加拿大因精神障碍而被认定无刑事责任能力者的国家跟踪项目。第2部分：标签背后的人。
The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: the people behind the label.
作者信息
Crocker Anne G, Nicholls Tonia L, Seto Michael C, Charette Yanick, Côté Gilles, Caulet Malijai
机构信息
Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Associate Director, Policy and Knowledge Exchange, Douglas Mental Health University Institute Research Centre, Montreal, Quebec.
Associate Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Senior Research Fellow, Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services, Coquitlam, British Columbia.
出版信息
Can J Psychiatry. 2015 Mar;60(3):106-16. doi: 10.1177/070674371506000305.
OBJECTIVE
To examine the psychosocio-criminological characteristics of not criminally responsible on account of mental disorder (NCRMD)-accused people and compare them across the 3 most populous provinces. In Canada, the number of people found NCRMD has risen during the past 20 years. The Criminal Code is federally legislated but provincially administered, and mental health services are provincially governed. Our study offers a rare opportunity to observe the characteristics and trajectories of NCRMD-accused people.
METHOD
The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 to April 2005, followed until December 2008.
RESULTS
The most common primary diagnosis was a psychotic spectrum disorder. One-third of NCRMD-accused people had a severe mental illness and a concomitant substance use disorder, with British Columbia having the highest rate of dually diagnosed NCRMD-accused people. Most accused people (72.4%) had at least 1 prior psychiatric hospitalization. Two-thirds of index NCRMD offences were against the person, with a wide range of severity. Family members, followed by professionals, such as police and mental health care workers, were the most frequent victims. Quebec had the highest proportion of people with a mood disorder and the lowest median offence severity. There were both interprovincial differences and similarities in the characteristics of NCRMD-accused people.
CONCLUSIONS
Contrary to public perception, severe violent offenses such as murder, attempted murder or sexual offences represent a small proportion of all NCRMD verdict offences. The results reveal a heterogeneous population regarding mental health and criminological characteristics in need of hierarchically organized forensic mental health services and levels of security. NCRMD-accused people were well known to civil psychiatric services prior to being found NCRMD. Risk assessment training and interventions to reduce violence and criminality should be a priority in civil mental health services.
目的
研究因精神障碍而不负刑事责任（NCRMD）的被告的社会心理和犯罪学特征，并在加拿大人口最多的三个省份之间进行比较。在加拿大，过去20年里被认定为NCRMD的人数有所上升。《刑法》由联邦立法但由各省管理，心理健康服务由各省管辖。我们的研究提供了一个难得的机会来观察NCRMD被告的特征和轨迹。
方法
国家轨迹项目研究了2000年5月至2005年4月期间在不列颠哥伦比亚省（n = 222）、魁北克省（n = 1094）和安大略省（n = 484）被认定为NCRMD的1800名男性和女性，随访至2008年12月。
结果
最常见的主要诊断是精神病性谱系障碍。三分之一的NCRMD被告患有严重精神疾病并伴有物质使用障碍，不列颠哥伦比亚省双重诊断的NCRMD被告比例最高。大多数被告（72.4%）至少有过一次精神科住院治疗。索引NCRMD犯罪中有三分之二是针对个人的，严重程度范围广泛。家庭成员，其次是警察和精神卫生保健工作者等专业人员，是最常见的受害者。魁北克省情绪障碍患者的比例最高，犯罪严重程度中位数最低。NCRMD被告的特征存在省际差异和相似之处。
结论
与公众认知相反，谋杀、谋杀未遂或性犯罪等严重暴力犯罪在所有NCRMD判决犯罪中所占比例很小。结果显示，在心理健康和犯罪学特征方面，这是一个异质性群体，需要分层组织法医心理健康服务和安全级别。NCRMD被告在被认定为NCRMD之前，民事精神科服务机构对他们很熟悉。风险评估培训以及减少暴力和犯罪的干预措施应成为民事心理健康服务的优先事项。
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