man in prison looking into camera
Sean Clifton was found "not criminally responsible" for nearly stabbing a woman to death in Cornwall, Ont. and was in a psychiatric hospital (Photo: courtesy of J.S. Kastner Productions)

Topics: Justice | Health

John Kastner’s bold documentaries change minds about mental illness

People "not criminally responsible" for horrible crimes can be rehabilitated, maybe even forgiven


Justice was not seen to be done by most Canadians two years ago when a Toronto jury declared Richard Kachkar “not criminally responsible” after he ran down and killed a police officer in 2011 with a stolen snowplow. They were shocked when authorities in Manitoba allowed Vince Li, who beheaded a fellow bus passenger, to make escorted day trips to nearby Winnipeg from the Selkirk Mental Health Centre. Vancouver was still shaking with outrage that authorities there were considering the same privileges for Allan Schoenborn, the Merritt, B.C., man who had been confined for only three years since killing his three children in 2008 while in a psychotic state.

All agreed that something had to be done — and the result was the federal government’s Not Criminally Responsible Reform Act. The bill promised to clamp down on what seemed to be a dangerously lenient system that put the rights of violent criminals above the rights of their victims. The families of the victims of the Li, Kachkar and Schoenborn attacks all stood solemnly in support of Prime Minister Stephen Harper when he introduced the bill.

But to another group, the bill inspired only panic.

Working under the direction of Toronto documentary maker John Kastner, this coterie of filmmakers, psychiatrists, patients, nurses and hospital administrators had spent the previous three years crafting a boldly sympathetic portrait of a man just like Li, Kachkar and Schoenborn. Their subject — Sean Clifton — had been declared not criminally responsible after stabbing a young woman almost to death at the front door of a Walmart store in Cornwall, Ont., in 1999. Hoping to inspire sympathy for him with the film, they now faced a stinging backlash.

With an audience discussion scheduled to follow the film’s April 2013 premiere at Toronto’s Hot Docs festival, Kastner and his crew braced for the worst. What happened instead was the exact opposite. NCR: Not Criminally Responsible shocked anger into silence, and silence gave way to rapturous applause. The audience had witnessed a dual miracle: the slow, genuine rehabilitation of a monster back into a man, coupled with the growing understanding of the family he attacked and their ultimate sympathy for his plight.

Frightened that Clifton would strike again, the stabbing victim, Julie Bouvier, and her parents, Andy and Noella, had for years done their utmost to ensure he would never be freed from the psychiatric hospital where he was being held. But after getting to know him through the making of Kastner’s film, they moved from fear and loathing to unreserved forgiveness.

Bouvier had agreed to participate in the film on the condition that her face be obscured, fearing a further attack from the man who had almost killed her. After its premiere, she stepped forward in full public view to deliver a message of forgiveness. “I accept his apology, and I feel his sincerity in this,” she says in the film’s final scenes. “I truly understand he is remorseful for everything that happened that night and don’t hold anything against him.”

Learning to forgive Clifton “set us free,” Noella Bouvier told the press at the film’s Brockville, Ont., premiere. Later in Toronto, Andy Bouvier took the opportunity to criticize the pending law that would make it harder for previously violent psychiatric patients to gain the small degree of freedom that Clifton then enjoyed.

NCR caused a sensation at Hot Docs. Since then, repeated screenings have inspired a dramatic counter-narrative to the popular perceptions embedded in the government’s punitive new legislation, changing the minds and opening the hearts of virtually all those who see it. The bill became law last July, but Kastner’s NCR and his successor documentary on detained psychiatric patients, Out of Mind, Out of Sight, continue to nudge viewers beyond their bias against those deemed not criminally responsible, demonstrating the power of art to bring about social change.

“My goal was to help destigmatize these patients,” director Kastner explains in a recent interview. And to do it in the most audacious manner possible: “To take somebody who has committed an act of monstrous violence and show you he is not a monster — to make you understand this person is not evil, just ill, and then go beyond that to make you actually feel for that person. And to do all that without diminishing the ordeal of the victim.”

But the barriers he faced were formidable. “For perfectly understandable reasons, they hide these people out of view,” Kastner says. “You see photographs of them looking scary as hell, and then they disappear from public view. You never get to meet these people; you never get to hear them speak.”

