The NCRMD Defense

Before answering the question we need to understand what DSM-5 is it is shortened from Diagnostic and Statistical Manual Of mental Disorders and the five shows how much it has changed over the years. This classification wouldn’t be possible without Emil Krapelin who developed the first modern classification system for abnormal behavior which helped form the first DSM. The DSM-5 list approximately 400 mental disorders each one explains the criteria for diagnosing the disorder and key clinical features and sometimes describes features that are often times not related to the disorder. The classification is further explained by the back ground information such as: research finds, age, culture, gender trends, and each disorder’s prevalence, risk, course, complications predisposing factors, and family patterns. The DSM-5 is the only one of the editions that seeks both categorical and dimensional information as part of the diagnosis, rather than categorical information alone (Comer, 2013, pp.100). Now that we know what DSM-5 is we need to know what categorical information and dimensional information mean. Categorical information refers to the name of the disorder indicated by the patient’s symptoms. An example of this would be when a clinician must decide if a patient is showing

It is sometimes argued that “the creators of DSM-III and DSM-IV sacrificed validity for the sake of reliability”(Wakefield, 1992, cited in Gray, 2002, p 614). This refers to greater emphasis being placed upon superficial symptoms and less upon underlying symptoms and possible cause which could have an important influence upon individuals (Gray, 2002). Since behavior always involve interaction between the individual and their environment, it can be difficult to assess whether the disorder is within the person or whether it is an environmental influence such as a traumatic experience or related to poverty (Gray, 2002, p.612). This can cause problems when diagnosing is extremely difficult to scientifically distinguish between people’s normal responses or whether it is something more (Gray, 2002).

The strengths when working with clients on a medical model perspective is that the use of the DSM provides a common language to use in the medical community. The DSM provides reliability and structural guideline to each mental disorder. The structural guidelines in the DSM provide an organized list of criteria and specifiers to help determine the severity of the mental disorder. When diagnosing a client, there are many similar signs and symptoms to each mental disorder; thus, the DSM provides the clinician information about differential diagnosis, prevalence, possible co-morbidity, age of onset, and progressive development of symptoms. Hence, focusing on the medical model and using the DSM can be beneficial to both the client and the clinician providing treatment.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has a number of features. First of all, every disorder is identified using a name and a numerical code. In addition, the manual provides the criteria for diagnosing each disorder as well as establishes subtypes of a disorder and examples that would illustrate the disorder. The manual goes further by addressing the typical age of onset, culturally related information, gender-related information, prevalence of a disorder, typical clinical course of a disorder, typical predisposing factors of a disorder and genetic family patterns of a disease (Summers, 2009). The DSM-IV is a tool that is used by mental health practitioners and social service workers. As has been demonstrated

The insanity defense has become popularized by criminal television shows, but it is not used as portrayed. According to Dr. Zachary Torry, a psychiatrist, the defense is actually used in one percent of cases and not even one-fourth of those cases will succeed in front of a jury (Torry). Furthermore, the legal definition of insanity is very different than the societal definition. As stated by George Blau, a criminal defense lawyer, “insane” does not describe someone who is psychotic or crazy, but it instead describes someone who does not know the difference between right or wrong. They are found not guilty by reason of insanity (NGRI) because one of the three traits of a crime is not evident. The three traits are a guilty mind (mens rea), a prohibited act, and a pre-established sentence (Blau). For the insane, there is no mens rea because someone cannot feel guilty for an act that they do not know is wrong. Therefore, those found NGRI have a different punishment than those convicted of a crime. Their sentence is often time at a mental institution where treatment is available, but the sentences can be irregular and unchecked by government associations. Therefore, the insanity defense may need to be amended, by requiring monitoring of the cases and adopting the mens rea approach or to be completely abolished because of its potential improper use and a lack of proof.

Since our justice system is designed to punish those who have deliberately chosen to do something wrong, there is a defence for those who have a “disease of the mind” (Verdun-Jones, Criminal Law in Canada, 2015, p. 206) because they, technically speaking, did not choose to do so in their right mind. Such defence is the defence of “not criminally responsible on account of mental disorder” (Verdun-Jones, Criminal Law in Canada, 2015, p. 204). As stated in section 16(1) of the Criminal Code (Carswell, 2015):

It is to be submitted that the proposal of the Law Commission in the 2013 Discussion Paper presents on balance the most fitted approach to non-responsibility defences, since it eradicates the current illogical distinction between ‘insanity’ and ‘automatism’. Under this proposal, the ‘M’Naghten rule’ should be abolished and replaced by a new non-responsibility defence relevant to those cases of ‘total lack of criminal capacity resulting from a recognised medical condition (provided the other criteria of the defence are met) without limiting it to mental disorders’, assuming no culpable fault. The pertinent criminal capacities in this defence are the abilities to make a rational judgment, to comprehend the wrongfulness of a conduct and to have control of one’s body. This general defence would lead to the special verdict ‘not criminally responsible by reason of a recognized medical condition’ and disposal powers may attach. Under the ‘recognised medical condition defence’ the accused would only have an evidential burden and it would be for the prosecution to disprove beyond reasonable doubt that he/she is not criminally liable by reason of a recognised medical condition. Regarding automatism, the common law defence would be abolished and the reformed defence would be

