A new study says people such as Vincent Li have an easier time securing needed mental-health care after they commit acts of violence.
Once treated, they're also the least likely to reoffend, partly due to the fact they're so closely monitored and medicated while incarcerated and after they've been released.
Those are the key findings of experts in a study of 1,800 cases of people found not criminally responsible for offences under Canada's Criminal Code from May 2000 to April 2005.
Li, a schizophrenic, was found not criminally responsible for the death of Tim McLean, who was beheaded on a bus in 2008 by Li, who was having a psychotic episode.
Though the study's release comes on the heels of news Li was granted new freedoms and may someday walk the streets of Winnipeg — the timing was coincidental.
The biggest study of its kind since 1992, the National Trajectory Project was published online in the Canadian Journal of Psychiatry Thursday. Made up of five papers based on a joint review of cases from Ontario, Quebec and British Columbia, the study was led by researchers at McGill University, the Royal Ottawa Mental Health Centre and the University of British Columbia.
"It is easier for people with serious mental illness to access treatment after they are charged with a crime than it is for them to get professional help before," Michael Seto, a director at the Royal Ottawa Health Care group and one of the study's lead authors, told the Free Press.
The study says less than 0.2 per cent of criminal cases in a given year receive a verdict of not criminally responsible on account of mental disorder and found only 13 cases of severe violent reoffending.
"(Such) cases can conjure thoughts of violent offenders faking a mental illness to avoid prison time, shortened hospital stays with early release into the community accompanied by fears the individual will reoffend," the article states.
However, data from the project show a low incidence of violent crime. About half the cases involve minor assaults, property offences or other non-violent crimes. Overall recidivism is lower than that of the general prison population.
Experts, including a Winnipeg psychiatrist who once served on the same board that granted Li new freedoms, applauded the study's timing.
"The bottom line is this, if you have a mental illness, first of all the issue is getting it recognized and the second (challenge) is getting to a psychiatrist or a mental-health worker who sticks with you," said Dr. Fred Shane, who spent 20 years on the Manitoba Criminal Code Review Board.
Though he has yet to read the study, Shane said the findings fit his experience.
"There are many people who obviously are in community and are mentally ill, and until it explodes on you, they don't often come to the attention (of the system) or if they do, it's been transient," he said. "If you're mentally ill, all you can do is you hope to get a fit."
Those offenders are so closely monitored the rates of new offences drop off dramatically, he said.
Alberta psychologist Patrick Baillie, who consults with the Calgary police, noted in an editorial in the same journal the findings offer the first concrete evidence of how strict new federal laws play into myths about mentally ill offenders.
Bill C-54 was passed in 2013 and came into effect last July. It introduces a new high-risk category, limits access to community treatment options for offenders and also limits the powers of the criminal review boards to discharge offenders, handing authority for offenders designated as "high risk" over to the courts instead.
"This legislation played into certain beliefs, among them the notions that most cases involved serious violence, that the verdict is used too frequently... as when someone fakes a mental illness... and that after a brief period of hospitalization, they are released," Baillie wrote.
Federal justice officials were so keen to get their hands on the study, they asked for it to be released to them before it was published, Baillie noted in the editorial.
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The study confirmed dangerous offenders are rare and psychiatrists and mental-health experts are doing a good job protecting them and the public, Baillie wrote.
"Since time immemorial, criminal law systems have considered the simple idea that an accused person should not be convicted when their illegal behaviour stemmed from a disease of the mind," he wrote.
"A truly safe society does not change that established principle by incarcerating people with mental disorders or by further stigmatizing them, but rather, ensures procedures are in place to protect both the individual and the public."
— with files from The Canadian Press
Better treatment after offence
KEY findings of a new study on offenders incarcerated as not criminally responsible found they received better treatment after they committed an offence and didn't reoffend nearly as often as people think. The study was based on 1,800 cases of people under the category of criminally not responsible in Ontario, Quebec and British Columbia, the first joint review to look at provincial rates since 1992. It did not include cases from Atlantic Canada or the Prairies.
Fifty-one per cent had no prior contact with the criminal system.
Seventy-two per cent had at least one prior hospital stay for mental illness.
Sixty-five per cent of those who committed acts of violence attacked friends, family or health-care workers; 23 per cent attacked strangers.
One in 10 was homeless.
The main diagnosis was a psychotic disorder and one-third of the individuals had a substance abuse addiction at the time of their psychotic break.
Offenders released from jail or prison were more likely to reoffend than offenders in mental health centres who had been found not criminally responsible.