An opinion letter by Anne Crocker, PhD

Anne Crocker is a researcher and the Director of the "Services, policy and population health” theme at the Douglas Institute.

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Being found Not Criminally Responsible on account of mental disorder (NCR) does not mean escaping justice! And having a mental illness does not necessarily result in an NCR verdict. Based on the principle that it is inappropriate to punish people who had no criminal intent at the time they committed an offence, the NCR defence is a mechanism used for certain offenders living with a mental disorder.

Many people are more familiar with its former name of not guilty by reason of insanity. This former name creates confusion since it does not correspond to reality and perpetuates the myth that mental illness allows a person to escape justice. In fact, people found to be NCR are neither freed nor returned to their homes with no further supervision. They are almost systematically in custody in a mental health institution.

Longer terms for people with mental health problems

People with mental health problems likely to be held longer than others found guilty of similar offenses. In fact, people with mental health problems may be held by the justice system -during the judicial procedures – for longer periods than those with no disorder.

It is false to think that people found not criminally responsible on account of mental disorder “get away with” anything! The preliminary results of a current study we are leading show that Quebecers found not criminally responsible on account of mental disorder seem to confirm the observations of many people in the mental health and legal fields: these people are held longer than if they had been found guilty and sentenced to prison for the same offenses. However, they are sent to mental health care facilities that are better suited to their needs and their recovery.

Violence and mental illness: readjusting perceptions

The link between mental health problems and certain violent behaviours is mitigated by a number of factors, including drug addiction, precarious living conditions, prior victimization, and sometimes symptoms of the mental illness itself. The vast majority (90%) of people with mental illness are not violent. In Canada, people suffering from mental illness are responsible for less than 3% of violent crimes. People living with mental health problems are fifteen times more likely to be the victims rather than the perpetrators of violence.

Family tragedies

Families are the most frequent victims. Acts of violence rarely target total strangers but rather occur in the homes of the perpetrators, often against loved ones. These families, close relations, and friends are thus often faced with distressing choices – heartbreaking situations where their desire to help and support the person with a mental health problem is offset by their need to ensure their own safety when a situation deteriorates – all with little support or services.

The mental health and public safety sectors are feeling growing pressure to identify the people most at risk in a highly heterogeneous population where many factors are at play. This is why researchers and clinicians are developing and implementing better screening, assessment, and risk management tools. But these developments often take place under difficult conditions at a time when mental health is still the poor cousin of health care, especially in terms of funding.

Despite all the efforts made over the past several years to explain mental illness and eliminate the taboos surrounding both illnesses and patients (through testimonials and explanations of the progress made in the areas of research and care), we still find news stories of tragedies where the mental illness of the person who committed a crime is at the forefront.

This attitude magnifies public fears of the potential violence of people living with schizophrenia, for example, out of all proportion to reality. This only perpetuates the stigma that hinders the social, community, vocational, and educational integration of people with mental disorders and increases their marginalization and isolation. Misunderstanding too often leads to fear and rejection, which seriously undermines the efforts targeting care, prevention, and even recovery.

Relevant Links


Justice and Mental Health in Québec
When a person suffering from a mental disorder commits an offence
The PAJ-SM in Montreal
When a person presents a danger to him or herself or others