Psychiatric assessment of

Richard Wills

by Dr. Jeffrey McMaster

conducted at the

Whitby Mental Health Centre

IX.MENTAL STATES EXAMINATION

Mr. Wills presented consistently throughout his assessment, He presented as an

adequately kempt, Caucasian individual appearing older than his stated age,
presumably because he wore a long beard and long grey hair. His fingernails
were long. Mr. Wills tended to lean on the interviewer's desk during the
interview, and often while doing so, invaded the interviewer's space. He
responded after considerable redirection, to not lean towards the interviewer, Mr.
Wills attempted to exert considerable interpersonal control during the interview.
He monitored the interviewer's note taking and responses to his answers. He
often insisted that the interviewer write something down verbatim. Mr. Wills
often provided only vague, incomplete accounts to questions asked of him, and
often answered them only after considerable response latency. However, Mr.
Wills spoke in an animated and spontaneous fashion of topics of his choosing
which tended to consist of exculpatory and explanatory narratives of the material
time. Mr. Wills was reluctant to answer questions posed to him by the interviewer
and often went on tangents to topics of his own choosing. Mr. Wills' responses
also tended to have a scripted and rehearsed quality about them in that he could
not answer clarifying and elaborating questions and instead tended to exert
control over the interview, to return to the topic of his choosing. Mr. Wills
maintained good eye contact. There was never any evidence of thought disorder.

Mr. Wills presented as entitled and arrogant. He consistently devalued others

including nursing staff, past psychiatrists, lawyers, acquaintances, friends, and
cue court. Mr. Wills' mood was described as mildly down. His mood objectively
appeared overall within the euthymic range but prone to periods of frustration,
anger, dismissiveness, and condescension, He denied suicidal and violent
ideation.

Although Mr. Wills claimed to hear voices, at no time did Mr. Wills appear to be
responding to internal stimuli. While Mr. Wills regularly stated that there were
"two or three Ricks", the multidisciplinary team did not notice any personality
changes in Mr. Wills, albeit he did present as moody at times.

Cognitively, Mr. Wills appeared in the average to above average range. Mr. Wills'
insight into his psycholegal circumstances was good. As aforenoted, he regularly
attempted to portray himself in an exculpatory light. He had a good account of
his legal affairs over the previous two years. In fact, he stated that he had made
more progress acting as his own counsel than during the time with his previous
lawyers. He was well aware of the nature the assessment, that it was an
assessment of whether he was not criminally responsible due to mental disorder.
Mr. Wills expressed some concern that the treatment team was “crown-oriented,”
and stated that in his opinion he might be better served by a less “crown-
oriented” assessing team at the Royal Ottawa Hospital.

As aforenoted, Mr. Wills continually drew attention to comments which were

exculpatory in nature. For example, he stated “I'll trust you’ll do your job well.”
He indicated that he expected the staff at the WMHC to “do their job” and be
professional and added that if the assessment showed that if there were “two
Ricks… then the staff would be doing their job well.” He also stated “It wasn’t
me, wasn’t me as a police officer, it wasn’t even Rick.”

X. COURSE IN HOSPITAL
Mr. Wills was admitted to the WMHC FAU on December 10, 2003. He regularly
complained of gastrointestinal symptoms. Mr. Wills' medications as prescribed for
him at the detention centre were continued at the WMHC with the exception of
risperidone (antipsychotic medication) which was discontinued. At the WMHC,
FAU, Mr. Wills was treated with the following medication: zopiclone 7.5 mg per
night, omeprazole (for gastrointestinal symptoms) 20 mg per day, Celexa
(antidepressant medication) 60 mg per day in divided doses.

Mr. Wills presented consistently throughout his inpatient assessments. Mr. Wills
immediately spoke of music in his head “saying nice things.” He stated that he
felt that he had a mental illness which he wished had been taken care of sooner,
“so that it (the offense), wouldn’t have happened.” He also complained of
buzzing in his head.

He spoke of poor concentration and a difficult time reading the newspaper, albeit
staff did not observe any difficulties with his concentration.

He spoke of hearing “Linda’s voice” sometimes and also spoke of hearing other
voices as well.

