Ontario's premier said Friday that people with mental illness who commit crimes should be in jail, calling a patient who had been detained at a mental health hospital for killing his roommate an "animal."

Doug Ford teed off for a second time on the case of Zhebin Cong, who was found not criminally responsible for killing his roommate with a meat cleaver in 2014.

Cong, who has schizophrenia, was an in-patient at the secured forensic unit of the Centre for Addiction and Mental Health (CAMH) in Toronto but failed to return on July 3 from an unaccompanied trip into the community. City police have said he has left the country.

Last month Ford called into a talk radio show to discuss the incident, calling the man a "nutcase." The premier was criticized for that language and when asked Friday if he regrets it, he said not at all.

"It's about time politicians stop hiding behind podiums and being politically correct," Ford said. "He grabbed a meat cleaver and chopped up his roommate ... just imagine if it was your daughter that this animal chopped up."

Ford said federal laws need to be tougher to deal with people like Cong.

"We've got to put these people away and if they have mental health issues they can be dealt with in jail — simple as that," he said. "I'm passionate about helping people who have true mental illness ... Stop sympathizing with axe-wielding murderers and all this bleeding heart stuff."

Internal review underway

CAMH has announced an external review of procedures for granting passes and privileges as several patients have managed to walk away recently. An internal review is also underway.

The hospital has defended the use of community passes, describing them as an important part of the care a patient receives and that supports rehabilitation and recovery.

NDP critic Catherine Fife said Ford's choice of words around mental illness is "shocking."

Police say Zhebin Cong, 47, boarded an international flight on July 3. (Toronto Police Service)

"For him to just use the language around calling individuals who suffer from mental illness animals is something that I never thought I would ever hear a premier say in the province of Ontario," she said.

Fife also took issue with Ford saying he wants to help people with "true" mental illness.

"This is something that I truly have never seen from a leader, who would declare himself qualified to determine who really is mentally ill and who is not," she said.

Review boards manage cases

When people are found not criminally responsible because of mental illness, review boards manage their cases.

The independent tribunals made up of at least five people, including at least one psychiatrist, can order that the person remain detained in a hospital, with varying levels of privileges, release the person on a conditional discharge or order an absolute discharge, based on risk.

The review board system lets people found not criminally responsible into the community once they're deemed ready for short periods of time under close supervision to see how well they can cope. If they do well, they can be granted more privileges at subsequent hearings, step by step.

If they don't fare well, the review board pulls the reins of supervision a little tighter.

In Cong's case, police have said CAMH told them Cong presented a low risk to public safety, but the review board said in its most recent decision in April that he continued to pose a significant threat to public safety.

Toronto police are also conducting a review.