With a handful of Emmy awards to his credit and a record of insightful films on prisons, Kastner challenged the professionals who guard the gates to open up, warning them that continuing to protect their patients from the public gaze would only reinforce the stigma they all hoped to break down. “I said you cannot destigmatize anyone by hiding them away,” he recalls. “It just doesn’t work.”

Kastner’s appeal failed to impress the gatekeepers at the Centre for Addiction and Mental Health (CAMH) in Toronto. But Dr. John Bradford, chief psychiatrist at the Brockville Mental Health Centre in eastern Ontario, agreed to take the chance. Kastner says he and his crew ultimately spent more than three years filming at the hospital, inside “a fishbowl of professional oversight.”

Adds Bradford, “You can imagine trying to persuade a hospital board to allow that type of exposure over a significant period of time. It certainly wasn’t easy.”

The results, however, are remarkable. Of the few films in history that have depicted real life inside a mental-health hospital, none has gone as deep as NCR and its followup. What sets them apart is their almost unnerving intimacy. There are no talking heads in these films, no policy discussions or legal arguments, little psychiatry even. What they show instead are astonishing human dramas that confront and confound all the unspoken preconceptions that politics ignores.

Hostile public reaction and opinion polls have shown repeatedly that few Canadians believe the psychiatrists and jurists who say that Vince Li, who decapitated 22-year-old Tim McLean on a Greyhound bus in 2008, is no longer a threat to the public. Every new privilege the Manitoba Review Board grants Li sparks fresh outrage. But to watch Sean Clifton in NCR transform under treatment from a shivering, psychotic wreck into a gentle, thoughtful and remorseful man would astonish anyone. To watch the Bouvier family come to forgive him — an unexpected drama that culminates in the film’s final frame — is truly amazing. “Film is tremendous for capturing personality and emotion,” says Kastner.

Critics of the government clampdown — essentially the entire mental-health establishment — took a more conventional approach in their campaign against the government bill. Experts emphasized empirical research, prepared for the Department of Justice itself, that showed how unlikely it is for such people to commit another crime after release: ordinary criminals are far more likely to reoffend than those found NCR, the government’s own study showed. Of the latter, those who committed murder while in the grip of psychosis are the least likely of all to reoffend.

Witnesses at the House of Commons justice committee decried the contradiction of punishing mentally ill people for acts that they’d already been declared not responsible for by courts. They complained that treating them more harshly would only reinforce the stigma that condemns all those with mental illness. And they emphasized that the proposed reforms would do nothing to protect victims from further attacks by the likes of Li, Kachkar and Schoenborn.

A new study released subsequent to the law emphasized the point, finding that 72 percent of all Canadians declared NCR after committing an offence had previously been hospitalized for mental illness — and subsequently released.

“Look at Li,” says Bradford. “He was in hospital in Toronto with lots of doctors and mental-health care, and for reasons which are difficult to understand, he was released, although clearly he was not well, and goes travelling across the country in a psychotic state.”

As a specialist in forensic psychiatry, which treats those patients formerly known as “the criminally insane,” Bradford is the leader of a tribe whose work is little known and less understood. They are the professionals called on by courts to plumb the diseased minds of the country’s most notorious criminals, and they pay the price: Bradford almost lost his life to suicide after suffering a breakdown following prolonged exposure to the minds and deeds of such figures as Paul Bernardo and Russell Williams.

But the forensic system, supervised by judicial review boards that decide whether or not to release patients and on what terms, actually works. “It just doesn’t make sense” to target a system that successfully treats the most difficult patients, according to Bradford. Prior to their offences, neither Li, Kachkar nor Schoenborn had ever fallen under the jurisdiction of one of the review boards that determine the fates of those declared NCR. Needless to say, none of them had ever been prematurely released by one.

“What they should be doing is going after the general mental-health system, which fails repeatedly, and failed again in this situation,” Bradford says.

That hasn’t happened for reasons all too familiar to Canadians: the forensic system is a federal responsibility while the general system is provincial, resulting in the usual lack of co-operation. Above all else, incarcerating people in prisons is cheaper than treating them for the illnesses that account for their transgressions. “I’ve been in this business for so long, lobbying governments and advocating reform, and I’m convinced that’s a large part of it,” Bradford concludes wearily.

