National Trajectory Project Part I: A Study of Individuals Declared Not Criminally Responsible on Account of Mental Disorder in Canada

Project number: 
Approval date: 
Monday, July 28, 2014
Principal Investigator: 
University of British Columbia (UBC)
Funding Agency: 
Mental Health Commission of Canada,Canadian Institutes of Health Research(CIHR)
Datasets requested: 
Mental Health (BC Ministry of Health)
Medical Services Plan (BC Ministry of Health)
Deaths (BC Vital Statistics Agency)
Hospital Separations (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
PharmaCare (BC Ministry of Health)
Consolidation registry (Ministry of Health)
Research objective: 

There are 8 objectives to this study:

1) Explore the demographic, psychosocial, and criminological profile of people declared NCRMD in Canada as a function of geographical region and type of institution of detention.

2) Evaluate the importance and systematization of violence risk assessments presented to the Review Boards.

3) Report the rationale for decisions made by the Review Boards as a function of the disposition rendered (absolute discharge, conditional discharge, or custody).

4) Establish rates of criminal recidivism and psychiatric rehospitalization of discharged offenders as well as track positive outcomes.

5) Examine the migration trajectories or sedentary patterns of people declared NCRMD.

6) Identify the individual and organizational factors associated with these trajectories.

7) Determine the use and predictors of mental health services by this clientele prior to NCRMD verdict, during the jurisdiction of the Review Board, and following discharge.

8) An economic analysis of the costs associated with health services (i.e., mental health services, physical health services, prescription medications) used by this study sample will be examined.

In addition, each of these objectives will be examined with respect to culture and gender of NCRMD individuals.

*The current study is an exploratory and descriptive study. As such, many of the objectives do not have specific hypotheses.

Objective 7: We hypothesize that service use preceding the criminal offence (P1) will predict service use in subsequent periods (P2 and P3), thus increasing the power to detect the effects of other variables. We will then be in a position to test the hypothesis that the greater relevance and systematization of risk assessment presented before the Review Board will be associated with a return to the health region of origin when services are readily available, in the case of Quebec and possibly Ontario. If the return to the health region of origin is away from urban areas, service use is likely to be lower because service use is generally limited in rural areas. The analyses will be adjusted with the use of co-variables (age, gender and severity of offence). If the hypothesis is confirmed, these results would provide support in favour of better/increased training for the Review Board members and clinicians outside of large metropolitan areas.

Page last revised: September 2, 2019