Does our system for dealing with mentally ill offenders need a rethink?

Posted on July 29, 2019 in Health Debates

Source: — Authors: – Opinion/Editorials
July 28, 2019.

There are good reasons to be concerned about the case of Zhebin Cong, the man who used a cleaver to kill an acquaintance in Toronto in 2014, was found not criminally responsible on account of a mental disorder and sent to Toronto’s Centre for Addiction and Mental Health for treatment, and who fled the country this month while out on a day pass.

There are also good reasons not to overreact or condemn the system that put Mr. Cong in a mental-health hospital, and attempted to gradually reintegrate him into the community.

That Mr. Cong abused his temporary freedom to board a plane and leave the country caused a visceral reaction in many people, including Ontario Premier Doug Ford. He said in a radio interview that someone like that should be locked up forever.

“You throw away the key,” he said.

Tough talk, but based on a misunderstanding of how best to deal with mentally ill people who commit crimes.

Under common law principles going back centuries, an accused must have the mental ability to form intent in order to be held criminally responsible. It’s why we don’t try six-year-olds as adults. It’s why if your dog bites someone, he will not be put on trial. Like all people found not criminally responsible (NCR), Mr. Cong’s case was managed by the Ontario Review Board, a body made up of judges, lawyers, psychiatrists, psychologists and the public.

According to a board report obtained by the media, Mr. Cong was deemed to be a threat as recently as this spring. He was required to stay in detention at the Centre for Addiction and Mental Health (CAMH) for at least another year, where his medication and treatment could be managed.

In some ways, Mr. Cong was a good patient. He followed his treatment, was granted unsupervised day passes and always returned to the hospital by curfew.

But he was also fixated on going to China to see his mother, with whom he talked regularly on Skype. He was frustrated that the review board wouldn’t give him a travel pass, and that he was being asked to co-operate with social workers in finding housing for his eventual release. He didn’t want to live in Toronto; he wanted to go home.

This is where the review board needs to take a close look at Mr. Cong’s case. It did not deem him a flight risk, and he was likely still in his possession of his passport. The board, as well as CAMH, must explain why they failed to foresee what in hindsight was a man determined to skip town.

There are also questions about the two-week lag between July 3, when Mr. Cong went missing and immediately left Canada, and July 16, the day police reported he had fled the country. Toronto police are currently investigating why it took them so long to figure out what happened.

These are serious issues. But they shouldn’t be used to condemn the whole process for treating people such as Mr. Cong.

The law has long accepted that people who commit crimes while suffering from a mental illness can’t always be held responsible. At the same time, those found NCR need to be detained and treated in psychiatric facilities – for the safety of the public, and with the goal of treating and rehabilitating them.

Day passes, and eventual release into the community, are a part of that process if a patient is making progress.

The last place a person such as Mr. Cong belonged was in prison – places that often exacerbate inmates’ mental illnesses before returning them to society.

As well, it is wrong to characterize a mentally ill person who has committed a violent crime as permanently dangerous. According to a study from 2015, among people who committed a major violent crime and were found NCR, fewer than 1 in 100 went on to reoffend. Treatment often works.

People found NCR are sometimes a threat, which is why they’re in a mental hospital. But to lower the threat, they need medical help, not crass characterizations such as “crazy” and “nutcase,” which are words Mr. Ford used to describe Mr. Cong.

There is no question that something went very wrong in this case. CAMH, the review board and the police can all do better. But there is no reason to scrap a system that, in dealing with mentally ill people who have committed crimes, is reducing threats and serving the public interest.

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