(Ontario Review Board)
At one time, the supervision of these patients/individuals was under the direct authority of the Lieutenant Governor of each province. As a result of changes in the Criminal Code of Canada in 1992, this responsibility was devolved to the provincial Review Boards, the decisions of which could now be appealed directly to the Courts of Appeal.
Under the Criminal Code of Canada, each province must establish Review Boards to oversee the rehabilitation of individuals found Not Criminally Responsible or Unfit to Stand Trial.
Purpose of the Review Board
The purpose of these Review Boards is to review the status and conditions of accused persons found Unfit to Stand Trial or Not Criminally Responsible and held under the Mental Disorder Provisions of the Criminal Code of Canada. (note: "accused person" is the legal term used in the CCC)
Each Board is composed of a Chair or Alternate Chair, who is usually a judge or senior lawyer, at least one psychiatrist, one individual who is a lawyer in that particular province, one individual licensed to practice psychology or medicine, and one individual who is a lay person. The quorum consists of three members, one of which must be a psychiatrist and the other, a lawyer. Different jurisdictions use different combinations, with some provinces having a full five member panel whereas others use typically only three members.
Appointments to, and administration of, the Review Boards is a provincial responsibility.
Each Review Board retains jurisdiction over the accused only while they present “a significant threat to the safety of the public”. The implications of these words have been judicially interpreted, most recently by the Supreme Court of Canada in R v Winko . Now, the burden is on the hospital housing the forensic patient to justify the individual’s continued detention as being a significant threat. The terms have been held to mean at ‘significant likelihood of creating a criminal offence’ and this need not be violent. Thus, an individual who repeatedly made threats but did not commit a violent act, could continue to be detained under the legislation.
Hearings are held at least annually for each person detained under the the Review Board's jurisdiction ("the accused"). The hearings are usually held at the hospital site where the individual is detained. The major parties present are the detained individual, hospital representatives, and a representative from the Attorney General. Hearings are open to the public although this may be waived by the Review Board or Court.
Possible Board Outcomes
The Review Board records written decisions about each case. The outcomes might be Absolute Discharge, Conditional Discharge, or various Detention Dispositions which refer to level of security, hospital, or access to community privileges.
Consideration Issues for Review Boards*
The primary concern for the Review Boards in their deliberations is the consideration of the level of risk to the safety of the public. They consider a wide range of issues in their deliberations. These may include such things as:
Seriousness and nature of index offense (eg. Was this accused’s only offense? Did unique environmental factors play a role and are they likely to be repeated? Was there a history of violence? Was there a history of arrests or violence before 15 years?)
Institutional behaviour (Good behaviour in hospital does not necessarily imply good community behaviour. Is there evidence of impulsivity?)
Time since index offense
Insight into need to seek help for relapse
Speed of relapse or potential
Accused’s attitude to index offense ( remorse, insight, affect about offense)
Accused’s response to increasing privilege levels ( within hospital, accompanied or unaccompanied community privileges, increased duration of passes, results of random alcohol/drug screening
Presence of paranoid psychosis or depressive psychosis at time of index offense
Index offense a homicide/ filicide/sexual
Suicide risk factors
Family and other support in community
Medication compliance (eg 36% of released NCR patients with good medication compliance readmitted within 5yrs of release (cf. 92% of non-compliant patients))
Substance abuse risk factors
Quality of after-care
Special issues related to psychopathy
Potential of violence risk
Potential of escape risk
Concerns for other patients (eg on mixed gender units)
Professional comfort-level of non-forensic mental health/health professionals with forensic patients/detainees
*Note/disclaimer: These criteria are intended to be representative for educational purposes only of the type of factors and issues that Review Boards may consider in their deliberations. This list does not represent any official set of criteria for any Review Board.
Further Reading and Resources
Release Decision-Making, 2nd Edition (2006), Webster, C.D. & Hucker, S.J.,Wiley: London. forthcoming: 2006 (first printing, 2003, sold out)
Serin R, Mailloux D. & Hucker S.J. (2001) “The Utility of Clinical and Actuarial Assessments of Offenders in Pre-release Psychiatric Decision-Making.” Forum on Corrections Research13/2, 36.
© Stephen Hucker, MB,BS, FRCP(C), FRCPsych 2003 - 2011
This material is provided for personal use only. Any other use is strictly forbidden without the express written permission of the author