Mental Health and the Criminal Code (14:IX)

A. Fitness to Stand Trial

An accused is presumed fit to stand trial until the contrary is proven on a balance of probabilities (s 672.22 of the Criminal Code). The burden of proof is on whichever side raises the issue (s 672.23(2)).

An accused is deemed “unfit to stand trial” under s 2 of the Criminal Code if he or she is incapable of understanding the nature, object or possible consequences of the criminal proceedings, or is unable to communicate with counsel on account of mental illness. If the verdict is that the accused is unfit to stand trial, any plea that has been made will be set aside and the jury will be discharged (s 672.31). Under s 672.32 the accused may stand trial once he or she is fit to do so. For more information on the test of fitness see R. v Taylor (1992), 77 CCC (3d) 551.

The court may order a trial (not an assessment) on the issue of the accused’s fitness to stand trial at any stage in the proceedings prior to a verdict, either on its own motion or on an application of either the prosecution or the defence (s 672.23).

If a person is found unfit to stand trial, he or she may be detained in a mental health facility until he or she recovers sufficiently to be able to proceed with the trial. An inquiry must be held not later than two years after the verdict and every two years after that. The court may now extend the period for holding an inquiry where it is satisfied that such an extension is necessary to determine if sufficient evidence can be adduced to put the person on trial (s 672.33).

After the court finds a person unfit to stand trial, a disposition hearing must be held by the review board within 45 days, taking into account the safety of the public and the needs of the accused, and must make a disposition that is the least onerous and restrictive to the accused pursuant to s 672.54. A recent case, Evers v British Columbia (Adult Forensic Psychiatric Services), 2009 BCCA 560, stated that the review board erred in proceeding with a disposition hearing in the absence of the accused without first attempting to ensure the accused’s presence by issuing a warrant or allowing a short adjournment. Further, the court stated that fear of non-compliance with medical treatment cannot be the main objective motivating a detention order, nor can the Review Board impose treatment as a condition on the accused.

In Demers v Attorney General of Canada, 2004 SCC 46, the court found that the former sections 672.33, 672.54 and 672.81(1) violated the Charter rights of permanently unfit, non-dangerous accused persons. The court wanted to ensure that an accused found unfit will not be detained unnecessarily when he or she poses no risk to the public. Pursuant to this decision, these sections have been amended.

Now, a review board may make a recommendation to the court to enter a stay of proceedings if it has held a hearing and is of the opinion that the accused remains chronically unfit and does not pose a significant threat to public safety. Notice of intent to make such a recommendation must be given to all parties with a substantial interest in the proceedings (s 672.851).

The review board, the prosecutor, or the accused may apply to order an assessment of the accused’s mental condition if necessary to make a recommendation for a stay of proceedings, or to make a disposition if no recent assessment has been made (s 672.121). A medical practitioner or any person designated by the Attorney General may also make an assessment. An assessment order cannot be used to detail an accused in custody unless it is necessary to assess the accused, or the accused is already in custody or it is otherwise required.

Appeal for an order for a stay of proceedings may be allowed if the Court of Appeal finds the assessment order unreasonable or unsupported by evidence. A recent case (R v J.J.G. (2014) BCSC 2497) considered the issue of whether statements made by an accused during the fitness to stand trial hearing are admissible in the trial. In this case, the accused made an admission of guilt during the fitness hearing. The court ruled that the statements were inadmissible at trial.

B. Criminal Responsibility

1. Defence of Mental Disorder – Criminal Code, Section 16

If an accused is found to have been suffering from a mental illness at the time of the offence which resulted in:

• A lack of appreciation of the nature and quality of the offence (i.e. he or she could not foresee and measure the physical consequences of the act or omission) (R. v Cooper (1980), 1 S.C.R. 1140; or
• A failure to realize that the act or omission was wrong (i.e. he or she did not know it was something that one should not do for moral or legal reasons (Chaulk v The Queen (1990), 3 S.C.R. 1303;

Then that person may be found not criminally responsible by reason of a mental disorder (NCRMD). This is a verdict distinct from either guilty or not guilty. If an accused is found NCRMD, the court can decide whether the accused will receive an absolute discharge, a conditional discharge, or be detained in a psychiatric hospital. Alternately, and more often in practice, the court can defer this decision to the British Columbia Review Board. If the accused is not found to be a significant threat to public safety (discussed below), he or she must be given an absolute discharge.

