A Review of the Interpretation of the Canadian Test for Fitness to Stand Trial.

In 1991, Canada introduced Bill C-30 to amend the Criminal Code (mental disorder). Bill C-30 codified accumulated law specifying the criteria for fitness to stand trial. This test was clarified in a landmark case, , which appeared to accept the limited cognitive capacity test.

Contributors to Physician Burnout and Well-Being in Forensic Psychiatrists in Canada.

The experience of burnout in forensic psychiatrists has not been well studied, with most studies focusing on the experiences of forensic nurses, the impact of vicarious trauma and compassion fatigue in forensic mental health professionals, and the risk of posttraumatic stress disorder related to workplace exposures. This study reports on a national survey (34% response rate) conducted with forensic psychiatrists across Canada to understand the rate of, and contributors to, burnout and professional fulfillment. Just over half of the physician respondents reported experiencing burnout, which is in line with other recent surveys in Canada that have indicated elevated levels of burnout since the onset of the pandemic.

An International Comparison and Review of Self-Induced Intoxication Causing Automatism.

The topic of self-induced intoxication causing automatism is a complex legal question that straddles the border of psychiatry, the law, and social policy. It has been argued that women and children are predominantly positioned as victims of sexual and domestic violence, in which substances often play a part. This consideration sensitizes society to any legal measures that may potentially excuse, mitigate, or absolve perpetrators.

Addressing the Mental Health Needs of Inmates Through Education for Correctional Officers-A Narrative Review.

Introduction: People with mental illness are overrepresented in correctional facilities. Correctional officers (COs) lack education to respond to inmates with mental illness. A review was conducted of mental health education programs for COs to identify factors related to effectiveness.

The Ontario Court of Appeal Takes a New Look at Automatism in .

Automatism has long been a significant topic of discussion between forensic psychiatry and the courts. In a recent case, the Ontario Court of Appeal addressed this concept in the setting of a Canadian law, s. 33.

International Child Abduction: The Complexities of Forensic Psychiatric Assessments Before the Hague Convention.

The Hague Convention is an international intergovernmental agreement that facilitates the return of abducted children to lawful parents across international borders. Children may not be returned if it can be established that the return would result in harm to the child. Forensic psychiatrists may be called upon to provide an expert opinion regarding the potential harm to come to a child, as well as various other psycholegal issues.

Toward a New Model of Training in Canadian Forensic Psychiatry.

The Royal College of Physicians and Surgeons of Canada has recently introduced a new model of training for residents and fellows in all specialties and subspecialties, including forensic psychiatry. This model, Competence by Design, is intended to improve the training of residents with the goal of increasing the competence of practicing specialists. In the Competence by Design model, training is broken down into four distinct phases.

Ethics, Empathy, and Detached Concern in Forensic Psychiatry.

Clinical medical ethics are ruled by the principles of beneficence and non-maleficence. In forensic psychiatry, however, the duty to serve as an agent of the justice system overrules these principles; thus, examination subjects may indeed experience harms incurred by the psychiatrist's testimony. Alan Stone argued more than 30 years ago that the participation of psychiatrists in legal proceedings runs two essential and opposing risks: skewing justice to serve patients and deceiving patients to serve justice.

Measurement-based care in forensic psychiatry.

Measurement-based care (MBC) is the systematic evaluation of a patient's symptoms or factors before or during an encounter. It is used to inform treatment and behavioral health interventions. This article argues that MBC is the natural consequence flowing from evidence-based practice.

Adaptation of the Clinical Global Impression for Use in Correctional Settings: The CGI-C.

Provision of mental health care in correctional settings presents unique challenges. There is a need for a simple-to-use tool to measure severity of mental illness in correctional settings that can be used by mental health staff from different disciplines. We adapted the severity scale of the Clinical Global Impression for use in correctional settings, which we have called CGI-C, and carried out a reliability study.

The American Academy of Psychiatry and the Law Practice Resource for Prescribing in Corrections.

The practice of prescribing in jails and prisons is often different from that in the community. Serious mental illness is common among inmates, and so are co-morbidities such as substance use, impulse-control, attention-deficit/hyperactivity, and personality disorders. Operational requirements, staffing, and the physical plant of the institution may complicate the provision of treatment according to community standards.

A comprehensive approach to managing threats of violence on a university or college campus.

Horrifying, high profile acts of violence on campuses remain relatively rare, nevertheless, academic administrators are required to manage threats of violence on campus on an increasingly regular basis. These threats take two primary forms, those in which the perpetrator and the intended victim(s) are clearly identified, often involving repeated threats and threatening behaviour towards an individual; and those involving anonymous threats to commit acts of larger scale violence. Complicating factors in managing these threats include: fear contagion; mass media and social media attention; responsibilities to all members of the university community sometimes including individuals issuing the threat and the intended victims; demands for safety and security measures that are often at odds with professional advice; and permeable campus boundaries that cause security challenges.

The Mock Trial: Revisiting a Valuable Training Strategy.

The number of forensic psychiatrists has increased dramatically over the past 40 years. With this welcome development has also come some challenges for educating future generations of practitioners, specifically the greater demands on training programs and the need to divide practice hours among a larger pool of individuals. Junior trainees and experienced practitioners alike can benefit by supplementing work experience with well-designed, theoretically informed simulations.

From schadenfreude to contemplation: lessons for forensic experts.

In 2005, the Chief Coroner of Ontario instituted a review into 45 cases of criminally suspicious child deaths about which a prominent pediatric forensic pathologist had expressed an opinion that the cause was homicide. Subsequently, a provincial inquiry was called to review the practice and oversight of pediatric forensic pathology in Ontario and to make recommendations to restore and enhance public confidence in forensic pathology. Recommendations from the inquiry addressed medical subspecialization, the evidentiary basis for expert opinion, oversight of the profession, and development of best forensic practices.

The case that has psychiatrists running scared: Ahmed v. Stefaniu.

In the three decades since the definitive decisions regarding duty to warn and protect, several cases have shaped psychiatric practice. In this article we present a tragic case that we postulate may have a significant effect on psychiatric practice in Canada. A psychiatric patient murdered a relative some 50 days after the patient left the hospital.

Commentary: attacks on Royalty--the more we know, the more we can classify.

Over the past 20 years stalking has increasingly been construed as a social, legal, and psychiatric problem that is distressingly common, causing significant harm to victims. Research in this area has demonstrated that there are recognizable features that groups of stalkers share and, by increasingly sophisticated classification, it is possible to make predictions about this phenomenon. It is anticipated that a new proposed classification can increase our ability to manage risk.

Advances in idiopathic scoliosis in children and adolescents.

The understanding of idiopathic scoliosis continues to evolve. At some time in the foreseeable future the term will be oxymoronic. It may eventuate, based on a series of laboratory and genetic tests, that there will be three groups: One in which the curve will never be of significance and regular follow-up is unnecessary.

The admissibility of expert evidence in Canada.

Recent decisions in Canadian Law suggest that it is evolving in a manner heavily influenced by American law. A recent Supreme Court decision uses the framework of prevailing law and superimposes the more stringent criteria enunciated in Daubert v. Merrell Dow Pharmaceuticals, Inc.

The diagnosis and treatment of back pain in children and adolescents: an update.

The conditions described for the most part are diagnosed by characteristic history, comprehensive physical examination, and selective laboratory and imaging studies. Most can be treated by nonoperative means. With the exception of tumors, surgical intervention is performed only after a thorough trial of conservative management.