On the way to Lakeridge Health Corporation-Oshawa (LHCO) for a CT scan of the

head, he was very talkative to the male staff, about his past hockey
accomplishments and gave advice on skating.

At times he made complaints regarding staff. On December 18, 2003, he accused

a male staff of being unprofessional. He presented in an angry, sarcastic manner
and attempted to interrupt and talk over both staff. Although he was redirected,
nursing staff deemed him “unable to really listen to staff.” Mr. Wills made
inquiries into the personal lives of staff, necessitating that staff establish
boundaries. Mr. Wills positioned himself on the ward, such that he could be
vigilant of the activities of staff. He questioned the status of male staff, and
made inquiries into the hierarchy of the ward staff.

He was observed coaching a copatient on how to be found criminally responsible

as this patient did not want to be found not criminally responsible. Mr. Wills
regularly advised staff that if they did their jobs correctly, he would get the
“proper care” he needed.
Mr. Wills advised nursing staff that he understood the seriousness of his crime
but “there is treason and terrorism also in the Criminal Code” which he opined
were more serious as they involve more than a couple of people.

Mr. Wills advised staff that he had "holes" in his memory. Mr. Wills advised
nursing staff that he had done psychological testing (on the FAU) that he
believed would help “show what I’ve been saying.” However, he later dismissed
the psychological testing stating, “psychometry testing was not beneficial and
should have been done differently.” Mr. Wills’ complaints of memory problems
included the fact that he wanted a reminder to transfer his clothes to the dryer
on January 25, 2004.

Mr. Wills was noted to be inconsiderate toward copatients. For example, on

January 20, 2004, he went on the phone at 8:58 p.m. although he was aware that
a copatient was expecting an emergency phone call at 9:00 p.m. At 9:00 p.m.
when staff requested that he get off the phone, he was rude and argumentative
regarding the correct time. He then accused staff of being rude. The rules of
phone calls were explained to him when he was asked to get off the phone. He
asked staff for an apology. When Mr. Wills was informed that he exceeded the
phone limits on other occasions, he said in a rude tone of voice, “so does
everyone else.” Mr. Wills also challenged the ward rules as regards to doors
being closed on rounds; he was argumentative and not accepting of direction.

When nursing staff questioned him about a previous day's interview with Dr.
McMaster, Mr. Wills interrupted and stated “So you saw it, it was like three
different people wasn’t it.” Mr. Wills was able to repeat much of what was said in
the interview. He continued to state that he had “something wrong with him.” He
indicated that he came to the FAU for “help” and he endorsed having a mental
illness but could not specify same. Mr. Wills, in keeping with his vigilance towards
staff, often spoke to copatients in a huddle, and would cease speaking when staff
approached. Staff noted that he was not thought disordered and expressed
himself clearly, especially as regards to his needs.

He presented as entitled; for example he questioned staff why the couch on the
ward was moved without his consent. Staff noted that his activities around
reading the newspaper, his telephone use, his position in the day area and dining
area and his reading of the Bible were regimented and precise. Mr. Wills was
noted to use Imovane to sleep every evening and often slept until noon.

XI.PSYCHIATRIC IMPRESSIONS AND RECOMMENDATIONS

i. Fitness to Stand Trial

From a psychiatric perspective, Mr. Wills presented as fit to stand trial according
to the usual criteria.

ii. Psychiatric Diagnoses

Physical examination and laboratory investigations did not reveal the presence of
any physical illness that would make understandable the behaviour leading to
Mr. Wills current charges or explain or provide a cause for our psychiatric
findings.

Diagnostically, Mr. Wills does not appear to suffer from a major mental illness,
such as schizophrenia or manic depressive illness. He does not appear to suffer
from a dissociative disorder. Rather, Mr. Wills appears to suffer from a narcissistic
personality disorder. As well he would appear to meet the criteria for the
diagnosis of malingering, albeit strictly speaking in the DSM-IV, malingering is
more a descriptor than an actual diagnosis.

Personality traits are characteristic ways of interacting with one's environment.

