The Review Board Systems in Canada: An Overview of Results from the Mentally Disordered Accused Data Collection Study

3. Results (cont’d)

3.5 Primary Diagnosis

Just over half of the accused within the Review Board systems (51.7%) had a single diagnosis, while 29% had two diagnoses on file and 18.4% had three or more. The results in Table 10 represent the "primary" diagnoses, which was determined according to the following hierarchy: schizophrenia, affective disorder, organic brain disorders, mental retardation, delusional disorders, personality disorders, substance abuse disorder, and other diagnoses. For example, if an accused was diagnosed with an affective disorder and a substance abuse disorder, the primary diagnosis was coded as an affective disorder.

When comparing NCRMD and UST accused, NCRMD accused were more likely to have been diagnosed with affective disorders and personality disorders while UST accused were more likely to have been diagnosed with mental retardation and organic brain disorders or to have not had a diagnoses on file.

Table 10 – legal status (ncrmd/ust) by primary diagnosis
Diagnosis Type NCRMDN (column %) USTN (column %) TOTALN (column %)
Schizophrenia 3,518 (51.7%) 1,054 (56.2%) 4,571 (52.7%)
Affective disorders 1,812 (26.6%) 245 (13.1%) 2,057 (23.7%)
Delusional disorders 310 ( 4.6%) 77 ( 4.1%) 387 ( 4.5%)
Mental retardation 206 ( 3.0%) 170 ( 9.1%) 377 ( 4.3%)
Personality disorders 302 ( 4.4%) 45 ( 2.4%) 347 ( 4.0%)
Organic brain disorders 150 ( 2.2%) 125 ( 6.7%) 274 ( 3.2%)
Substance abuse disorder 166 ( 2.4%) 17 ( 0.9%) 182 ( 2.1%)
Other diagnoses 310 ( 4.6%) 95 ( 5.1%) 405 ( 4.7%)
No diagnosis on file 28 ( 0.4%) 49 ( 2.6%) 78 ( 0.9%)
  • Percentages may not always total 100% due to rounding error.
  • Totals may not be exact due to the rounding of the weighted data.

If an accused was diagnosed with schizophrenia and a substance abuse disorder, the substance abuse disorder diagnoses would not be reported in Table 10. Therefore, in order to understand how often each particular diagnosis occurs within the NCRMD/UST population, Table 11 provides information on all primary, secondary and tertiary diagnoses. Although not often coded as a primary diagnosis, more than one–quarter of NCRMD/UST accused had been diagnosed with a substance abuse disorder and approximately 18% with a personality disorder. The same differences between NCRMD and UST accused found in the primary diagnoses found in Table 10 were also found in Table 11.

Table 11 - primary, secondary and tertiary diagnoses
Diagnosis Type NCRMD N (%) UST N (%) TOTAL N (%)
Schizophrenia 3,518 (51.7%) 1,054 (56.2%) 4,571 (52.7%)
Affective disorders 1,914 (28.1%) 254 (12.5%) 2,168 (25.0%)
Substance abuse disorder 2,137 (31.4%) 365 (19.4%) 2,502 (28.8%)
Personality disorders 1,304 (19.2%) 235 (12.5%) 1,539 (17.7%)
Mental retardation 474 (7.0%) 270 (14.4%) 744 (8.6%)
Delusional disorders 403 (5.9%) 79 (4.2%) 482 (5.6%)
Organic brain disorders 207 (3.0%) 150 (8.0%) 357 (4.1%)
Other diagnoses 1,177 (17.3%) 376 (20.0%) 1,552 (17.9%)
  • Percentages do not total 100% as many accused received more than one diagnosis.
  • Totals may not be exact due to the rounding of the weighted data.

Table 12 contains information on the relationship between the primary diagnosis and demographic information. Youth were less likely than adults to have been diagnosed with schizophrenia, affective disorders or delusional disorders but much more likely to have been diagnosed with mental retardation or "other diagnoses". Seniors were much less likely than adults to have been diagnosed with schizophrenia and affective disorders but much more likely to have been diagnosed with delusional disorders, organic brain disorders and "other diagnoses".

Females were less likely than males to have been diagnosed with schizophrenia but more likely to have been diagnosed with affective disorder.

Aboriginal accused were less likely than non–Aboriginal accused to have been diagnosed with the common diagnoses (i.e., schizophrenia, affective disorders) and much more likely to have been diagnosed with mental retardation and substance abuse disorders.

Table 12 – primary diagnoses by demographic information

In addition to the general diagnoses, information was collected on Fetal Alcohol Spectrum Disorder (FASD) separately, even when it was also coded as an organic brain disorder. The results revealed that 65 accused had a suspected or confirmed diagnosis of FASD. Although this represented only 0.4% of NCRMD accused, it represented 2.1% of UST accused. As well, there were significant differences according to age and Aboriginal status. Slightly more than one in ten accused youth under 18 years of age (11.5%) had a suspected or confirmed FASD diagnoses compared to only 0.5% of adult accused. In addition, approximately 14% of Aboriginal accused had a confirmed or suspected FASD diagnosis compared to 0.2% of non-Aboriginal accused. In fact, when Aboriginal status and age are combined, the issue becomes even clearer – 73.7% of Aboriginal youth under the purview of Review Boards had a confirmed or suspected diagnosis of FASD. It should be cautioned, however, that the number of Aboriginal youth in the sample was very small. As well, given the case law in Saskatchewan that suggests a relatively high number of youth diagnosed with FASD are being found UST, the lack of data from Saskatchewan and Manitoba is particularly problematic in this instance.

As Table 13 indicates, there were also specific differences in offending behaviour according to the primary diagnosis. For example, compared to the overall percentage, accused diagnosed with mental retardation were much more likely to be charged with sexual offences and much less likely to be charged with violent offences. In addition, accused diagnosed with an organic brain disorder were also more likely to be charged with a sexual offence. Again, in comparison to the overall percentage, accused diagnosed with a delusional disorder were more likely to be charged with a violent crime as were accused diagnosed with a substance abuse disorder. Finally, accused diagnosed with an affective disorder were more likely to be charged with a non-violent crime compared to the general percentage.

Table 13 – Offence type by primary diagnosis
Diagnosis Type Violent N (row %) Sexual N (row %) Non-Violent N (row %)
Schizophrenia 3,435 (75.1%) 218 (4.8%) 919 (20.1%)
Affective disorders 1,420 (69.0%) 53 (2.6%) 584 (28.4%)
Other diagnoses 317 (78.2%) 11 (2.8%) 77 (19.0%)
Delusional disorders 319 (82.6%) 2 (0.5%) 65 (16.9%)
Mental retardation 166 (44.1%) 153 (40.5%) 58 (15.4%)
Personality disorders 254 (73.2%) 11 (3.3%) 82 (23.5%)
Organic brain disorders 196 (71.3%) 28 (10.0%) 51 (18.7%)
Substance abuse disorder 149 (81.7%) 6 (3.3%) 27 (15.0%)
No diagnosis on file 46 (59.4% 11 (13.9%) 21 (26.7%)
Total 6,302 (72.6%) 493 (5.7%) 1,884 (21.7%)

Percentages may not always total 100% due to rounding error.

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