Motivational Influences in Persons Found Not Criminally Responsible on Account of Mental Disorder: A Review of Legislation and Research Stephanie R. Penney, Ph.D. * ,† , Andrew Morgan, M.D., FRCPC † and Alexander I. F. Simpson, BMedSci, MBChB, FRANZCP † This paper provides a review of the legislative reforms and case law that have impacted the defense of Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canada over the past three decades. As in other jurisdictions internationally, we observe that legislative reforms of procedural, as opposed to substantive, aspects of the NCRMD defense have impacted the manner in which NCRMD criteria are applied in common practice. More people are being declared NCRMD in recent years, and there is greater heterogeneity in the offending and psychiatric profiles of these individ- uals, suggesting that NCRMD criteria are being applied more liberally over time. In light of the substantial growth of the forensic mental health system over the past two decades, witnessed both in Canada and abroad, we propose that the study of moti- vational influences underlying the offending behaviors of persons with serious mental illness (SMI) is necessary to begin disentangling symptom-based offending from violent and antisocial behaviors that may have other motives. This, in turn, can help to deter- mine legal issues, better define the nature of each person’s offending and treatment needs, and provide a more fine-grained analysis of the drivers behind the growth expe- rienced by the forensic system. Copyright # 2013 John Wiley & Sons, Ltd. INTRODUCTION The Criminal Code of Canada (CCC; Criminal Code, 1985) provides for the diversion of people with serious mental illness (SMI) by the courts into treatment if the person is Unfit to Stand Trial (UST) or Not Criminally Responsible on account of Mental Disorder (NCRMD). In regards to the latter, Section 16 of the CCC encompasses the legal principle that, if certain criteria are met, no person who was suffering from a mental disorder at the time of the commission of an offense may be convicted of a crime. The legal test requires that the mental disorder render the defendant incapable of appreciating the nature or consequences of his or her actions or incapable of knowing the legal or moral wrongfulness of the offense. Similar criteria are used in most Western countries to absolve or diminish the criminal responsibility for an offense committed by a person with SMI showing similar incapacities (see Howard, 2003; Zapf, Golding, & Roesch, 2006, for reviews). *Correspondence to: Stephanie R. Penney, Centre for Addiction and Mental Health and the University of Toronto, Toronto, Ontario, Canada. E-mail: stephanie_penney@camh.net † Centre for Addiction and Mental Health and the University of Toronto, Toronto, Ontario, Canada. Copyright # 2013 John Wiley & Sons, Ltd. Behavioral Sciences and the Law Behav. Sci. Law (2013) Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/bsl.2067