When dealing with the question of the accused’s mental capacity for criminal responsibility, the court has much the same power to order an assessment to obtain evidence on this question (s 672.11(b)) as it does with respect to an accused’s fitness to stand trial. Pre-trial detention of an accused while awaiting in-custody assessments was held to violate s 7 of the Charter by an Ontario court (R. v Hussein and Dwornik (2004), 191 C.C.C. (3d) 113 (O.S.C.J.)). However, R v Hussein was not followed in a more recent Ontario case (Phaneuf v Ontario (2010), 104 O.R. (3d) 392). The Court ruled that the relevant provisions in the Criminal Code (specifically s.672.11) cannot be interpreted as requiring that accused who are ordered assessed in custody in a hospital must be taken immediately to that hospital and cannot be detained in a detention centre pending transfer to the hospital. Accordingly, it was held that R v Hussein was wrongly decided.

The accused is always entitled to put mental capacity for criminal responsibility into issue by calling evidence relating to it. The Crown is allowed to adduce evidence on the accused’s mental capacity for criminal responsibility where the accused has raised the issue or has attempted to raise a reasonable doubt using a defence of non-mental disorder automatism (a mental state lacking the voluntariness to commit the crime). Where the accused pleads not guilty, does not put mental capacity in issue and does not raise the defence of non-insane automatism, the court may allow the Crown to adduce evidence on the issue of mental capacity only after it has been determined that the accused committed the act or omission (R. v Swain (1991), 63 CCC (3d) 481 (SCC)).

An accused is presumed to not suffer from a mental disorder that exempts him or her from criminal responsibility until the contrary is proven on a balance of probabilities (s 16(2)). An official finding that the accused is NCRMD will occur only when the Crown has otherwise proven the accused guilty beyond a reasonable doubt and the mental disorder exempting the accused from criminal responsibility is proven on a balance of probabilities, the burden of which is on the party that raises the issue (s 16(3)).

C. Disposition Hearings After NCRMD

A finding of NCRMD ends criminal proceedings against the accused. There will then be a disposition hearing either in court or by the review board (s 672.38). Under s 672.54 a person found NCRMD may be:

• a) discharged absolutely where the review board or court finds that the accused is not a significant threat to the safety of the public;
• b) discharged subject to conditions considered appropriate by the court or review board; or
• c) detained in custody in a psychiatric hospital subject to conditions considered appropriate by the court or review board.
• d) With the passage of Bill C-14, discussed fully below, the court may also designate a person as a high-risk accused.

When the review board renders a decision under s 672.54, it must take into consideration “the need to protect the public from dangerous persons, the mental condition of the accused, the reintegration of the accused into society and the other needs of the accused” and must choose the option that is “the least onerous and least restrictive to the accused”.

The review board must review cases in which a person is found NCRMD at least once a year if the person is still detained in a mental facility or is fulfilling conditions pursuant to the disposition hearing (s 672.81). However, as a result of the operation of s 672.54, it is possible for individuals found NCRMD to be subject to prolonged or indeterminate detention or supervision by the review board, even for committing relatively minor offences.

In response to a number of cases challenging the constitutionality of s 672.54, the Supreme Court in Winko v Director of Forensic Psychiatric Institute and the Attorney General of BC, [1999] 2 S.C.R. 625 [Winko] rejected arguments that s 672.54 violates the Charter. According to Winko, a “significant risk to the safety of the public” means a real risk of physical or psychological harm to members of the public that is serious in the sense of extending beyond the mere trivial or annoying. The conduct giving rise to the harm must be criminal in nature. The process of determining whether the accused is a significant threat to public safety is non-adversarial, and the courts or review board may take into consideration a broad range of evidence, including the past and expected course of the accused’s treatment, present medical condition, past offences, the accused’s plans for the future and any community support that exists. See Winko for a complete discussion of the application of s 672.54. Bill C-14, discussed fully below, codifies some of this decision, such as the definition of “significant harm”.

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