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Jeff Wong, a clinical and forensic psychologist based in Hamilton, has been involved with a few such cases, including that of a teenage boy who struck another young man who subsequently died of his injuries, and one of a teenage girl who smothered a toddler to death in their foster home.
The young man is functioning back in the community and is not a risk for committing another violent offence, Dr. Wong said, while the young woman is in secure custody working on reducing her chances of re-offending.
"She's making progress," he said. "It's not just lip service."
Yet few troubled youngsters receive the IRCS sentence.
Ottawa initially estimated that about 50 IRCS sentences would be handed out each year across the country, and made agreements with the provinces and territories to pay for treatment. Through the program, each jurisdiction can receive up to $200,000 to support specialized assessment and treatment, and the federal government would provide an additional $100,375 per offender each year.
But according to the Canadian Centre for Justice Statistics, only 16 young people received the sentence from 2003 to 2007. There have been a handful of cases since then.
Officials said some early cases may have fallen through the statistical cracks. Some jurisdictions have been slow to adopt the new option. In other cases, young offenders may have refused treatment.
Nicholas Bala, a professor at Queen's University in Kingston who specializes in children's law, said often offenders are not being properly identified when they enter the system. "There is power for the judge to order an assessment," he said. "But often under [the act] it's not done. They are then incarcerated. Sometimes their mental-health problems become exacerbated when they're in custody and then they're released without treatment."
Even if candidates for the program make it to the assessment, Mr. McCaffrey says, they are being rejected for what he considers invalid reasons.
"We've had children thrown out of these programs because of smoking," he said, " 'Johnny's not obeying the rules, therefore he's not a good candidate for the program.' Adolescent boys will smoke. I don't know if that's a legitimate reason to give up on somebody."
At the same time, the health-care system remains chronically short of doctors and facilities to make the initial assessment. Sometimes mental-health workers won't make a diagnosis because of the young person's age.
Over all, says Carole Saindon, a federal Justice Department spokeswoman, the original criteria for the program were "overly restrictive," and very little funding has been used.
In April, 2007, the Justice Minister expanded the scope to include other serious violent offences such as aggravated assault, wounding with intent, arson and disregard for human life. The federal budget for the new five-year agreements - April 1, 2008 to March 31, 2013 - is more than $11-million a year.
Mr. McCaffrey, who has handled the bulk of Alberta's IRCS cases, said these kids are destined for a life of crime - or worse - if they wind up in a penal environment rather than a therapeutic one. He recalled a case involving one teenage boy he thought should have qualified for an IRCS order, but ended up in an adult prison - where he committed suicide.
"That may have happened anyway," Mr. McCaffrey said. "I'm not suggesting that that's the cause. I'm suggesting that really it is the last stop for these people."
Not everyone is enamoured of the IRCS program. Some view the sentence as a kind of easy ride or camp for kids responsible for heinous crimes. Others are willing to wait and see.
Now 15, J.R. appeared last month in a Medicine Hat courtroom via video-conference from the hospital for her mandatory annual sentence review.
She has had a number of diagnoses, including conduct disorder and oppositional defiant disorder. And defence lawyer Tim Foster told the court that a recent report by a new psychiatrist wasn't entirely positive, describing her as suffering from a "failure to internalize." But he said J.R. is "engaging well and participating" in psychotherapy and group activities and had had "very few difficulties."
J.R.'s grandfather said from his home in Sudbury that he speaks to his granddaughter by phone once a month. He doesn't sound as convinced about her progress.
"I think you need to read between the lines," he said. "I don't know [if] she's doing too well. It's debatable."
As for B.J.A., who killed his mother, lawyer James Conway said regular meals, along with medication and individual and group therapy, have improved his physical and emotional health. By 2006, he was allowed to move to a group home. "He's really doing excellent," his father said then.