Definitions
Unfit to Stand Trial
A person may be found unfit to stand trial if their mental illness prevents them from:
1. Understanding what is happening during court (i.e. the nature or object of the proceedings)
2. Understanding the possible outcomes of the court proceedings
3. Being able to communicate with/instruct their lawyer
The two main goals of the forensic mental health system (Hint: both start with 'R')
Rehabilitation and Reintegration
Pass Level 0
- Access to passes to the secure outdoor yard
- Participate in group programs and other rehab activities on the unit
Detention Order
•Says that an individual will be sent to a psychiatric facility and says which facility.
•Depending on the individual, he/she is sent to a maximum, medium, minimum or outpatient program for follow up.
A detention order may or may not have community living as an option.
•It says the maximum level of passes a person can receive for the year : e.g escorted, accompanied or indirectly supervised passes on the hospital grounds and/or in the community.
•May order an individual to abstain from using alcohol and drugs/give random urine samples
•Some individuals have family or friends screened as approved persons to take them on hospital grounds, into the community and/or for overnight passes in the community.
NCR
NCR = Not Criminally Responsible
At the time of the committed offence, the person suffered from a mental disorder which rendered him/her of:
1) incapable of understanding the nature and quality of the act or
2) Incapable of knowing that it was wrong.
Members of the ORB
- Chairperson (judge or former judge)
- Psychiatrist (specializes in mental health)
- Mental Health Professional
- Lawyer
- Community Member
Pass Level 3
- Access to escorted passes in the community for group programs and other rehab activities
- Access to accompanied passes on hospital grounds with an approved person
Absolute Discharge
•An absolute discharge means that an individual is released from the ORB and has total control over his/her life.
•The police will know that the individual was under the ORB and released, however, there is no criminal record as a result of the index offence(s).
•At this point, an individual can choose if he/she wants to continue with treatment for his/her mental disorder .
Treatment Order
If a person is found Unfit to Stand trial, the court can order the person to be placed on a Treatment Order (Form 48) to try to make the person Fit to Stand Trial.
Under a Treatment Order:
- The person will receive treatment at a mental health facility
- The person does not have to consent to treatment
- The treatment can happen for up to 60 days
Requirements for Approved Persons
1. The Person does not have a criminal history
2. The person will not be actively using substances or be intoxicated while with the patient
3. The person is mentally well
Pass Level 9
- Access to indirectly supervised passes in the community for extended periods of time (e.g., overnight passes)
Conditional Discharge
- If an individual gets a conditional discharge order, they can live in the community
The disposition will outline the following:
•Live within a certain area/radius
•Not to contact/go near certain people, directly or indirectly
•Abstain from using intoxicants (drugs and alcohol) and provide random urine samples to the team
•Indicate a minimum reporting requirement as an outpatient
(e.g visit outpatient team no less than once per month).
•An individual on conditional discharge can select where they want to live.
•Re-admissions are either voluntary, made under the Mental Health Act, or if an individual is arrested by the police and brought to hospital.
• The administrator and the ORB need to know if an individual has been re-admitted to hospital and a Restriction of Liberty may be held
ORB
ORB - Ontario Review Board
The ORB is a quasi judicial panel which imposes legal penalties on an individual. The job/mandate of the board is to review dispositions of individuals under the ORB who were found NCR or unfit to stand trial. Ontario’s Lieutenant Governor in Council appoints members of the board.
Types of Risk
Static Risk and Dynamic Risk
Static risk examples: criminal history, relationship of offender to the victim, age at time of IO, substance abuse history, personality disorder
Dynamic risk examples: active psychosis, non-compliance with medication, lack of insight, drug/alcohol abuse, psychosocial instability, anger or hostility, negative peer associations
Pass Level 5
- Access to indirectly supervised passes on hospital grounds for group programs and other rehab activities (i.e., Therapeutic Neighborhood)
Disposition
•A disposition is a legal order that outlines the conditions the individual must follow over the next year
•The disposition also outlines privileges over the next year
OPIC
OPIC - Office of the Person in Charge
•Is accountable to the Ontario Review Board in the management of individuals in their care
•Responsible to ensure that the ORB disposition is followed
•Must design and implement a program for the recovery of each individual in its care
- Review privilege requests every Monday
3 Types of Orders on a Disposition
1. Detention Order
2. Conditional Discharge
3. Absolute Discharge
Pass Level 7
- Access to indirectly supervised passes in the community for structured rehabilitation activities (e.g., community programs, employment, education, volunteering, etc.)
Difference between Privileges and Conditions?
Privileges involve increasing amounts of freedom and responsibility, such as walking on the hospital grounds or visiting the community.
•The doctor and multidisciplinary team will decide what level of privilege you will start with and work toward, as long as the privileges are allowed by your ORB disposition.
•The team may take away, or suspend, privileges if you do not use them properly or do not follow unit rules. The team will also suspend privileges if they are concerned that you are a danger to yourself or others.
Some examples of conditions placed on you might include:
•giving random urine samples to see if you have been using drugs or alcohol
•making regular visits to your case worker or psychiatrist
•not carrying or owning weapons
•Also, you must follow the rules and regulations of the hospital unit you are connected to.