The basics
Can I get help in the forensic system for problems other than mental health?
Yes - many forensic/psychiatric hospitals also have programs to help with drug and alcohol abuse, family problems, social skills, sexual problems, financial difficulties, physical health problems.
Who is the person that can best help you make decisions about treatment/ the ORB on your team?
What is the forensic mental health system?
It is the system that cares for people with mental illness who have come into contact with the law. The role of the forensic mental health system is not to punish, but to help rehabilitate and reintegrate people into the community.
What does ORB stand for?
Ontario Review Board
Can you refuse to take part in a forensic assessment?
Yes - you have the right to refuse to take part in some or all of the assessments. Even if you and/or your friends and family decide not to take part in the assessment, the forensic psychiatrist must still report to the court. They will use any available info to do so, such as police and hospital records, info given by friends, family, or observations of you in the hospital.
Where can I turn for help if I feel I am being treated unfairly?
If you cannot solve a problem with your team, there are other people you can turn to:
- client/patient relations coordinators
- director of the forensic program at your hospital
- Psychiatric Patient Advocate Office
Who works in the forensic mental health system?
police, defense counsel, duty counsel, crown counsel, judge, court support workers, psychiatrist, nurse, psychologist, social worker, recreation therapist, occupational therapist, patient advocates
When will I have my first hearing?
Within 45 days of entering the system. After the first hearing, you will have a hearing every year.
What happens at the ORB?
You sit in front of the panel with your lawyer. A Crown Attorney and your psychiatrist will also be present. Family members/ friends can also attend. Your psychiatrist and Crown Attorney will give background info and a report to the board. Your lawyer will speak on your behalf.
Can you refuse to accept treatment?
Yes, unless:
- the doctor signs a certificate saying you're incapable of consenting or refusing
- you have been found Unfit to Stand Trial and the judge has ordered treatment to enable you to become Fit to Stand Trial or help you stay Fit to Stand Trial
Name two of your rights under the ORB?
1. respect
2. be involved in and asked about your treatment and care even if you are incapable of consenting to or refusing treatment
3. limited confidentiality
4. access to an interpreter if needed
5. to be present at your ORB hearing unless you are a danger to yourself or others at the time of the hearing
6. to speak or present evidence at your hearing
7. the right to a lawyer, and confidential communication with your lawyer
8. contact a spiritual adviser
9. the right to be in a safe environment when staying in a forensic mental health unit
10. right to talk to a patient advocate, client relations, family advocate, etc.
Others?
Who makes up the ORB?
psychiatrist, lawyer, psychologist, community member, and a chairperson (either a senior lawyer or a retired judge)
What does "Not Criminally Responsible" mean?
The Criminal Code of Canada states that you are NCR for an offence if a mental disorder prevents you from appreciating the nature of your actions OR knowing that your actions were wrong.
What happens immediately after the hearing?
The ORB will make a disposition. This is a decision/order which states:
- whether you should live in the community with regular hospital visits
- what level of security you require
- provide random urine samples to see if you have been using drugs or alcohol
- making regular visits to your CMHA worker or psychiatrist
- not carrying or owning weapons
How long do I need to stay in hospital?
There is no set date for discharge as it will depend on your rehabilitation goals.
What is in the report prepared by the hospital for the ORB hearing?
The report outlines:
- the things that have gone well and anything that has not gone so well over the past year
- the privileges and conditions recommended by the team for the next year
- your expectations and hopes for the next year, if you have told the team what they are
Can I appeal an ORB decision?
There is a process of appeal if you believe that the ORB has made an unfair decision. You cannot appeal the decision just because you don't like it; you have to be able to argue that the decision was not made fairly or lawfully. Talk to your lawyer to find out more about whether you have grounds to appeal.
When am I no longer under the authority of the ORB?
Either when you have been granted an absolute discharge, or you have been found Fit to Stand Trial and returned to court.
What are the possible outcomes of an ORB hearing?
1. Absolute discharge if you are not "a significant threat to the safety of the public".
2. Conditional discharge - this means you are no longer required to live in the hospital, but must follow the conditions set by the ORB and continue to attend annual ORB hearings.
3. Detention order - this means that the ORB believes you would be a threat to the public if released, and so you remain under the authority of the ORB and will have another ORB hearing in a year.
After an absolute discharge, do I still have to be in contact with mental health professionals?
No - but most people find it is easier to stay connected to a hospital or community mental health services in order to get the support necessary to avoid coming back into the forensic mental health system