Podcast
Questions and Answers
People who have a mental illness have to live with many negative attitudes that others have about ______.
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.
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.
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.
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.
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 ______.
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.
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
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 ______
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
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 ______
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 ______
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
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
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 ______
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 ______
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 ______
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
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
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
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?
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?
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?
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?
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?
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?
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?
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?
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:
'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?
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?
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?
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?
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)?
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?
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?
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?
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?
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?
Who can work in the forensic mental health system?
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What does a forensic assessment aim to determine?
What does a forensic assessment aim to determine?
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What does involuntary admission in the hospital involve?
What does involuntary admission in the hospital involve?
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Who decides if an individual should be granted bail?
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?
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?
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?
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:
"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?
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?
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?
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?
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?
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?
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?
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?
'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.
