A second psychiatrist has testified that she believes Richard Kachkar was psychotic around the time he struck and killed Toronto Police Sgt. Ryan Russell with a stolen snowplow.

Dr. Lisa Ramshaw told court that Kachkar "had a break from reality" around January 2011 when the officer died.

She is the second psychiatrist to take the stand in Kachkar's murder trial. He has pleaded not guilty to first degree murder. His lawyer argues that Kachkar should be found not criminally responsible in Russell's death.

"My opinion based on all the information (is) that he was more likely than not...unable to access the wrongfulness (of his actions)," she testified on Day 17 of the trial.

Like Dr. Phillip Klassen who took the stand last week, Ramshaw believes Kachkar began to develop a mental illness around 2005, shortly after the death of his adopted father.

"He has declined significantly...and has not been able to engage in any meaningful relationships," she told court. "He was largely unemployed...his work was less and less specialized (and) his financial management and financial support declined."

"Mr. Kachkar's communication style is disorganized...he can be difficult to focus," Ramshaw testified. "He has been described by anyone who has had contact with him as having this style of communication."

According to Ramshaw's testimony he painted a picture (the clearest so far) about what he remembered from the morning of Sgt. Russell's death. He has told others he remembers nothing or recalls very few details.

Ramshaw told court that Kachkar said to her he remembered driving down a road when "a police officer came and walked in front and started shooting and hit the windshield...he tried to move the truck."

"He indicated that he didn't intend to hit a police officer (and) didn't know at the time if the police officer was hurt," Ramshaw testified, telling court about how Kachkar detailed the experience to her "He was very sorry for what happened...expressed remorse (and) he was perplexed by the whole experience."

Kachkar reported to Ramshaw that he was scared and ran out of the Good Shepherd Shelter in Toronto because he thought something bad was going to happen.

He has been seen on surveillance video running barefoot out the shelter's back exit. He headed to a Tim Horton's where Ramshaw testified that he reported still feeling uneasy, stealing the snowplow to "escape."

Ramshaw remains on the stand and will address criminal responsibility Friday.