In most cases, the Actus Reus, meaning a “guilty act” would be present, however may vary for the case for the Mens Rea element, meaning a “guilty mind”. Without either of these two elements, the defendant is not guilty, which can apply in the cases for Not Criminally Responsible offenders. When understanding the mind of an NCR offender, it is critical to grasp the Mens Rea within the crime because if a mental illness had prevented for the “guilty mind” to be present during the time of the crime, should it really be the mentally ill offender’s fault? Under Section 16 of the Criminal Code of Canada, an individual can only be considered as an NCR offender if either the mental disorder made it impossible for the offender to understand the morality of their actions and/or the offender could not understand the nature or quality of their actions (Legal Aid Ontario, n.d.). A judge can establish an NCR assessment whenever the defendant pleads guilty, however, this may vary from case to case (Legal Aid Ontario, n.d.). The NCR assessment is taken into account when proving the credibility of the mentally ill offender and whether or not their actions were intentionally towards a person when committing the crime (Mental Health Commission of Canada, 2013). Therefore, to be considered a NCR offender itself is a difficult argument to prove in court. In addition, the offences that a mentally disordered civilian has been presumed to commit must be proven to the court with the Mens Rea element present. According to a study by the Mental Health Commission of Canada (2013), most NCRMD individuals who have been accused of one of the violent offenses such as homicide, attempted murder, and sexual offences, have been diagnosed in the psychosis spectrum, being 37.8%, while 68.9% (113 individuals studied) had psychosis issues. About 21% have personality disorders, 23.6% with

Many cases require alternate defences for those who suffer from mental disorders, this defence is known as Not Criminally Responsible on Account of Mental Disorder also known as NCRMD. A defence such as this is used to explain that the perpetrator had a disorder that made them unaware of the crime they had committed and that the crime was wrong. Applying NCRMD as a defence can be difficult as there are many requirements a person needs to meet before they are deemed not responsible. In some cases, it is hard to prove that the offender had a mental disorder at the time of the crime and that it is a valid defence as to why they committed the crime unknowingly. There is a lot of discussion around NCRMD being successful or unsuccessful and what should happen to the offender if they are deemed NCRMD. A recent case where NCRMD was used as a defence and was successful, was in the case of David Siu. NCRMD is a successful and valid defence if it is used in the right case to protect those in the system with mental disoders.

The Criminal Code of Canada provides for the NCRMD defence in section 16, part of which states that: “No person is criminally responsible for an act committed or an omission made while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or omission or of knowing that it was wrong.” In reference to the case of R. v. Chaulk (1990) 3 S.C.R, the Supreme Court of Canada determined that the word ‘wrong’ in reference to all cases of regarding NCRMD means both ‘legally wrong’ and ‘morally wrong.’ In order to claim a NCRMD defence, the defendant must prove on a balance of probabilities that the accused was

The DSM is a classified system used by psychiatrist and other clinical professions in order to diagnose clients and patients who show signs of some type of disorder. The two advantages of using this model or classification system ranges from the validity of an assessment used by clinicians and other health care professionals. Build around the concepts and purposes for the DSM model is that it supports a number of standard assessments of diagnosing different treatment providers. Furthermore, (Comer, J. 2016) suggest that the DSM-5 requires clinicians to provide both categorical and dimensional information which is part of being consistent in diagnosing. From a categorical perspective this refers to the name of a particular category of a disorder which is indicated on behalf of the client’s symptoms. From the dimensional perspective it is a rating of how the client symptoms and the severity of the dysfunction through various dimensions.

Being able to form a diagnosis properly for a client is a process that is wide-ranging and broad. The Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association [APA], 2013) supports recommendations and standards for identifying a diagnosis for a client. The procedure of diagnosing is more than skimming for symptoms in the DSM; one must assess, interview and identify issues, as well as refer to the DSM for a diagnosis.

Filicide can be defined as the act of murdering one’s own child or children; acts of filicide are normally projected loudly in media. There are cases of filicide in which the defense of the accused, plead as not criminally responsible on account of mental disorder referred to as NCRMD. In order to submit the verdict of NCRMD, the criminal act must have been committed at a time in which the accused had already been previously diagnosed with a mental disorder; therefore, resulting in the prevention of understanding the act and its quality. Similarly, in the R. v. Schoenborn case, Schoenborn sought for defence of NCRMD while being charged with first-degree murder for his three children. He had been attempting to fix his relationship with his life partner but was rejected; thereafter, he brutally murdered their children in his partner’s trailer home in Merritt, British Columbia. He was found NCRMD in April 2008 and was held at the psychiatric hospital in Coquitlam, British Columbia. Recently, he has been granted day passes to be in the community outside of the psychiatric facility. There are many cases like this one, where different factors lead to the act of filicide. These factors associated to filicide may be situational, including separation, substance abuse and various others. There are numerous filicide cases in which NCRMD is included; therefore, making it evident that mental health is a significant risk factor. It is essential that one assesses what

The diagnostic process for personality disorders currently covers a broad scope of various tests and symptoms, causing a source of frustration for psychiatrists (Aldhous). The symptoms and side effects of several personality disorders can tend to blur together, making diagnosis challenging (Aldhous). Most psychiatric patients are diagnosed with several personality disorders at once, with twenty percent of people with personality disorders simply diagnosed with a “personality disorder not otherwise specified” (Aldhous). Using the Diagnostic and Statistical Manual of Mental Health Disorders, commonly referred to as the DSM, psychiatrists attempt with great difficulty to categorize their patients into a specific disorder, only to diagnose

Roy Blunt, American politician, once said, “People with mental health problems are almost never dangerous. In fact, they are more likely to be the victims than the perpetrators. At the same time, mental illness has been the common denominator in one act of mass violence after another.” There is a misconception that mental disorders such as dissociative identity disorder and schizophrenia are the same. Today’s society often see all mental disorders as one, however, they are very much different. If one was to say someone with multiple personalities is the same as someone who has hallucinations and/or has delusions, they are incorrect, which is why in specific cases such as schizophrenia, the legal term “not guilty due to mental disorder” should be valid.