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People who have a mental illness have to live with many negative attitudes that others have about ______.
them
The doctor must decide if you still meet the conditions for ______ admission.
involuntary
The doctor must decide if you still meet the criteria for ______ admission.
involuntary
A Form 4: 'Certificate of Renewal' will be used if you meet the criteria for ______ admission.
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A doctor can only fill out Form 1 under conditions set out in the Ontario ______ Act.
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Some people do not want to stay in the ______.
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Being held in the ______ is part of the process if a doctor decides you need a longer inpatient psychiatric assessment.
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An accused is found unfit to stand trial if they are unable to understand the nature or object of proceedings due to ______ disorder
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A provincial Criminal Code Review Board handles both UST and NCR accused under the auspices of the provincial Criminal Code Review ______
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Review boards are independent quasi-judicial administrative tribunals mandated under the Canadian Criminal Code Review board hearings are held not less than ______ for each individual under their jurisdiction
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The dispositions a review board can order include detention order, conditional discharge order, and absolute discharge ______
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The majority of the accused in the sample had prior contact with psychiatric services and/or the criminal justice ______
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The majority of the accused had a psychotic spectrum disorder and over half had a substance use ______ in the reporting year
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A range of index offences was observed, with the majority being ______ in nature
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The Canadian forensic psychiatry system is comprised of a unique subset of justice-involved ______
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Psychotic spectrum disorders remain the most common diagnoses and substance use disorders are increasingly ______
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Substance use represents a critical risk factor, and it is imperative that interventions targeting substance use are increasingly incorporated into ______
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A forensic assessment may be requested by a lawyer, Crown, or Judge to determine whether you are ______ to stand trial
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If you are found Not Criminally Responsible, you may receive either an absolute discharge, a conditional discharge, or a ______ order
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The Ontario Review Board (ORB) is composed of a panel that includes a psychiatrist, a mental health professional, a lawyer, and a community member with a background in ______ health
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What is the primary role of the forensic mental health system?
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What does 'forensic' mean in the context of the forensic mental health system?
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Why does society believe it is unfair to punish individuals with mental illness for a criminal act?
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What is the goal of the criminal justice system?
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What is the main reason for involving individuals with mental illness in the forensic mental health system?
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Which term describes when a person has trouble knowing what is real and refers to competence to stand trial?
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In the context of mental illness, what does 'psychotic illnesses' primarily refer to?
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What is the purpose of a forensic assessment requested by a lawyer, Crown, or Judge?
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'Dual diagnosis' in relation to mental health refers to a combination of:
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Why does society have a forensic mental health system in place for individuals with mental illness?
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What is the criteria for being considered 'Unfit' to stand trial according to the Criminal Code of Canada?
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What is a possible consequence for an individual found 'Not Criminally Responsible' for an offense?
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What decision-making body is responsible for determining ongoing aspects such as security level and hospital placement for individuals in the forensic mental health system?
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What must happen for an individual to cease being under the authority of the Ontario Review Board (ORB)?
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Under what circumstances can an individual be forced to accept treatment in a forensic setting?
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What is the role of the Ontario Forensic Mental Health System according to the text?
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Who decides whether an individual should be granted bail in a criminal case?
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What is one of the factors considered by the Ontario Review Board when determining if an individual could successfully live outside of a hospital?
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Who can work in the forensic mental health system?
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What does a forensic assessment aim to determine?
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What does involuntary admission in the hospital involve?
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Who decides if an individual should be granted bail?
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What role does a recreation therapist play in the forensic mental health system?
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When can a doctor fill out Form 1 for involuntary admission?
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What is the purpose of a Form 3 in the forensic mental health system?
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"Double stigma" in the forensic mental health system refers to:
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Which term describes an accused who is unable to stand trial due to a mental disorder?
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What is the most common disposition that a review board can order for an accused in the Canadian forensic psychiatry system?
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What percentage of the accused in the sample had a psychotic spectrum disorder?
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In the study, what was observed as the majority type of index offenses committed by the accused?
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What type of risk factor is highlighted as imperative to target in interventions in the Canadian forensic psychiatry system?
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What percentage of the accused had prior contact with psychiatric services?
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What is rendered if a court determines that an individual was suffering from a mental disorder at the time of the offense or omission?
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'Legally Incompetent' refers to an accused who cannot understand the nature or object of proceedings due to what condition?
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Study Notes
Forensic Mental Health in Ontario: An Information Guide
- The mental health system is a network of people and services that care for individuals with mental illnesses.
Why do we have a Forensic Mental Health System?
- It is unfair to punish individuals for criminal acts if they have a mental illness that prevents them from understanding their actions or the consequences of their actions.
- The system aims to help rehabilitate and reintegrate individuals into the community, rather than punish them.
Myths about Mental Illness
- People with mental illnesses are not inherently dangerous or violent.
