When a person is acquitted on account of mental disorder, that does not mean that he is released and that is the end of the proceedings. This person then falls under the aegis of the Commission for the Review of Mental Disorders of Quebec (CETM), which is a division of the Administrative Tribunal of Quebec.
The CETM essentially has two mandates: that of ensuring public safety, but also that of meeting the social needs of the accused person and enabling his social reintegration. “Someone who has committed crimes because they were actively psychotic will not be sent to prison, but rather they will be ensured that they have access to health care that will allow them to better control their risk of recidivism”, specifies the forensic psychiatrist Stéphanie Borduas-Pagé, medical chief of the service of legal psychiatry of the University institute in mental health of Montreal.
They are said to have been acquitted, but sometimes their sentence is much greater, as they can remain in hospital detention for years.
The CETM can decide to detain the person in the hospital with or without leave, depending on the assessment of the risk to public safety.
It can also release the person in the community with more or less procedures to follow depending on the risk factors for the population. “The Review Board no longer considers the state of the accused at the time of the offenses, but rather the risk he represents now. This means that there may be people who have committed fairly minor offences, non-violent offenses such as theft and misdeeds, but who will remain under the CETM’s mandate for a very long time because they still present active risks. They are said to have been acquitted, but sometimes their sentence is much greater, because they can remain in hospital detention for years,” remarks Dr.D Borduas-Pagé, who follows patients who have been under the commission’s mandate for more than 30 years, while others were released after a year or two.
Studies have shown that patients who are found not criminally responsible and who are under the mandate of the CETM have a lower recidivism rate, because they have access to specialized care and follow-up as long as it is believed that they represent a risk.
Among the hospitals that detain people under the mandate of the CETM, we find the three university mental health centres, that of Quebec City, Montreal and the Douglas Institute, the Albert-Prévost mental health hospital, and general hospitals, such as Charles-Lemoyne Hospital. The Philippe-Pinel National Institute of Forensic Psychiatry, where security is more important, welcomes cases that represent a greater risk.