To detain or to release? Correlates of dispositions for individuals declared not criminally responsible on account of mental disorder

Can J Psychiatry. 2011 May;56(5):293-302. doi: 10.1177/070674371105600508.


Objective: The extent to which risk assessment advances have influenced release decision-making by review boards (RBs) of individuals found not criminally responsible on account of mental disorder (NCRMD) remains unclear. Our objective is to identify the psychosocial, criminological, and risk measure correlates of RB decision-making.

Method: Data were collected through structured interviews and file reviews conducted between October 2004 and August 2006 in the sole forensic psychiatric hospital in Quebec and in 2 civil psychiatric hospitals in a large metropolitan area designated to care for people found NCRMD. The final sample consisted of 96 men.

Results: Dynamic, clinical risk factors are associated with decisions to detain or release people found NCRMD, rather than traditional historical risk factors such as criminal history.

Conclusion: Dynamic variables seem appropriate for the RBs to consider given the intention of the NCRMD legislation. Further, dynamic variables provide direction for titration of treatment and supervision. Results are discussed regarding enhancing evidence-informed RB dispositions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Comprehension
  • Crime / legislation & jurisprudence
  • Crime / psychology*
  • Decision Making
  • Forensic Psychiatry
  • Hospitals, Psychiatric / legislation & jurisprudence
  • Humans
  • Insanity Defense*
  • Interview, Psychological
  • Male
  • Mental Competency
  • Mental Disorders* / complications
  • Mental Disorders* / diagnosis
  • Mental Disorders* / psychology
  • Middle Aged
  • Patient Discharge* / legislation & jurisprudence
  • Patient Discharge* / standards
  • Professional Staff Committees* / legislation & jurisprudence
  • Professional Staff Committees* / standards
  • Quebec
  • Risk Assessment / methods*