

BECAUSE (motivation underlying behaviour) MOTIVATION