Although social attitudes and the law tend to lag behind advances in treating people with mental illness, the law in Canada is starting to give them more respect than it used to.

So reported the Chief Justice of the Supreme Court of Canada—Beverly McLachlin—at the annual meeting of the American Academy of Psychiatry and the Law in Vancouver, British Columbia. The meeting was held last month.

Criminally charged mentally ill persons in Canada once faced a sort of no-win situation. If they were found sane, they had to stand trial like other criminals and take the consequences, but if they were found insane and did not have to stand trial, they were locked up, often for years. Thanks to actions by the Canadian justice system and the Canadian Parliament, however, criminally charged mentally ill Canadians now have a new option, McLachlin pointed out. It is called a "mental disorder defense."

Under this new kind of verdict, McLachlin explained, the accused goes before a review board. The review board determines whether the person poses a risk to the public and decides whether he or she should be institutionalized or discharged and what kind of treatment is appropriate. The person must also appear before the review board annually after that to determine how to be further handled.

The mental disorder defense has survived constitutional scrutiny and seems to work well on the whole, she said, although it is certainly not without its challenges—say, ascertaining the risk that a criminally charged mentally ill person might pose to the public.

"Research has undermined the stereotype of the mad criminal," McLachlin said. It is now clear that the mentally ill are not necessarily mentally ill forever. "The emphasis is not on punishment, but on protection of the public and rehabilitation," she stressed.

This new verdict, she added, shows that Canadians have made "enormous advances in bringing the criminal system up to speed" with what is known about mental illness.