Thus despite all expert opinion, the new NCR bill became law. Judges hearing NCR cases now have the power to designate an accused as “high risk” and subject them to longer and more severe detention than they would otherwise experience.

But now, a judge’s willingness to use that power might depend to no small degree on whether he or she has seen Kastner’s films. Since their initial release, both documentaries have circulated extensively among the legal and health professionals active in this annex of the justice system, creating an impact far out of proportion to the size of their audiences.

Laureen Harper, spouse of the prime minister and a well-known campaigner for mental health, wrote Kastner to commend the film’s success at raising awareness “in such a compelling manner.” Supreme Court Chief Justice Beverley McLachlin, author of a landmark decision that shaped the current review board system, was another early fan. Louise Bradley, president of the Mental Health Commission of Canada, praised NCR as “one of the most powerful tools I have seen for educating people on this complex issue.”

The films are also now widely used to train lawyers and health-care workers. Of NCR, Dr. Ivan Silver, vice-president of education at CAMH, wrote, “I believe it could help change a whole generation’s attitude towards sufferers, perhaps more than almost any film I have seen.”

For professional and lay viewers alike, the essential revelation of the films is a fact often stated but rarely believed — that the majority of people who commit such grotesque acts in the grip of “florid” psychosis can actually regain their sanity well enough to live almost normal, quiet lives indefinitely.

“In the vast majority of cases, people do respond to the medication,” says Chris Summerville, CEO of the Schizophrenia Society of Canada. Anti-psychotic drugs perform regular miracles in the forensic system, aided by strict protocols and regular tests to ensure they are taken. Patients also benefit from intensive counselling and “psychiatric rehabilitation” in forensic hospitals — services that are far less likely to exist in the prisons where many of the mentally ill end up.

As one of the few outsiders who has visited Vince Li at the Selkirk Mental Health Centre, Summerville reports that he is a model inmate. The Manitoba Review Board agrees, having recently transferred Li to an unlocked ward and permitted him to make unescorted day trips away from the hospital.

“Recovery is rather a new concept to the public,” says Summerville, who has struggled with mental illness himself. “But we know that recovery is not a cure,” he adds. Without medication, patients like Li can quickly slide back into psychosis.

The limits of treatment emerge tragically in Out of Mind, Out of Sight, the second of the two documentaries Kastner filmed inside the Brockville hospital. It focuses on an intelligent and presentable young man who killed his mother after absconding from a mental hospital in Ottawa. The beauty of Michael Stewart’s story is that his family has never judged him — they blame the illness, not the man — and they continue to love him as he recovers his identity. But Stewart’s hard-won lucidity only brings him closer to the horror of his past.

“He cannot say the word ‘mother,’” notes Kastner, who spent years waiting for Stewart to open up to the camera. “He talks about ‘the victim.’ In some cases, he even talks about the ‘victim’s spouse,’ meaning his father.”

Even for a patient as capable and non-threatening as Stewart, there is no cure. “He’s now living in the community,” says Bradford. “But he’s never going to function up to the level of his intelligence or his upbringing.”

For many of the other tragic figures who haunt the same corridors, there is no treatment. Their prominent roles in the second film make it far less easily redemptive than the first. “That’s hard for me to look at,” Silver admits, adding that about 20 percent of forensic patients never get any better. “As a helping professional, you deal with that by wearing a certain tint of rose-coloured glasses. It’s maybe on the healthier side of denial.”

In this terrain, the boundaries and the outcomes are never clear-cut. Shawn O’Neill had spent 17 years under mandatory psychiatric care for a threatened knife attack when the Ontario Review Board decided to grant him an unconditional release. Under supervision, O’Neill never committed another offence. But within months of gaining an absolute discharge from the review board, he attacked and stabbed four people in downtown Toronto.

NCR doesn’t address such failures, nor does it confront the larger problem of mentally ill patients incarcerated in the conventional penal system. The public can only move so much at a time.

Indeed, the fear that seeks to punish the mentally ill often originates in courtrooms, where juries can’t stomach the notion that despicable violence should escape harsh penalty.

But for those who are willing to see, the two Kastner films open up a whole new world. And in the process, they are gradually and artfully eroding the prejudices of an old, familiar one.


This story first appeared in The United Church Observer’s May 2015 issue with the title “Men not monsters.”

John Barber is a journalist in Toronto.


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