By Nina Dragicevic  

When you combine the stigma of a mental illness with the stigma of criminality, the result is immeasurably greater than the sum of its parts. We fear violence, but much more so from the unknown — troubled, unpredictable minds we may not understand.

When a trial finds an accused not criminally responsible on account of medical disorder — NCRMD, or NCR for short — the offender appears to be met with lenience. High-profile cases which may incite public outrage and fear often pose the uncomfortable question: What happens when the offender is released?

Not Criminally Responsible: Wedding Secrets revisits Sean Clifton 17 years after he repeatedly stabbed a stranger just outside a local shopping centre in Cornwall, Ont. Clifton was declared NCR and received eight years of treatment at a forensic psychiatric facility at Brockville, Ontario. The 2013 CBC documentary NCR: Not Criminally Responsible gained unprecedented access to Clifton, his treatment team, his victim and her family. The new film updates Clifton’s story as he gains acceptance and forgiveness in the community — and attends a serendipitous wedding that brings everyone together.

FROM THE FILM: Sean Clifton is one of the lucky NCR patients who now navigates his community freely.

Is Clifton’s story of treatment, release and acceptance an extraordinary one? It shouldn't be. The truth about NCR individuals conflicts with the public perception of them, says Dr. Anne Crocker, associate professor at the Department of Psychiatry at McGill University and researcher with the Douglas Mental Health University Institute.

“A lot of what the general public, decision- and policy-makers know about mentally ill persons in conflict with the law is through popular media portrayals,” she says, “whether it be the news, TV shows, or movies which are often sensationalistic. We know from research that individuals with mental illness are generally more likely to be victims of violence rather than perpetrators of violence.”

Mentally ill people are generally not violent. They are 2.5 – 4 times more likely to be the victims of violence than the rest of the population.

Crocker leads the research team of The National Trajectory Project, a 2015 study of individuals declared NCRMD in three of the country’s most populous provinces — Ontario, British Columbia and Quebec. The data gathered, examined and followed on 1,800 cases, between May 2000 and April 2005, revealed facts about Canada’s NCR population that may be surprising to some people.

“This study provides one of the first in-depth analysis of the NCR accused, processing, practices and short-term outcomes in Canada,” Crocker says.

Most crimes committed are not violent or against strangers

Serious violent crime is only nine per cent of NCR cases, the research project found. The remaining 91 per cent of charges resulting in an NCR verdict consist of — in descending order — assault, threat, property offence, other and weapons. Unlike the cases often portrayed in the media, most offenders' victims are people they know like family, friends or first responders trying to help.

NCR offenders are much less likely to commit another crime

Recidivism (a relapse into criminal behaviour) after three years is 17 per cent for the NCR population, the project found. This rate is half of the general prison population, at 34 per cent.

NCR individuals receive forensic care while in custody including a wide range of treatment and interventions which helps keep recidivism rates low. Crocker says, “Treatments address mental health needs as well as criminogenic issues — factors known to be associated with crime and violence.” 

Serious, violent reoffence is almost zero

Contrary to the perception that NCR accused are dangerous offenders who are likely to reoffend, the study found that recidivism three years later of a serious, violent offence is a mere 0.6 per cent.

Some have trouble with alcohol and drugs which contributes to their problems

Thirty-one per cent of NCR individuals have a substance use disorder, suggesting additional influences on an accused’s actions. The project further found that “alcohol or drug abuse at the time of the offence was mentioned in one-quarter of cases.”

This is significant, Crocker says. “Substance use may not only interact with symptoms of severe mental illness, but also represent an important criminogenic factor, for everyone, not only persons with a mental illness.”

“We know that substance use decreases inhibition, increases impulsiveness and affects judgement,” she says. “This is true in the general population at large, and also among persons with mental illness. It is an important issue clinical teams address in combination with the symptoms of severe mental illness.”

These crimes could be preventable

Seventy-two per cent of NCR individuals had at least one psychiatric hospitalization prior to the offence, the study finds, suggesting that offences were not entirely unforeseeable or unpreventable.

“This provides a unique opportunity to examine more closely how to develop prevention strategies,” Crocker says.

Knowledge is power — and knowing the facts about NCR individuals ultimately protects the public through interventions and treatment proven to work.

“We need this research in order to truly understand what policies and practices would be best for maintaining public safety and promoting the rehabilitation of persons with serious mental illness who come into conflict with the law,” Crocker says. “It's a bad idea to make policies and practices based on myths or assumptions about people found NCR.”

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