Files on all 48 Alberta patients under Warrants of the Lieutenant Governor were reviewed in late 1984, early 1985. Few were on Warrant as a result of unfitness to stand trial and all carried a primary diagnosis involving major mental disorder. More than half were considered paranoidal. Two-thirds of the population had killed someone or attempted to do so. Only eight had not previously been inpatients in psychiatric hospitals. Nearly half of the patients offended against relatives. Close to two-thirds had a previous criminal record. The Alberta Hospital's Forensic Service is described as is the province's Board of Review. Two briefcase studies help portray the system of gradual release. The authors comment on the design of services for this group of patients known to be hard to treat and administer.
References
1.
Information obtained at the Annual Meeting of the Lieutenant Governors’ Boards of Review, Banff, Alberta, October 1984.
2.
The most recent survey was by Webster CD, Phillips MS, Stermac L. Persons held on warrants of the Lieutenant Governor in Canada. Canada's Mental Health 1985; 33: 28. The only other such study of the Canadian WLG population was by Quinsey VL, Boyd BA. An assessment of the charactristics and dangerousness of patients held on warrants of the Lieutenant Governor. Crime and Justice 1977; February: 268.
3.
JobsonKBCommitment and release of the mentally ill under criminal law.Criminal Law Quarterly1969; 11: 186–203.
4.
PhillipsMS, LandauT, OsborneCPersons discharged from warrants of the Lieutenant Governor. Can J Psychiatry 1987; 32(5): 343–350. Phillips MS, Landau T, Sepejak DS, Osborne C. The Advisory Review Board and characteristics of patients on warrants of the Lieutenant Governor in Ontario.Bull Am Acad Psychiatry Law1983; 13: 373–384.
5.
For a summary, see QuinseyVLThe long-term management of the mentally abnormal offender. In: HuckerSJ, WebsterCD, Ben-AronMH eds. Mental disorder and criminal responsibility.Toronto: Butter-worths,1981.
6.
HodginsSA follow-up study of persons found incompetent to stand trial and/or not guility by reason of insanity in Quebec.Int J Law Psychiatry1983; 6: 399–411.
7.
Law Reform Commission of Canada.Mental disorder in the criminal process.Ottawa: Ministry of Supplies and Services,1976.
8.
SharpeG, RichterJMental disorder project: criminal law review draft recommendations. Unpublished paper 1984.
9.
GlasbergR, WayneIThe beginning of a new story: post release adjustment of men found not guility by reason of insanity. In: HuckerSJ, WebsterCD, Ben-AronMH eds. Mental disorder and criminal responsibility, 1981.
10.
The present Clinical Director — Forensic, A.D. Milliken, M.D., has pointed out that the view projected in the text here, though adequate, could provide more detail about the kinds of control issues which can and do arise between the hospital and the half-way house. It is his view, one he would doubtless be willing to discuss with anyone about to establish a half-way house for WLG patients, that the hospital would do well to retain some authority over staff selection and performance.
11.
WeisstubDNLaw and psychiatry in the Canadian context.New York: Pergamon,1980: 719–720.
12.
See WebsterCD, PhillipsMS, StermacL, HodginsSEstablishing a Canadian data base for forensic psychiatric patients under warrants of the Lieutenant Governor: rationale and feasibility.Report to Department of Justice,Canada, 1985.
13.
MonahanJPredicting violent behavior: an assessment of clinical techniques.Beverly Hills: Sage,1981.
14.
Such a house exists on the grounds of the Forensic Psychiatric Institute of the Forensic Psychiatric Services Commission of British Columbia.
15.
SavageHSThe relevance of the fitness to stand trial provisions to persons with mental handicap.Autonomy1980; 1: 3.
16.
HansenDJSt. LawrenceJS, ChorstoffKA.Effects of interpersonal problem-solving training with chronic aftercare patients on problem-solving component skills and effectiveness of solutions.J Consult Clin Psychol1985; 53: 167–174.
17.
BoydNOntario's treatment of the ‘criminally insane’ and ‘potentially dangerous’: the questionable wisdom of procedural reform.Can J Criminol1980; 4: 151–167.
18.
GriffithsCT, KleinJF, Verdun-JonesSNCriminal justice in Canada: an introductory text.Toronto: Butterworths,1980. See especially pp. 333–338.
19.
A brief unpublished 1985 report by Mr. Walter Coombs, R.S.W./C.S.W., Supervisor, Forensic Social Work Unit, Alberta Hospital, is of considerable help in understanding the function of the specialized half-way house. In a 5-year period from December 1979 to December 1984, the programme has accommodated 56 persons who have accounted for 74 placements. Twenty-one of those 56 have been WLG patients. It appears that the WLG patients, more than the civilly committed ones, alternate more often between living in the house and living in the hospital. But, as Mr. Coombs points out, this could have more to do with the WLG status than the patient's mental condition per se. He also makes the point that the adjustment of the WLG patients is made relatively more difficult because, not infrequently, they have killed or hurt the very relative who otherwise might have taken care of them. Coombs explains in his report that over half of the 74 placements have resulted in individuals being placed in less secure living circumstances. His summary conclusion bears repeating here: “Because those accepted as residents have rehabilitation problems which are compounded as a consequence of mental illness and criminal offences, this venture should be viewed as a significant achievement. Since the majority of residents were schizophrenic with a paucity of “significant other” support, limited educational skills and relatively lengthy institutionalizations, the results are satisfying and justify the expense and effort deemed necessary to support such a programme” (p. 2).
20.
Our understanding of procedures in Alberta was greatly aided by the Honourable Neil Primrose, Q.C., Chairman, Alberta Review Board and by Ms. Lorraine Russell, Secretary to the Board of Review, who kindly provided much helpful information.
