Re: Thinking Aloud by Trudy Klassen, "Mental disorder law needs to be changed."
Thank you for addressing this difficult issue and my condolences to the families of the two people killed and to those who were brutally assaulted with absolutely no provocation by a man ultimately judged "not criminally responsible on account of mental disorder" (NCRMD).
The mental illness of the accused, Mr. Goodridge, included the delusional belief that these killings were necessary to defend himself and to stop the angry voices in his head. Mr. Goodridge has also had a long history of serious mental illness and was not taking his antipsychotic medication when these horrendous events occurred. He is now in a special hospital receiving appropriate care and treatment for his illness.
In addition to the recommendations about discharge, I wish to raise some legal issues that could help prevent the occurrence of such senseless violence.
Before that, two points of clarification.
First, Ms. Klassen says that "at the discretion of his treatment team, this man will go free." It should be noted that while the medical team provides input, the decision for conditional or full release is actually made by an independent review board, with a lawyer as chair.
Next, Ms. Klassen is rightly concerned that psychopaths are responsible for a huge amount of violent crime. But the assumption that psychopaths fall under the NCRMD classification is incorrect. Although psychopaths have a mental disorder, they generally do not quality as "not criminally responsible" because they do know right from wrong.
It is important here to note the difference between psychopathy and psychosis.
Psychopathy is a disorder for which there is currently no psychiatric treatment.
However, many people in the forensic hospital system have treatable brain illnesses like schizophrenia and bi-polar, which cause psychosis.
A person suffering from psychosis has difficulty distinguishing what is real from what is not real. Symptoms include seeing or hearing things that are not there (hallucinations) and false beliefs (delusions). If treated in a timely manner, people with early symptoms of psychosis are unlikely to develop delusions or hallucinations that can lead to violent behaviors.
Some advocates say that people with a mental illness are no more dangerous than others. That is wrong. People with an untreated mental illness, like Mr. Goodridge, are indeed more dangerous. The good news is that, with treatment, people with psychotic illnesses are no more dangerous than others. In other words, violence is a treatment issue. Treatment works and it is key to preventing the senseless tragedies caused by untreated mental illness.
In the case of Mr. Goodridge, he was involuntarily admitted to hospital seven times in Alberta. These readmissions were likely related to not taking his medication. In B.C., the law requires that a person involuntarily admitted to hospital for a mental disorder will receive treatment for their illness. In addition, they may also receive treatment in the community if they will not voluntarily comply with essential conditions of their hospital discharge (taking prescribed medication, regular doctor's visits, stable residence).
Such laws are designed to reduce the awful consequences untreated mental illness that Mr Goodridge suffered and caused.
Citizens of British Columbia should actively lobby their MLAs to retain these important laws in the name of individual patient health and public safety rights.
Unfortunately, the B.C. Community Legal Assistance Society (CLAS) wants involuntary patients - including those in forensic hospitals like Mr. Goodridge - to be able to refuse the very treatment that is necessary for their release.
It is hard to believe that an organization supposedly dedicated to furthering human rights is advocating for laws that will deny liberty rights, since people with serious mental illness cannot be released if they do not receive treatment. As well as disrupting family and community life and denying personal autonomy, untreated patients are more likely to interfere with the rights of others, including assaulting nurses and other patients. They are also more likely to be put into restraints and seclusion because medical staff cannot provide treatment with antipsychotic medications,
Everyone agrees that patients and families should have input into treatment decisions. But to allow patients to refuse the very treatment required for their release is "madness."
I would urge people concerned with the well being of people with serious mental illness, their families and their communities to write to their MLA and to the B.C. Minister of Health and the Minister of Mental Health expressing their opposition to treatment refusal for involrmtary patients.
While these "pre-incident" suggestions will reduce the NCRMD findings, Ms. Klassen is expressly concerned about what happens when the ill person is released.
What if they go off their medication and reoffend?
The positive finding here is that people with NCRMD status who are fully released by a review board have much lower rates of reoffending than people released from prisons. However, a small number do commit an offence, usually not as serious as the initial offence. To ensure longer periods of supervision, review boards can keep a person on a conditional release order in the community and have their treatment supervised for many years if they are concerned about danger. For those patients released but who may relapse, a long-term supervision period makes clinical sense. I personally would support such a measure with appropriate safeguards. That is an issue for the federal government.
D. Halikowski, President
BC Schizophrenia Society
Prince George Branch