When personality traits are maladaptive and inflexible, and cause social or
occupational dysfunction, then personality disorders are said to exist. Personality
disorders tend to become evident by adolescence or by early adulthood and tend
to be sustained thereafter, with some attenuation of the more dramatic
personality traits towards middle and late age. The course of the symptoms of a
personality disorder may fee adversely affected by psychosocial stress, an
unstructured living situation, alcohol or substance abuse and noncompliance
with psychiatric or psychological treatment. Psychiatric treatment with
individuals who suffer from personality disorders tends to fall within the
psychological, rather than the pharmacological realm, albeit at times a
pharmacological approach may be used in an adjunctive fashion targeting
specific behavioural constellations. Of note, psychological treatment of
personality disorders may be complicated and limited, by an individual's lack of
motivation to change.

Diagnostically, Mr. Wills appears to suffer predominantly from a narcissistic

personality disorder.

As described by the DSM-IV, individuals with narcissistic personality disorder

evidence a pervasive pattern of grandiosity, need for admiration and lack of
empathy which begins in early adulthood and is present in a variety or contexts.
Such individuals may manifest a grandiose sense of self importance (in
behaviour or fantasy) and may routinely over estimate their ability or inflate their
accomplishments. They often appear boastful or pretentious. They may lively
assume that others attribute the same value to their efforts and may be
surprised when the praise that they expect and feel they deserve is not
forthcoming. Often implicit in the inflated, judgements of their own
accomplishments is an underestimation or devaluation of the contributions of
others. They are often preoccupied with fantasies of unlimited success, power,
brilliance, beauty or ideal love. They may ruminate about “long overdue”
admiration and privilege and compare themselves favourably with famous or
privileged people. Individuals with a narcissistic personality disorder may believe
that they are superior, special, or unique and expect others to recognize them as
such. Their own self esteem will be enhanced or mirrored by the idealized value
of the assigned to those with whom they associate. They are likely to insist on
having only the “top” personal or professional affiliated with them, and will orient
toward being affiliated with the “beat” institutions; however they may devalue
the abilities or credentials of those who disappoint them.

Individuals with this disorder generally require excessive admiration. Their self
esteem is almost invariably fragile and may be preoccupied with how well they
are doing and how favourably they are regarded by others. A sense of
entitlement is evident in these individuals’ unreasonable expectations of
especially favourable treatment. This sense of entitlement is often combined
with a lack of sensitivity to the wants or needs of others, and may result in the
conscious or unwitting exploitation of others. They tend to form, friendships or
romantic relationships largely based upon advancing their purposes or otherwise
enhancing their self esteem individuals with a narcissistic personality disorder
generally evidence and lack of empathy towards others and have difficulty
recognizing the desires, subjective experiences and feelings of others. When
recognized, the desires, needs, or feelings of others may be viewed
disparagingly as signs of weakness or vulnerability. Those who relate to
individuals with narcissistic personality disorder, typically find an emotional
coldness and a lack of reciprocal interest.

Individuals with a narcissistic personality disorder are often envious of others,

but believe that others are envious of them. They may begrudge others
successes or possessions, feeling that they better deserve those achievements
or privileges. Individuals with this personality disorder often display snobbish,
disdainful or patronizing attitudes.

Vulnerability and self esteem make individuals with a narcissistic personality

disorder very sensitive to “injury” from criticism or defeat. Although they may
not show it outwardly, criticism may haunt these individuals who may leave
them feeling humiliated, degraded, hollow and empty. They may react with rage,
or defiant counter attack. Interpersonal relations are typically impaired due to
problems derived from entitlement, the need for admiration, and a relative
disregard for the sensitivities for others. Though overwhelming ambition and
confidence may lead to a high achievement, performance may be disrupted by
intolerance of criticism or defeat.

The majority of individuals with this diagnosis are male. The prevalence or this
disorder in the general population is less than 1%.

iii. Assessment of the Psycholegal Issue of Criminal

Responsibility

Mr. Wills was referred to the WMHC, FAU, to assess whether, from a psychiatric
perspective, he would qualify for a defence of not criminally responsible due to
reason of mental disorder. According to Section 16 of the Criminal Code of
Canada, no person is criminally responsible for an act committed or an omission
made, while suffering from a mental disorder that rendered the person incapable
of appreciating the nature and quality of the act, or omission, or of knowing that
it was wrong. Every person is presumed not to suffer from a mental disorder so
as to be exempt from criminal responsibility by virtue of Subsection 1 until the
contrary is proved in the balance of probabilities.

