Mental Health: Not Criminally Responsible
Originally published in The Local. Reprinted in the Globe and Mail.
On Jan. 22, 2012, 19-year-old Ahmed Sualim walked into a convenience store in Toronto’s Caledonia-Fairbank neighbourhood, pointed a silver revolver at the cashier and left with $200. Four days later, Mr. Sualim held up an Esso station. Three days after that, he ran off with a diamond ring from a Peoples Jewellers in Scarborough.
The stickups quickly escalated, becoming more frequent and brazen. By the time he was arrested on Feb. 1, he had stolen $80,000 worth of cash and jewels in 10 separate incidents. The cops had fingerprints and video surveillance linking him to the crimes. In the fall of 2014, a judge sentenced Mr. Sualim to more than five years in jail.
While the trial was relatively straightforward, the story was more ethically complicated than it initially appeared. For a long time, Mr. Sualim had been mentally unwell. In his adolescence, he’d spent hours talking to himself in the bathroom mirror. He’d warned his family that nefarious forces were plotting to bomb their home and complained about recurrent headaches, which he attributed to a chip having been implanted in his brain. Throughout the week of the crimes, he’d listened repeatedly to the song Otis by Jay-Z and Kanye West, and believed that there was a message for him embedded in the lyrics. “I was hearing voices saying rob,” he told a clinician, “but Jay-Z said it was okay, that I would not be in trouble.”
In 2017, Mr. Sualim’s lawyers appealed his conviction, arguing that at the time of the robberies he’d been in the grips of a psychotic episode. They hoped to overturn the guilty verdict and have it replaced with a designation of “not criminally responsible.” An NCR ruling doesn’t render a person innocent. Rather, it specifies that the defendant committed the crimes in question but cannot be deemed criminally accountable, because they were not mentally capable at the time of making ethical choices. NCR patients are transferred from the criminal-justice system to the health-care system, which has an entire field, called forensic psychiatry, devoted to their recovery.
Mr. Sualim won his appeal and was later given NCR status. In the summer of 2018, he was brought to the forensic ward at the Centre for Addiction and Mental Health (CAMH), Canada’s largest psychiatric hospital, where he was to be confined until doctors determined that he no longer presented a public risk.
Mr. Sualim’s crimes – a series of mid-level robberies, followed by a speedy arrest – were always of limited interest, and the story would have disappeared from the public record had it not been for a series of events last summer that had little to do with him.
First, in early June, Kleiton Da Silva, who’d been given NCR status after killing a man in a street brawl, went missing from CAMH and allegedly robbed a bakery. A month later, Zhebin Cong, who’d been found NCR for stabbing a man to death in a boarding house, went AWOL and then fled the country. In late July, Mr. Sualim also left CAMH under the supervision of a hospital staff member and then walked off on his own.
Because Mr. Sualim’s disappearance happened so shortly after the more dramatic incidents involving Mr. Da Silva and Mr. Cong, it got folded into the media narrative. Outlets reported that CAMH had seen a spate of “escapes” in two months. Pundits wrote panicked op-eds about the threat to public safety. In a radio interview, Ontario Premier Doug Ford referred to NCR patients as “animals.” “We’ve got to put these people away,” he later argued, “and if they have mental-health issues they can be dealt with in jail – simple as that.”
The Globe and Mail recently revealed that at CAMH disappearances such as Mr. Sualim’s happened more than 300 times in the past decade and as many as 43 times a year. Other forensic facilities in Canada may have slightly higher or lower rates, but such incidents occur everywhere. When confronted with such data, it’s hard not to instinctively agree with Mr. Ford that the system is failing. But a closer look shows that the opposite is true. The fact that NCR patients sometimes go missing is evidence that a complex, responsible system is working well.
This is an excerpt. Read the full text here.