Forensic Mental Health in Ontario
The Forensic Psychiatry system in Canada falls under federal legislation. Healthcare is organized provincially including the Review Boards that oversee the management of mentally ill accused persons who are either Not Criminally Responsible (NCR) or Unfit to Stand Trial. The decision of NCR or Fitness to Stand Trial are determined by the courts.
The assessments of NCR or Fitness to Stand Trial are done by a designated forensic hospital at the request of the courts.
While serving their respective areas, the designated forensic hospitals are in regular communication to share their available resources which reduce wait times and optimizes availability of forensic mental health services.
What is Forensic Mental Health?
Forensic mental health is the intersection of the mental health system and the criminal justice system.
In Canada, a person can only proceed to trial on a criminal charge when they are able to understand the nature of the proceedings against them, the functioning of the court, and the potential consequences. Where a person is found by the court not to meet these criteria, they are said to be ‘Unfit to Stand Trial’ (Unfit).
Similarly, in Canada a person can only be found guilty of a criminal offense where, at the time of the offense being committed, they had mens rea and actus reus, they appreciated the nature of their actions or omissions, and knew that they were wrong. Where a court finds that a person with a mental disorder does not meet these criteria, that person must be found by the court to be ‘Not Criminally Responsible on Account of Mental Disorder’ (NCR).
The forensic mental health system provides care and rehabilitation to people suffering with mental illness and who are involved in the criminal justice system.
When an NCR accused person has progressed in their rehabilitation sufficiently that the Review Board finds that they are no longer a significant threat to the safety of the public, the Board must grant an absolute discharge. An accused person who has been absolutely discharged is no longer subject to either the judicial or the forensic mental health system’s oversight.
Where are Forensic Mental Health hospitals?
Forensic mental health services for adults include the assessment, management and treatment of mentally disordered persons in conflict with the law. These services are mandated by the Criminal Code of Canada (CCC) that requires the Province of Ontario to provide the forensic services defined therein.
Under the CCC the Minister of Health for a province designates specific hospitals as forensic service providers. In Ontario, the Minister has designated:
- Centre for Addiction and Mental Health (Toronto)
- Waypoint Centre for Mental Health Care (Penetanguishene)
- North Bay Regional Health Centre (North Bay)
- Providence Care (Kingston)
- Royal Ottawa Health Care Group (Ottawa and Brockville)
- Southwest Centre for Forensic Mental Health Care (St. Thomas)
- St. Joseph’s Healthcare Hamilton’s West 5th Campus, (Hamilton)
- Thunder Bay Regional Health Sciences Centre (Thunder Bay)
- Ontario Shores Centre for Mental Health Sciences (Whitby)
Common Questions About Forensic Mental Health
How many persons are receiving forensic mental health services?
Serving approximately 1600 individuals, the forensic mental health system offers assessment, inpatient and outpatient care and treatment. The forensic mental health system also offers outreach services, consultative services, academic training and education, as well contributing to the growing knowledge base of forensic psychiatry through research and development.