As aforenoted, on the balance, it is my opinion that Mr. Wills does not suffer from
a major mental disorder such as schizophrenia or a dissociative disorder (such as
dissociative identity disorder). Instead Mr. Wills appears to buffer from a
narcissistic personality disorder, the features of which would not render him
incapable of appreciating the nature and quality of his acts or of knowing that
they were wrong.

Although Mr. Wills’ self report was that he suffered from hallucinations and
dissociative experiences, it was felt, on a balance of probabilities that these
features were malingered.

Mr. Wills appeared eager to call attention to his symptoms and often did so in a
somewhat stilted fashion. He reported that he was still experiencing symptoms
of major mental illness at the time of his assessment (not only at the material
time), but his presentation was not consistent with an individual who was
experiencing "internal stimuli." Mr. Wills’ symptoms did not fit into any known
diagnostic entity. Mr. Wills consistently attempted to take control of the interview
and behaved in a somewhat intimidating manner, consistent with malingerers.
Mr. Wills was evasive, asked for questions to be repeated or clarified, answered
questions slowly, and/or at times did not answer the questions. Such techniques
allow malingers more time to make up an answer or to ensure that their
“rehearsed” answers are consistent. Mr. Wills appeared to feign cognitive
deficits, which also is more common with individuals who malinger psychoses.
Mr, Wills did not show say symptoms such as thought disorder or negative
symptoms which may be seen in some psychotic disorders such as
schizophrenia. Mr. Wills refused to allow us to contact collateral information. Of
note, Mr. Wills did not allow us to contact Dr. O'Brien, who would have performed
a psychiatric assessment on Mr. Wills, most proximal to Mrs. Mariani’s death.

Many of Mr. Wills' reported symptoms appeared far-fetched and of low

probability. Mr, Wills appeared to present himself as blameless within the context
of his feigned illness. At the material time he reported the delusion that he felt
Mrs. Mariani was going to kill his children, yet at the game time he felt that he
had been taken over by another individual. These symptoms not only would
allow Mr. Wills to state that he was justified in the killing of Mrs. Mariani to
protect his children, but also would allow him to state that he had no control over
what he was doing, despite his awareness of same. Similarly, his behaviour after
the passing of Mrs. Mariani was such that it rendered him blameless within the
context of psychosis. He reported that Mrs. Mariani instructed him in terms of
how to behave to evade the police investigation, yet at the same time left Mr.
Wills blameless in so far A3 he felt that he was obeying a divine authority who
showed him “3 signs.” This excessive denial of responsibility is common in
malingerers.

Psychological testing was indicative of malingered memory and symptoms of

mental illness. Mr. Wills' entire presentation was that of an individual who
exerted an enormous amount of interpersonal control. There is no information
that anyone had ever noticed any mental difficulties in Mr. Wills around the
material time.

Even if Mr. Wills did suffer from a major mental disorder, it did not appear, from a
psychiatric perspective, that this mental disorder would have deprived him of the
ability to appreciate the nature and quality of his act or omission or to know that
it was wrong. In fact, Mr. Wills indicated that while Mrs. Mariani was toeing
murdered by “the other Rick,” he was horrified and felt that it was evil. Given
that Mr. Wills was watching the event, he clearly knew what he was doing, and
he seemed to be able to foresee and measure the consequence of his actions
(that she would be seriously injured). It would appear that even in the context of
his reported symptoms of mental illness, that he knew his acts were wrong. Also,
given his actions following the death of Mrs. Mariani, his actions to evade being
arrested by the police indicated a full appreciation of his acts and that they were
wrong. Following the onset of the investigation Mr. Willis was extremely
interested in the details of the investigation, offered to help the police with the
investigation, and attempted to imply that Mrs. Mariani's husband might be
responsible. He took extensive measures to avoid detection. Janet Amare began
to suspect that Mr. Wills was being manipulative. As aforenoted, Mr. Wills report
that he acted, in this fashion due to a command from Mrs. Mariani's voice is
deemed to be “far-fetched” and would not assist him in a defence of not
criminally responsible.

