Criminal acts and serious mental disorders: prison or psychiatric institution?

People with serious mental disorders who have committed

a criminal act have a different profile, that are incarcerated 

or hospitalized in a psychiatric institution.

"We see a clear difference between people with mental illness, which as a result of a crime are found guilty (incarcerated) and those which are declared not criminally responsible (psychiatric institution)," says Dr. Alexandre Dumais, the first author of the study and a researcher at the Institut Philippe-Pinel de Montréal, as well as to the University Institute in mental health of Montreal. "Since the adoption of the Bill C-30 in 1992, the number of accused suffering from serious mental disorders such as schizophrenia has greatly decreased in the centers of federal detentions. Conversely, the number of persons found not criminally responsible (NCRTM) has increased and these people find themselves in the network of the psychiatry", complete the clinical assistant professor at the Faculty of Medicine of the University of Montreal and a psychiatrist at the Institut Philippe-Pinel de Montréal.

The purpose of this research, carried out in collaboration with the Center for Studies on the control measures in the mental health of the University Institute in mental health of Montreal, was to compare the profile of individuals suffering from serious mental disorders, which result in an offense, are either incarcerated (I=44) or who have been declared NCRTM and who are hospitalized in a health care unit of Forensic Psychiatry (H= 59). To obtain these results, the researchers have analyzed the data from a broad program of research which has explored the clinical profiles and socio-demographic of men suffering from serious mental disorders1.

Results

In the case of persons declared NCRTM who are hospitalized, researchers have observed differences with those who are incarcerated.

Higher level of education among people NCRTM (equivalent Secondary 5): 25% for the incarcerated versus 54% for the NCRTM
greater use of specialized mental health services among people NCRTM: 40% for the incarcerated versus 73% for the NCRTM.
More history of suicide attempts among incarcerated: 66% for the incarcerated versus 34% for the NCRTM
more criminal history with or without violence among incarcerated: 71-80% for the incarcerated vs. 25-29% for the NCRTM
more concurrent disorders with drugs or alcohol and a level of psychopathy higher among incarcerated persons.
"This study confirms the work of my colleagues of the Institut Philippe-Pinel de Montréal, namely that prisoners who have a mental disorder Serious have a particular profile, particularly with criminal behavior and psychopathic traits," said Jean-François Pelletier, a researcher at the University Institute in mental health of Montreal and an assistant professor at the Faculty of Medicine of the University of Montreal. "For their part, the profile of persons hospitalized NCRTM differs from the people who are incarcerated by the fact that they use more mental health services and that they are often already followed in psychiatry before committing their offense," explains Mr. Pelletier.


"The characteristics of the incarcerated persons lead to criminal behavior and the receding of psychiatric care they would need," says Dr Dumais. "An offender, it punishes but when it is also ill, should the treat! As well, new models of shared care between the systems of justice and health will need to be put in place to better deal with these patients and reduce the risk of violent behavior or antisocial. Some initiatives have seen the light of day in different countries, but have not yet been tested formally using rigorous research methods. The next studies will need to be interested in these models to determine which are effective." he concludes.