- Stigma surrounding mental illnesses leads to discrimination, disrespect, and worse.
- Individuals in the forensic mental health system face a "double stigma" due to unfair labeling.
Who Works in the Forensic Mental Health System?
- Police
- Defense and Crown Counsel
- Judges
- Court support workers and diversion programs
- Psychiatrists and psychologists
- Nurses and social workers
- Recreation therapists and occupational therapists
- Patient advocates and rights advisers
The Role of the Judge
- Decides if an individual should be granted bail
- Decides if an individual's mental health should be assessed
- Decides if an individual is fit to stand trial based on the mental health assessment
- Decides if an individual is not criminally responsible due to mental illness
- Decides the sentence if an individual is found guilty
Psychiatrists
- Medical doctors with special training in assessing and treating mental illnesses
- Can prescribe medications to treat symptoms, provide therapy or counseling, and assess individuals who may have a mental illness
- Conduct forensic assessments for the court
Entering the Forensic Mental Health System
- Individuals can enter the system through police charges, hospital assessments, or release without charges
- The Mental Health Act has strict rules for hospitalization against one's will
What Happens After Arrest?
- Individuals can be taken to a hospital for assessment under the Mental Health Act
- Release without charges is possible
- Hospitalization against one's will is only possible under specific conditions outlined in the Mental Health Act
Forensic Assessment
- Can be ordered by a lawyer, Crown, or judge
- Determines fitness to stand trial, criminal responsibility, or sentence
- May include assessment of an individual's mental health, fitness to stand trial, or criminal responsibility
Ontario Review Board (ORB)
- Oversees individuals found not criminally responsible or unfit to stand trial
- Makes decisions regarding an individual's level of security, hospital placement, privileges, and supervision in the community
- Considers an individual's risk to the public, mental health, and integration into society### Fitness to Stand Trial
- A lawyer, Crown, or Judge may request a forensic assessment to determine if an individual is fit to stand trial.
- Fitness is determined by the court, not by the mental illness itself.
- According to the Criminal Code of Canada, an individual is unfit if they cannot:
- Understand the nature, object, or consequences of court proceedings.
- Communicate with and instruct their lawyer.
Treatment Orders
- If found unfit, a judge may order treatment with medication to make the individual fit.
- The individual must take the prescribed medication, which may be administered by injection or orally if refused.
- If still unfit after 60 days, the individual is placed under the authority of the Ontario Review Board (OBR).
Determining Criminal Responsibility
- A forensic assessment may be requested to determine if a mental illness affected the individual's actions at the time of the alleged offence.
- The individual may be found "Not Criminally Responsible" (NCR) if a mental disorder prevents them from:
- Appreciating the nature of their actions.
- Knowing that their actions were wrong.
Forensic Assessment
- A forensic psychiatrist may assess the individual in jail, a courthouse, or a hospital.
- The assessment is presented in court in a report, and the judge makes a decision based on the report.
Ontario Review Board (OBR)
- A panel consisting of a psychiatrist, mental health professional, lawyer, and community member with a background in mental health.
- The panel makes ongoing decisions about the individual, including:
- Level of security required.
- Hospital placement.
- Privileges and supervision in the community.
- Decisions are made by a majority vote, considering:
- Risk to the public.
- Current mental health.
- Past year's mental health.
- Integration into society.
- Potential for successful living outside of a hospital.
Ending the Relationship with the OBR
- An individual is no longer under the OBR's authority when:
- Granted an absolute discharge.
- Fit to stand trial.
Mandatory Treatment in Forensic Settings
- An individual cannot be forced to accept treatment unless:
- A doctor signs a certificate stating they are incapable of consenting or refusing.
- Found unfit to stand trial and a judge orders treatment.
The Ontario Forensic Mental Health System
- A population-based review of the Ontario forensic mental health system.
- Legislative changes and landmark court cases contributed to the growth of the forensic psychiatry population.
- The OBR oversees one of the largest numbers of forensic facilities and forensic patients in Canada.
Canadian Legislation
- An accused is found unfit to stand trial (UST) if they are unable, due to mental disorder, to:
- Understand the nature or object of proceedings.
- Communicate with counsel.
- An NCR verdict is rendered if the court determines that the individual was suffering from a mental disorder at the time of the offence.
Population-Based Review
- A study reviewing the Ontario forensic mental health system.
- Methods: Data collected on 1,240 accused adults under the OBR's jurisdiction between 2014 and 2015.
- Results: The majority of the sample was male, single, unemployed, and had a high school education.
- Most were on a detention order, and almost half were living in the community at the time of the report.
- The majority had prior contact with psychiatric services and/or the criminal justice system.
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Description
Learn about forensic assessment in Canada, including when it is ordered and what it entails. Understand the criteria for assessing fitness to stand trial, criminal responsibility, pre-sentence evaluation, and dangerous offender assessment as per the Criminal Code of Canada.