Of note, Mr. Wills had an alternate motive for his offence. First of all, Mr. Wills was
described as an individual who had considerable difficulties within the context of
romantic relationships. He was noted to be verbally and physically abusive to
Joanne Wills, and others, possibly including Mrs. Mariani. Mrs. Mariani’s friends
made comments suggesting that Mrs. Mariani was extremely afraid of leaving Mr.
Wills due to his propensity for violence and behavioural discontrol.

Collateral Information indicated that Mrs. Mariani had attempted to leave Mr.
Wills on several occasions. It appeared that she had difficulty doing so for
reasons partly including the fact that Mr. Wills became extremely verbally-
aggressive to the extent that Mrs. Mariani was afraid of leaving him. Mrs. Mariani
may have started an affair with another man, and may have been trying to leave
Mr. Wills, contemporaneous to her death.

Mr. Wills was also described by other sources of information as having difficulty
with managing his anger. He was noted to be rude and belittling to members of
the public and to close relationships. He was consistently noted to be extremely
jealous and controlling. He was noted to be extremely sensitive to slights such
that he would expand a considerable effort in tracking down people on the road
who out him off. His actions proximal to the material time at the CNE were well
detailed and revealed that Mr. Wills had an extreme amount of difficulty in
managing his anger. He was verbally abusive, devaluing, disrespectful and
disparaging of a security guard and of his superior officer, secondary to feeling
slighted, Mr. Wills' presentation on the FAU was that of an individual who was
very controlling of others, and who seemed to be very sensitive to perceived
slights to Ms person to which he responded in a passive aggressive, controlling
or angry fashion. When slighted, or rejected, Mr. Wills historically responded with
rage, and verbal or physical abuse towards others, and by attempting to exert
control of others.

I note that Mr. Wills may have been under a great deal of stress around the time
preceding Mrs. Mariani’s death. He reportedly had financial difficulties. He was
socially isolated, perhaps partly due to the fact that he had recently broke his
ankle, but also in all likelihood, due to chronic interpersonal difficulties with
others. Mr. Wills presented as a loner. His broken ankle might have also been a
blow to his self esteem, given that he seeded to buoy his self esteem through his
accomplishments in hockey. Mr. Wills was also due to be in court with Joanne
Wills as regards to the separation agreement by the end of February 2002. Mr.
Wills might have also been stressed due to the fact that it was Valentine's week.

While under an increased amount of duress, Mr. Wills and Mrs. Mariani might
have had an argument which may or may not have included Mrs. Mariani’s
attempts to leave him. Given Mr, Wills' fragile self esteem, and need to control
Mrs. Mariani, he likely would have reacted in an extremely angry fashion at Mrs.
Mariani’s attempt to break up with him. Mr. Wills may have also been planning to
"control" Mrs. Mariani in the event that she did try to leave him. His purchasing
of the items prior to the offence does indicate premeditation on Mr. Wills' part,
and an attempt to evade detection, Mr. Wills did evade detection for
approximately four months until the date of his arrest in June of 2002.

iv. Psychiatric Recommendations

At the time of my assessment, Mr. Wills was not certifiable for involuntary
admission to hospital according to the Mental Health Act of Ontario. There was
no duty to protect extant. He presented as capable regarding managing his
estate, and consenting to treatment.

Mr. Wills may benefit from continued psychiatric or psychological treatment, He

may benefit from therapy regarding his narcissistic personality disorder, with a
focus of treatment on his use of control, power, devaluation, and exploitation in
the service of his self esteem, as well as on modulating his Intense affective
reactions to perturbations of same. He may benefit from anger management
therapy. He may benefit from continued pharmacotherapy targeting depressive
and anxiety symptoms.

I trust this report is of some assistance to your Honour in the court. If I can be of
any further assistance, please do not hesitate to contact me. I am available at
(123) 123-4567, or through the Forensic Liaison Officer, Ms. Robin Bowerman at
extension x1234.
Respectfully submitted,

Dr. J. McMaster, MD, FRCP(C)

Staff Psychiatrist
Forensic Assessment Unit