A forensic psychiatrist who interviewed Alek Minassian more than a dozen times says he does not believe the accused meets the criteria for a finding of not criminally responsible (NCR) as he was not suffering from psychosis before, during, or after the mass murder, a court heard Thursday.
Dr. John Bradford, who took the stand as a witness for the defence on Thursday, told the court that in the summer of 2018, he interviewed Minassian several times over his 60-day stay at St. Joseph's Healthcare Centre, where Bradford works as a staff psychiatrist.
He said that during that time, he and a team of nurses and doctors kept constant surveillance on Minassian, who was deemed to be a suicide risk and kept in an isolation suite.
He noted that doctors watched Minassian to see if he exhibited any behaviour consistent with psychosis.
Bradford told the court it was important to look out for any signs of delusional behaviour because in about 80 or 90 per cent of cases where there is a finding of NCR on the basis of a mental disorder, the traditional diagnosis is a psychotic condition, such as schizophrenia, where delusions are a key feature.
He said while Minassian showed ritualistic behaviour that was consistent with his autism spectrum disorder (ASD) diagnosis, there were no signs of delusional behaviour or psychosis and no history of psychosis reported by family or other sources.
Some of the ritualistic behaviours included frequent hand-washing, moving glasses of water around to different parts of his room, and smiling and talking to himself, Bradford said.
"It was clear very early on that he was not psychotic," Bradford said.
Minassian, who faces 10 counts of first-degree murder and 16 counts of attempted murder, has already admitted to driving a rented cargo van on sidewalks along a busy stretch of Yonge Street in North York on the afternoon of April 23, 2018, killing 10 pedestrians and wounding 16 others who were in his path.
His lawyers argue that Minassian is not criminally responsible for his actions under Sec. 16 of the Criminal Code. A person is NCR if they were suffering from a mental disorder that rendered them “incapable of appreciating the nature and quality of the act or omission or of knowing that it was wrong.”
The defence has said the only relevant diagnosis they will be relying on in this case is ASD and one psychiatrist, Dr. Alexander Westphal, is expected to testify that Minassian's "austic way of thinking" was "similar to psychosis."
Bradford said that while theoretically some experts could argue there is a "pathway" to NCR using only a diagnosis of ASD, he does not agree.
He noted that while ASD is "a significant mental disorder," he doesn't believe it has the same impact on the operating mind as psychosis.
"It (psychosis) is something that, once it takes hold, is a profound condition that takes over a person's operating mind," Bradford said. "I can't get my head around how this (ASD) would have an impact on a person's operating mind that would get them to Section 16. That is my opinion."
He added that he could only find one example where ASD was the sole diagnosis used in an NCR case in Canada, and that case, which involved the issue of consent, was not properly tested in court.
Bradford said there has been some research about mass homicide and ASD that suggests a "small number" of people who carried out mass murders had been diagnosed with the condition.
He was quick to point out that he was "absolutely not" suggesting there is any sort of causal relationship between ASD and mass murder.
"In broad general terms, most people with autism spectrum disorder are not violent, they don't engage of criminal behaviour," he said, adding that those on the spectrum are more likely to be victims of crime than perpetrators.
He acknowledged that his clinical experience in dealing with patients with ASD has been limited, which is why he asked one of his colleagues, Dr. Rebecca Chauhan, to assist in assessing Minassian.
Chauhan previously testified that during her interviews with Minassian, the accused appeared to be "hyper-fixated" on mass killings and the manifesto of Elliot Rodger, who killed six people and injured fourteen others in an attack in Isla Vista, Calif. in May 2014.
During his testimony on Thursday, Bradford said while the manifesto had some influence on Minassian, he conceded the accused later admitted that he affiliated himself with Rodger and the so-called "incel movement" to gain more notoriety.
Bradford said he believes Minassian's primary motivations for the attack were notoriety and strangely, fear of failing at his new job.
Minassian not a psychopath, psychiatrist says
Bradford, who has assessed some of Canada's most infamous mass murders, including B.C. serial killer Robert Pickton, agreed with Chauhan's assessment that Minassian displayed a significant lack of empathy.
He said the lack of empathy and emotion Minassian displayed in his interview with police after his arrest, which was recorded on video, was "quite chilling" at times.
Bradford said it was almost as if Minassian was "describing a video game" when he explained Elliot Rodger's mass murder as converting "the life status of certain individuals to a death status."
During his examination-in-chief, Minassian's lawyer, Boris Bytensky, also asked Bradford if Minassian could be considered to be a psychopath.
"It doesn't apply in the case of Mr. Minassian," he responded.
He said psychopaths are usually diagnosed with anti-social personality disorder and exhibit symptoms before the age of 18.
"He does have problems with empathy but I believe that comes from the autism spectrum condition," Bradford said.
He said when it comes to psychopathy and those with ASD, there are fundamental differences in terms of empathy.
Bradford explained that those with ASD generally have difficulty understanding the emotions of other people whereas psychopaths not only understand the emotional state of others, they spend a good deal of time manipulating other people's emotions and feelings.
He also noted that Minassian never displayed violent behaviour prior to the attack and did not lie excessively.
"He has lied a little bit but not in a consistent manner that would bring him anywhere near psychopathy," Bradford said.
The Crown's cross-examination of Bradford will continue on Friday morning.
