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Shabehram Lohrasbe's interest in forensic psychiatry can be traced back to his childhood, when he was growing up amid heavy religious tension in India. A follower of the ancient religion Zoroastrianism, he found himself in a tiny but impassioned cohort in which some members defended their beliefs fiercely. He recalls seeing school children fighting over it and adults beating one another to death.

"That used to scare the beejabs out of me because I couldn't understand it: How can people get so violent on the basis of religion?" he said. "It spurred an interest in, you know, how do people get so worked up that they can be so violent with one another?"

Dr. Lohrasbe is today a prominent forensic psychiatrist with nearly 30 years of experience and 6,000 individual assessments under his belt. He is a regular fixture in B.C. trial courts, where he testifies at all stages of proceedings, including assessing individuals' fitness for trial, mental state at the time of offence, mental disorders and future risk to community. When Crown or defence counsel must explain to the court how someone could do the inexplicable, they turn to Dr. Lohrasbe.

His higher-profile cases include that of Jay Handel, who killed his six children at their Quatsino, B.C., home in 2002, and Allan Schoenborn, who killed his three children in their Merritt, B.C., home in 2008. But the doctor has also assessed hundreds of individuals for non-criminal matters, including post-traumatic stress disorder and the psychiatric consequences of personal injury.

Shaped by decades of experience, the Victoria-based doctor has developed a "wish list" of sorts, a number of ideas on how to better navigate the intersection of the mental health and criminal justice systems. However, his ideas – which focus on prevention and protection rather than punishment – entail such a socio-political shift he is doubtful they will ever happen in his lifetime.

Take, for example, the growing impact of drug use on forensic psychiatry. In the first 20 assessments Dr. Lohrasbe did in which a violent offender was found not criminally responsible (NCR) on account of a mental disorder, drug abuse was identified as a primary factor in three. That was in the early 1980s. In the past year, drug abuse was identified as a primary factor in 18 out of 20 NCR assessments.

"The difference was startling," Dr. Lohrasbe said. "[Drug use] has completely changed forensic psychiatric practice … and it has altered the makeup of people sitting in prison."

This is further complicated by the "war on drugs," he continues. Such individuals deteriorate further behind bars, after which they are "unleashed" on to the public without rehabilitation, Dr. Lohrasbe said. Instead of punishment, they should be receiving treatment.

Similarly, he hopes to one day see the prevention of sexual violence by having treatment available to potential offenders before they offend. At present, a man who has deviant fantasies about a child, for example, has nowhere to seek help, he said.

"If he reports them to a doctor or therapist, they are obliged to disclose that information [to authorities] and all hell can potentially break loose in his life." He notes in some European countries, such individuals are encouraged to visit therapists, who are legally protected from consequences if they fail to prevent sexual offending.

"When you think about the damage done by the phenomenon of sexual abuse, it is horrendous," he said. "If you can shave a small proportion off from those potential offenders who become actual offenders, the downstream benefits are huge."

Large social forces, including the breakdown of family and religion, have "undermined the ways in which traditional societies 'absorbed' the harsher effects of individuals with mental disorders," Dr. Lohrasbe said. Unless there is a shift to prevention and protection, the presence of individuals with mental health issues in the correctional system will only increase.

"The ultimate change can only come from political will," he said, "and it's not happening."

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