A Rake’s Progress in a New Politics of Risk: Examining the Construction of Risk and Mental Disorder in Not Criminally Responsible on Account of Mental Disorder (NCRMD) Disposition Hearings in Ontario

In Canada, individuals accused of a criminal offence can raise a defence of Not Criminally Responsible on Account of Mental Disorder (NCRMD), stating they were suffering from a mental disorder that rendered them incapable of appreciating the nature or quality of the act, or of appreciating that it was wrong. Individuals found NCRMD are then rendered under the jurisdiction of a provincial mental health review board tasked with evaluating whether or not the individual represents a significant risk to the safety of the public.\ud This study adopted a methodological approach using qualitative content analysis to investigate the construction of risk in the decision-making process of the Ontario Mental Health Review Board (ORB). Results from the analysis of 30 printed rationales for decision, the justificatory document for any disposition made by a review board, indicate some ambiguity in conceptualizing risk and justifying the dispositions made by the ORB. In an effort to open the black-box of these justificatory documents, this study notes the objectivity effect of a medicalized language that obfuscates understanding of terms used by the ORB to justify risk assessments. Ultimately, the complexity of the notion of risk is reduced to a function of medical-biological psychiatric diagnostics and intervention, community or social normativity, and secondary risk management (defensive decision-making by professionals involved in the review process). These interpretations are then discussed in terms of policy implications under a new politics of uncertainty (Power, 2004)