Nova Scotia·Q&A

In the forensic mental health system, victims sometimes struggle to get support

Health care practitioners at the East Coast Forensic Hospital in Dartmouth, N.S., say balancing the needs of their clients with those of their victims can be difficult, and that victims sometimes fall through the cracks.

'The victims of our clients do seem to fall through the gaps at times,' says social worker Lianne Nixon

Under the Criminal Code, an accused can be declared not criminally responsible if their mental disorder renders them either incapable of appreciating the nature of their actions or unable to understand that their actions were wrong. (Jean Laroche/CBC)

A criminology professor says that for victims of crimes carried out by someone found not criminally responsible, the verdict can be difficult to process.

Under the Criminal Code, an accused can be declared not criminally responsible if their mental disorder renders them either incapable of appreciating the nature of their actions or unable to understand that their actions were wrong.

When someone is found not criminally responsible, they're not sentenced, but are instead treated by the forensic mental health system.

"If a victim wants punishment in terms of getting their justice, then they might feel the system has treated them unjustly," said Saint Mary's University criminology professor Jamie Livingston.

Each year, about 850 Canadians living with mental illness are deemed by a judge to be not criminally responsible for their illegal actions. That's about 0.5 per cent of the 350,000 criminal cases that come before the courts every year.

At a recent workshop at the East Coast Forensic Hospital in Dartmouth, N.S., practitioners discussed how to better meet the needs of victims of offences in which someone has been deemed not criminally responsible. 

Livingston and Lianne Nixon, a social worker at the forensic hospital, discussed this with Portia Clark, host of CBC's Information Morning. This interview has been edited for length and clarity.

What kinds of challenges come up for victims when someone is deemed not criminally responsible? 

Livingston: When someone is found not criminally responsible, the only formal way that [victims] are involved in the system is every year, a person who's found not criminally responsible is given a hearing before a Criminal Code review board who decides on the liberty of that person. And that's a chance for victims to read a victim impact statement, which can inform the decision that's made by a criminal code review board.

Lianne, you worked directly in some of these situations. What are some of the complications that you've experienced or seen unfold first-hand in your work as a social worker?

Nixon: We do have family members who are victims who are very much ready to be supportive in their loved ones lives, to be involved in the case planning, to be there, whether it be at the review board hearings or at team meetings, or even just helping clients get back into the community. We also have some victims who don't want to be involved in that process.

How often do you sense that someone who's been victimized somehow wants support or need some help with their own trauma or issues around what's happened?

Nixon: It's something that is a struggle for the clinicians at the East Coast Forensic Hospital because our client is the individual who committed the crime. So, it can be challenging to stay impartial if we are working with the client, as well as providing some form of support for the victim.

It works very smoothly when the victim wants to remain in a relationship with the client, but it can be awkward and tricky when the victim is no longer wanting that relationship. 

You wanted to be part of the recent workshop to hear what others had to say about how they navigate these situations. What were some of the things that you talked about that struck a chord or were helpful for you?

Nixon: Some of the themes that had come up were that it's an area that definitely is lacking for services, in that we feel as though the victims of our clients do seem to fall through the gaps at times. We saw themes coming up, like victims requiring more education around our system, and the complexity of our system, and also that ongoing support, and allowing [victims] to have a voice, whether it be at the review board hearings or in another form.

What are the misconceptions or areas of opportunity that you see there, Jamie?

Livingston: One of the major misconceptions is that the not criminally responsible defence is a get out of jail free card, and that people go to a fancy hospital and have all their needs taken care of. And there's no doubt that people who are found not criminally responsible are provided with great care and compassionate care as well, but at the same time their liberties are restricted and they're often placed in an environment that they experience as being very punishing.

Jamie Livingston, assistant professor in the Department of Criminology at Saint Mary's University, poses on campus in Halifax on Saturday, May 19, 2018. (Darren Calabrese/The Canadian Press)

Often, people find they spend more time in the forensic mental health system than they would have if they were found guilty of their offence.

As far as getting more help to victims who are caught up in cases like these, what could be more helpful, whether it's restorative justice models or otherwise?

Nixon: I think a restorative justice model would be excellent in our system, and it could be organized in a way that all parties are able to work together and come to an understanding of what our system is really doing. We don't look at things in a punitive way.

But again, there is a lot of struggles for our clients to manage their way through our system, and they often see it as punitive, so having those open discussions with a neutral body to mediate it would be an excellent opportunity.

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With files from CBC's Information Morning and the Canadian Press

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