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Lecture 9

Lecture 9.docx

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Carleton University
PSYC 3402
Julie Blais

Lecture 9 Man who beheaded bus passenger remains 'a significant risk’ - The Canadian Press, Thursday, September 17, 2009 - The Manitoba review board that decided the fate of a man who beheaded a sleeping passenger on a Greyhound bus released the reasons for its decision Thursday, calling Vince Li a "significant risk" to the public. - Li was found not criminally responsible for killing Tim McLean, 22, last summer in front of horrified passengers near Portage la Prairie, Man. - The Edmonton man stabbed and mutilated the body of McLean, a Winnipeg man who was returning home after working at a carnival in Edmonton. Ajudge ruled in March that Li suffered from untreated schizophrenia and did not realize that killing McLean was wrong. - Li's case was then handed over to the province's review board to decide whether he should be given an unconditional discharge, released with conditions or continue to be kept in a mental health facility. The board ruled in June that Li must remain in a locked ward of a mental health facility until his case is reviewed again next year. - HE WAS FOUND NOT CRIMINALLY RESPONSIBLE Definitions - Mentally disordered offenders (MDOs) are those individuals who have come into contact with the criminal justice system and who also have a mental disorder - The concept of mental disorder supposes we can adequately discriminate between “normal” and “abnormal” behavior - Majority of mental disorders • No known organic cause • Little understood etiology - Use of diagnosis is controversial and in-exact Diagnoses - DMS-IV • Axis I: clinical disorders (major depression, substance dependence, schizophrenia) – impact on affect and perceived reality • Axis II: personality disorders and mental retardation • Axis III: general medical conditions • Axis IV: psychosocial and environmental problems • Axis V: global functioning Prevalence - Serious problem in the CJS - Institutions • Canada: 38.4% of federal prison admissions = history + current psychological distress (Stewart et al., 2010) • US: 56% of state prison inmates have a “mental condition” (James & Glaze, 2006) - Probation • Rates vary (11.2% to 53%), however, significantly higher than general population (Sirdifield, 2012) Prevalence rate comparison Mental disorder by crime Serious problem - Why? • May threaten the safety of others or themselves within closed facilities • Appropriate identification • Appropriate care and treatment • Comorbid substance abuse (higher failure rates on community supervision) Important legal concepts - In order for criminal guilt to be found need to establish 2 elements: • Actus Reus = a wrongful deed • Mens Rea = criminal intent Assessment with MDOs - Assessments divided into 3 purposes: • 1) Assess fitness to stand trial • 2) Assess criminal responsibility • 3) Assess risk to reoffend 1) Fitness to stand trial - Unable to participate in defence • Mental state at the time of trial. Must understand: role of judge, possible consequences, and be able to communicate with counsel - According to Section 2 of the Criminal Code, an accused is unfit to stand trial (UST) if he/she is: • Cannot understand the nature or object of the proceedings • Cannot understand the possible consequences of the proceedings • Cannot communicate with counsel 2) Assess criminal responsibility - NCRMD: Not Criminally Responsible onAccount of Mental Disorder - 3 criteria must be established: • Mental disorder • Fail to appreciate the quality of the act • If understand act, do not believe it is wrong - If found NCRMD there are 3 possible outcomes: • Absolute discharge (13%) • Conditional discharge (35%) • Detention within hospital (52%) NCRMD facts - 2 per 1000 adult criminal cases uses this defence (Canadian data; Latimer & Lawrence, 2006) - 26% are successful (U.S. data; Silver et al., 1994) - 15% of those found NCRMD were charged with murder/attempted murder (Canadian data; Latimer & Lawrence, 2006) - NCRMD offenders spend more time in confinement (Canadian data; Harris et al., 1991) - Failure rates range from 30-60%; most involve violating rules of conditional release; 4% for new violence (U.S. data; Golding et al., 1989; Hodgins, 1987; Vitacco et al., 2008) Characteristics of NCRMD 3. Assess risk to reoffend - What predicts REOFFENDING? - Two main theoretical approaches: • General Personality and Cognitive Social Learning model of criminal behaviour (i.e., PIC-R) • Psychopathological OR clinical model of criminal behavior - GPCSL: • Criminal behavior is best explained by examining the person within his/her social learning environment • Person variables of interest are the Central Eight risk/need factors • Given the GPCSL is a general theory of crime, it should be applicable to a range of offender populations including MDOs - Clinical model: • Focus isALSO on person variables, HOWEVER, the person variables of interest are those related to the symptoms/presence of the mental disorder • E.g., MDOs commit crimes because they have schizophrenia, active psychosis, personality disorders, etc. - Clinical model has been criticized for: • Failing to identify relevant risk factors • Failing to identify relevant treatment targets that would actually reduce recidivism Theoretically informed meta-analysis - Which theory best predicts recidivism for MDOs? - Meta-analysis comparing the person factors of GPCSL model (i.e., the Central Eight) vs. the person factors of the clinical model (i.e., diagnoses and symptomology) (Bonta et al., 2013) - Terms: predictor, dangerousness, maximum security psychiatric institution, mentally disordered offender, mentally ill offender/inmate, recidivism, and violence - Sample: Published/unpublished studies; 1959 to June 2011 (PsycLit; NCJRS); dissertations; conference presentations - Study characteristics: • 126 studies, 96 unique samples, over 1700 possible effect sizes • Studies from 1959 – 2011; Median 1999 • Average sample size = 298 (range: 8 – 1175) • Average follow-up of 4.90 • Recidivism base rate  General = 39%  Violent = 23% - Sample characteristics: • Majority adult samples (88%)  Mean age = 32.7 • More frequent diagnosis (%)  Schizophrenia: 47.4  Bipolar/affect: 12.8  Other: 39.7 • Previous hospital/prison time = 51.6% - GPCSL approach: • Criminal History (CrimHist) • Antisocial Personality Pattern (Pattern) • ProcriminalAttitudes (Procrim) • Family/ Marital (FamMarit) • Education/ Employment (Edu/Emp) • SubstanceAbuse (Abuse) • *Not enough to look at Leisure/Recreation or Procriminal Companions - Clinical approach: • Clinical  Psychosis (schizophrenia)  Mood disorder (depression)  APD/psychopathy • MDO vs. non-MDO - Conclusions: • The Central Eight risk/need factors predict both outcomes for MDOs  Most predictive for general and violent • Clinical variables DO NOT predict recidivism  Only one that it does predict is antisocial personality disorder • Implications for risk prediction and treatment MDOs and violence - Homicides over a 38 year period in UK show only a small proportion of murders are committed by persons with major mental disorders (Taylor & Gunn, 1999) - Comparing clinical and non-clinical sample in a 12-month period, rates of violence were the same (Steadman et al., 1998) - Violence rates among mentally ill relatively low (Elbogen & Johnson, 2009) - Severe mental illness + substance dependence elevates risk for violence (also: Swanson et al., 1997)
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