Court-Referred Mental Health Assessment and Treatment
Assessment and treatment for British Columbians referred to us by the courts due to a severe mental health or substance use disorder.
Why would someone be referred to Forensic Psychiatric Services?
There are four reasons why someone might be referred to Forensic Psychiatric Services:
- Assessment: They have been sent by the courts for psychiatric assessment to determine their fitness to stand trial or to assist in determining whether they should be found not criminally responsible on account of mental disorder (NCRMD)
- Treatment: They have been found unfit to stand trial or NCRMD. This means they need treatment for serious mental health issues and will be cared for in the Forensic Psychiatric Hospital and/or one of the forensic regional clinics
- Temporary absences: If they are in custody at, or serving time in, a provincial correctional facility and have been certified under the BC Mental Health Act, they can also be sent to the Forensic Psychiatric Hospital for treatment of their mental illness. Typically, they will return to a correctional facility once their treatment is complete. While at Forensic Psychiatric Services, they will be subject to a specific set of security requirements since they remain in strict custody (for example, no visitors)
- Bail or probation orders: They have been referred to a forensic regional clinic on a court order for bail or probation
Forensic psychiatric assessments
Forensic psychiatric assessments are an important first step in getting people the help they need to manage their serious mental illness. The courts mandate that people receive their assessment within a specific time frame.
The courts will order assessments when:
- Mental illness may be a factor in the offence
- Mental illness is making it hard for someone to understand the trial
- The court needs a report to help understand their current condition
During the assessment, a social worker or a nurse will interview them. A doctor will also interview them.
They might ask questions about:
- Personal and psychiatric history
- Current symptoms
- Medication history
- How they were doing before the offence
- Observations about their behaviour and interactions
- History or signs of substance use
- Trauma history
- Strengths, abilities, and coping mechanisms
The social worker or a nurse will give the information to the doctor. Based on all the interviews, they will make a recommendation whether they are “unfit to stand trial” or NCRMD.
Fitness to stand trial
Mental illness can interfere with a person’s ability to think, reason, concentrate, and process information. This can make it hard for them to know what is going on during the trial. Severe symptoms such as paranoia can undermine a person’s ability to cooperate and communicate with their lawyer and assist in their defence.
An assessment of “fitness to stand trial” is about someone’s mental state at the time of court proceedings only. It is not connected to their mental state at the time of the offence. They may have been disabled by their symptoms at the time of the alleged offence but deemed fit to stand trial at the time of the trial. It is also possible for symptoms to appear in court that were not present at the time of the offence.
People are deemed fit to stand trial when they:
- Understand the charges against them
- Understand the possible consequences of the charges
- Understand the roles of the people in the court, such as the judge, crown counsel, etc.
- Can communicate effectively with their lawyer to assist in preparing their case
If someone is deemed unfit to stand trial, they may be admitted to the Forensic Psychiatric Hospital or to a forensic regional clinic for treatment. They will receive treatment until they are well enough to take part in the court proceedings.
Not criminally responsible on account of mental disorder
Not criminally responsible on account of mental disorder (NCRMD), as defined in the Criminal Code of Canada, means that a person has committed a criminal offence, and because of their mental illness:
- They were unable to understand the nature of the act they committed
- They were unable to know that the act they committed was wrong
- They should not be held accountable for their actions, due to mental illness
Mental illness can alter someone’s view of reality, impairing their ability to realize the criminal nature of their actions. It can affect their thought processes and lead them to believe they had no choice but to commit the crime. They may not be capable of understanding the nature of the crime or know that what they did was wrong.
To be found NCRMD, they will undergo a comprehensive clinical assessment by a psychiatrist and meet strict legal criteria administered by a judge. If they are found NCRMD, they will come under the jurisdiction of the BC Review Board. The BC Review Board is the authority that oversees the legal process for people who are found unfit to stand trial or who are NCRMD.
Receiving a diagnosis of NCRMD is not a "get out of jail free" card. In most cases, it means they will receive forensic psychiatric care for longer than their criminal sentence would have been. While being found NCRMD is not like being convicted in the traditional sense, it also is not the same as being found not guilty. It represents a unique third option.