Kimberlie Dean, Sara Singh, and Yin-Lan Soon
Amongst those with mental illness and a history of contact with the criminal justice system (CJS), “forensic patients,” constitute a small but significant subgroup. They typically have severe mental illnesses and have been charged with serious violent offences. As a group, they characteristically have complex mental health and other needs,1 and concern about their risk of reoffending is a key consideration for those tasked with oversight of their treatment and detention. As a result, forensic patients often spend long periods in secure mental health facilities2 and are often subject to high levels of supervision once judged to be safe to return to the community.
In many ways, the existence of this group of patients represents a failure of preventative mental health care – a criminalization of those with mental illness that lies at the extreme end of a spectrum of such criminalization. While diversion away from the CJS into mental health care following a serious index offence is a common outcome for those with severe mental illness, it can be seen as an act of diversion that has come late and at great cost, including for the victims of the serious violent offences typically committed. This review will consider the decriminalizing potential of efforts to prevent both initial and repeat contact with the CJS for those with severe mental illness, particularly for the subgroup of forensic patients.