February 28, 2014 4:20 pm
Updated: February 28, 2014 4:22 pm

Should Vince Li be granted unescorted visits? Experts weigh in

TORONTO – Chris Summerville says he knows Vince Li has come a long way since 2008.

The CEO of the Schizophrenia Society of Canada first met Li in 2009, one year after he stabbed Tim McLean and then ate parts of his body.

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At first, Li was standoffish, “subdued, very, very quiet and to himself,” Summerville told Global News. Now, six years later, Li is able to carry conversations, he’s stopped hearing voices. Instead, he takes walks, reads, watches hockey games on TV and does Bible study with the hospital chaplain.

“I’ve seen changes in him, drastic changes in him. The public doesn’t see that, they see him in shackles and a straight jacket,” Summerville said.

“He doesn’t display any odd behaviours or thinking patterns like paranoia or delusions. He’s a very nice gentleman, you wouldn’t pick him out in a crowd,” he said.

WATCH: Federal Minister Shelly Glover calls Vince Li decision “insulting” and implores Manitoba government to intervene

READ MORE: Public Safety Minister slams decision to allow Vince Li unescorted trips

On Thursday, a Manitoba review board decided to grant Li unescorted trips outside of the Selkirk Mental Health Centre where he has been treated for the past six years.

The provincial Criminal Code Review Board ruled that Li will be allowed to go out in public by himself for the first time since he stabbed McLean in July 2008. The unsupervised trips will start with 30-minute outings and increase to full days. Li will also have less supervision when visiting other cities, including Winnipeg and will move from a locked ward to an unlocked ward of the hospital.

Should the public be worried about Li’s unescorted trips?

In a 2012 interview with Summerville, Li said he first started to hear voices in 2004.

“I thought I heard the voice of God telling me to write down my journey. The voice told me that I was the third story of the Bible. That I was like the second coming of Jesus,” Li had said.

He went four years without treatment.

Dr. Duncan Scott, a Queen’s University psychiatrist and acting clinical director of the school’s forensic division, likens schizophrenia to a concussion.

“Every time you become psychotic, your brain becomes more injured and you don’t get better as quickly and require more help,” he told Global News.

“No intervention makes it more difficult for these people, and increases risk of relapse and suicide. We don’t understand the magnitude of these psychotic concussions, it’s much more difficult to treat when he’s been ill for longer,” he said.

READ MORE: Man who beheaded bus passenger gets unescorted trips from mental health centre

But the review process is thorough and well-established across Canada, Scott said. Review boards consist of a minimum of three people, including a chairperson, lawyers on either side of the Crown and defence, the defendant and people representing the victim.

Support staff go over Li’s progress with this review board about once a year – Scott estimates that by now Li’s undergone about seven reviews.

READ MORE: Victim’s mom “terrified” Vince Li is to be allowed out on his own

The trouble for Scott is that he said he hopes Li is taking supervised monthly dosages of medication to treat his condition. A daily dose of medicinal therapy could be overlooked.

“The problem with this man is he can get sick very fast, very quickly and go into some very heinous crimes,” Scott said.

“My concern is we’re not using the best therapy…I would feel more secure with him on supervised or unsupervised visits when he’s on this long-acting therapy,” he said.

Adherence – sticking to taking medication daily – tapers off in most people. Think about when your doctor hands you antibiotics to take for three weeks. Do you keep taking the drugs once you’ve recovered?

In most patients, only about 20 per cent adhere to taking their medication in the long run, Scott warned.

Dr. Oren Amitay, a registered psychologist and university lecturer, said the cycle is dubbed the “revolving door phenomenon.” Patients are admitted to hospital, they’re given medical intervention, they return for follow up, feel better, then question why they’re taking these drugs when they feel fine.

“Society owes it to this individual to get back on the street but we have to really, really be sure that this medication is being taken,” Scott said.

What is schizophrenia?

Schizophrenia is an extremely complex mental illness. Amitay says that it’s marked by not being in control of your senses, hearing voices or hallucinations and delusions.

“It’s the biggest punishment somebody can have. I don’t think any jail sentence competes with the hell of having schizophrenia. You can’t distinguish what’s real and what’s not. People have to understand that it’s a walking nightmare all the time,” he said.

It’s unclear what causes schizophrenia. It could be structural abnormalities in the brain, changes in key brain function or affected neurotransmitters.

Amitay says that the public needs to understand the difference between psychosis and psychopathy. In psychopathy, people can have no regard for others and their actions are deliberate and intentional. In Li’s instance, he was having a psychotic episode – “he truly was not in control of his mind at the time.”

“People have to understand it’s not like he’s walking off scot-free. He did something very wrong but it wasn’t his fault. He’s going to continue to pay the price for the rest of his life,” Amitay said.

Schizophrenia is a lifelong condition, Amitay told Global News. “All you can do is manage it, you cannot cure it.”

Summerville says Li also fears for relapse but he’s learned to manage his illness. He takes on therapy, joins support groups, undergoes rehabilitation.

The schizophrenia society, for example, helps people affected by the condition by teaching recovery tactics and moving beyond their limitations, like people with Parkinson’s, epilepsy or other illnesses would.

Right now, Li is in a relatively stress-free environment, but this will change. Li knows he has an uphill climb, Summerville said. He reads the newspapers and watches the news.

“He was embarrassed, he was ashamed, he was tearful, remorseful. The medications were kicking in and he was coming back to reality,” Summervile said.

He says that Li’s ordeal is only heightened because of his notoriety in Canada, and that being so high-profile is only adding stress to his recovery. Summerville said he hopes that Li will receive support and services as needed as he slowly returns into the community.

When asked if he could say anything to Canadian readers, Summerville told Global News:

“If I didn’t know what I knew, I’d be scared to death, too, if I were in his presence,” he said.

“But it wasn’t Vince Li who did it, it was schizophrenia that used his brain. I don’t know if that makes sense to most people but that’s the way schizophrenia is. You can’t punish an illness, you treat it and it is treatable,” Summerville said.

BELOW: The Canadian Press has prepared an interactive timeline with a list of decisions made by the court and Criminal Code Review Board in the case.

carmen.chai@globalnews.ca

© Shaw Media, 2014

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