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Making sense of NCR

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Earlier this week, the provincial review board agreed to loosen restrictions on Vince Li, a man found not criminally responsible for a grisly slaying in 2008.

In the wake of the developments, readers have inundated me with questions about mental illness, the Criminal Code and the system by which accused persons such as Vincent Li are reintegrated into society. In order to get the straight facts, I turned to Ken Mackenzie, manager of the forensic mental-health program at the Winnipeg Regional Health Authority. His unit oversees the treatment and supervision of all persons found not criminally responsible (NCR) in a court.

How many people are there in Manitoba who have been found NCR for a criminal act?

Mackenzie said right now, there are 110 NCRs in Manitoba. About 75 live in the community, and the rest are in either the psychiatric unit of Health Sciences Centre or Selkirk Mental Health Centre.

Did all NCRs commit violent, gruesome slayings?

No, in fact, NCRs involve a wide range of crimes. Only a small portion of the total number committed heinous, violent crimes.

Do NCRs, once they are released, ever reoffend?

The recidivism rate for criminals released from the corrections system is very high -- estimates range from 40 to 50 per cent. For NCRs, the recidivism rate is between 10 to 15 per cent.

However, for those NCRs hospitalized for the most violent crimes, the recidivism rate nationally is almost zero. In Manitoba, Mackenzie said he is not aware of any NCR responsible for a killing who committed another violent crime after being released.

The majority of "crimes" committed by NCR upon release are violations of the conditions of release: failure to take medication, leaving the jurisdiction with permission, failing to abstain from drugs or alcohol.

Can NCRs be released into the community after a period of time or do they stay locked up in hospital?

The goal following a finding of NCR is to eventually reintegrate that person into society. However, to receive a release order, the Criminal Code Review Board must be satisfied there is no threat to the community, there is no ongoing threat to the accused person, and all of the supports needed by that person in the community are available.

Who decides if and when an NCR is ever released from hospital?

Following changes to the Criminal Code in 1991, authority for release of an NCR falls to the Criminal Code Review Board in each province. The boards hold annual hearings on anyone admitted to hospital under an NCR order, and accept submissions from attending psychiatrists, mental-health workers, lawyers representing the accused person, the Crown and victim impact statements.

Is the opinion of the psychiatrist the final word on whether to release an NCR?

No. In fact, rather than relying on the discretion or opinion of any one psychiatrist, the mental-health system relies on two internationally recognized protocols for measuring the probability of violence in psychiatric patients. These protocols have proven to be accurate in assessing potential threat, and are routinely used in mental-health systems around the world.

Can a person found NCR for an act of violence be forced to take medication?

The Charter of Rights and Freedoms prevents the Crown from forcing anyone to take medication against their wishes, Mackenzie said. However, the board makes medication a condition in all release orders, with no exceptions. An accused person can refuse, but they will not be released, Mackenzie said.

Still, how can you ensure na NCR is taking medication once released?

Once found NCR, the accused person is under the supervision of the forensic mental-health system for, in most cases, the rest of their lives. Release conditions demand NCRs report regularly to mental-health workers, or get regular visits at home.

In instances where there is any concern about a person's ability to manage medication, a release order will specify it is to be administered by injection. This ensures regular contact with a health-care professional. Failure to take medication almost always triggers a readmission to hospital.

Is Vincent Li a psychopath like Paul Bernardo, Clifford Olson or Robert Pickton?

Schizophrenia, the illness that Li suffers from, is characterized by a break from reality, delusions and hallucinations. It is clinically different from the disorder that afflicts infamous serial killers, who are generally considered psychopaths, Mackenzie said.

Psychopathy is part of a group of mental disorders that cannot be treated with medication. Psychopaths are never found not criminally responsible. This is proven by the fact that Canada's most notorious serial killers have been declared fit to stand trial.

Can an NCR get an absolute discharge from release conditions?

Anyone released under an NCR finding can, in the future, apply for an absolute discharge, Mackenzie said. However, those people responsible for particularly violent crimes are almost never granted discharges.

In addition, even among those who do receive discharges, 95 per cent voluntarily continue working with the forensic mental-health unit to help them monitor medication, he added.

dan.lett@freepress.mb.ca

Republished from the Winnipeg Free Press print edition March 1, 2014 A4

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Updated on Saturday, March 1, 2014 at 7:47 PM CST: Changes photo.

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