Abstract
Background: Given the severity of their actions, forensic clients with an index offence of homicide are of particular concern to the safety of our community. Previous research has identified that many individuals who are found not criminally responsible (NCR) have had many touch points with the healthcare system prior to their offence.
Methods: We used a quantitative, retrospective, and archival study design to review electronic health records of individuals found NCR and were being treated in the forensic service at a provincial psychiatric hospital between 2014-2017. Recorded variables fell under three main categories: demographic, clinical, and legal. Basic descriptive and frequency analyses were used to examine the characteristics of the forensic patients in an attempt to better understand the trajectories of these individuals prior to the index offence of homicide.
Results: All of the individuals in this study had a primary diagnosis of schizophrenia. We found that patients had many psychiatric hospitalizations before the index offence (median = 4.21). Similarly, many individuals (n = 25, 73.5%) also had previous criminal justice involvement. Across the sample, 67.6% were using drugs and/or alcohol at the time of their index offence. Most patients committed second degree murder (n = 21, 61.8%), followed by patients who had committed first degree murder (n = 10, 29.4%). The majority (n = 19, 55.9%) of victims were family members of the forensic patients and the other categories of victims included strangers (n = 6, 17.6%), neighbours/roommates (n = 5, 14.7%), and friends/coworkers (n = 4, 11.7%).
Discussion: Our findings provide needed information to help us understand the trajectory of healthcare utilization and criminal justice involvement of individuals who eventually commit a crime of homicide and are found NCR. The better we can understand the characteristics and behaviour of these individuals prior to their serious crime, the better we can proactively engage these individuals and improve outcomes for everyone.
