Good morning. Thank you.
I am very pleased to be here today, and I'd like to thank you all for the opportunity to speak with you on the very important issue of addressing mental illness and addictions within the federal correctional system.
I will begin by briefly providing sorne background about the Canadian Mental Health Association, followed by an overview of community-based mental health services that have been funded within Ontario to address mental health needs of individuals within the provincial criminal justice and correctional systems. These initiatives may have some applicability within the federal correctional context. I will conclude by identifying broad recommendations pertaining to reintegration strategies for mentally ill offenders through the provision of specific services and cross-sector planning and coordination.
The Canadian Mental Health Association is a nationwide charitable organization that promotes the mental health of all persons and supports the resilience and recovery of people experiencing mental illness. It strives to achieve this objective through research, through the provision of public policy advice to government, through public education and mental health promotion campaigns for the community, and through community support services to men and women with serious mental illness. Each year it provides direct services to more than 100,000 individuals through the combined efforts of more than 10,000 staff and volunteers across Canada in 135 communities.
At CMHA's Toronto branch, as well as at a large number of branches across the country, we have a variety of services that operate at the interface of the mental health and criminal justice systems. I should add that many other community mental health agencies also provide services specifically targeting persons with mental illness and criminal justice involvement.
Within Ontario these mental health and justice services are organized across juncture points within the criminal justice, correctional, and forensic mental health systems. These services are aimed at reducing the involvement of persons with serious mental illness in the criminal justice system.
First among these services are prevention or pre-charge diversion programs, to which police can refer an individual for linkage to mental health services when the police believe the individual has a mental illness and that the person is at risk of coming into conflict with the criminal justice system or may have committed a minor public nuisance offence. The individual may be referred to treatment services in lieu of criminal arrest.
Second, there are court diversion initiatives, including mental health courts, which link mentally ill accused to treatment services. Criminal prosecution is stayed when the individual is successfully linked to mental health and addiction services. These court-based programs also assist in developing bail release plans and service care plans, which may be incorporated into probation orders for the remand population.
Third, we provide release-from-custody programs through which mental health workers within detention centres develop discharge plans for individuals pending their release to promote their successful reintegration into the community.
Fourth, we also provide intensive case management services dedicated to persons with justice involvement. These case management services include specialized programs targeted at persons with concurrent disorders--that is, a mental illness and an addiction--and/or a dual diagnosis, which is a mental illness and a developmental disability.
Included along this continuum of specialized community support programs are forensic assertive community treatment teams, which are mobile multidisciplinary teams that include psychiatrists, nurses, social workers, vocational specialists, addiction workers, and case managers. These forensic ACT teams work to reintegrate mentally ill offenders who are under the purview of Ontario Review Board pursuant to a finding of not criminally responsible due to mental disorder.
In addition to these community support programs and court-based and custody-based services, a continuum of residential services were also developed. These include short-term residential beds, often referred to as safe beds. These residential programs provide 24-hour on-site support for up to 30 days and provide interim housing pending linkage to longer-term housing. In addition, there is dedicated long-term supportive housing, with different levels of support that range from independent to 24-hour on-site support. There are also transitional rehabilitative programs that provide high-support housing and case management to individuals transitioning from the Ontario Review Board system to community mental health services.
In order to coordinate these services, both across program areas and across sectors, local and regional committees and a provincial human service and justice coordinating committee were established. These coordinating committees were established in response to a recognized need to coordinate resources and services and to plan more effectively for people with serious mental illness, developmental disability, acquired brain injury, and/or drug and alcohol problems who are in conflict with the law or at significant risk of coming into contact with the criminal justice system.
These committees are a joint collaboration between the ministries of the Attorney General, Community and Social Services, Child and Youth Services, Health and Long-term Care, and Community Safety and Correctional Services and various community mental health and addictions organizations.
Some elements in the continuum of services, such as forensic ACT teams, transitional and long-term housing programs, and specialized case management services, may have direct relevance to the federal correctional system. Moreover, these coordinating bodies may provide a vehicle for intergovernmental planning and coordination of services for individuals who are transitioning from the federal correctional system to community-based services. Conceivably, they could be replicated in other jurisdictions. Increased collaboration between the federal correctional and provincial health and justice systems is necessary to ensure continuity of care.
However, though these services may be transferable to the federal corrections population, it is important to recognize that these services alone may not he adequate. We currently do not have an adequate program infrastructure to address the complex range of needs of this population. Moreover, there is limited capacity among existing services to meet the needs of the federal correctional population. New investments are needed to build community capacity to provide adequate services for federal offenders who have serious mental illness. Moreover, such services would need to be evidence-based and targeted at criminogenic needs that predispose a person to recidivism, such as substance abuse, antisocial attitudes, and anger management problems. They also need to target the social determinants of health, such as having adequate housing and opportunities for employment.
Moreover, it is recommended that funding for the evaluation of new programming be included in any investment in the development of services. Building an ongoing infrastructure for research and development is necessary to ascertain more effective solutions and to ensure accountability for fiscal investments.
In sum, enhancing community capacity through the development of an infrastructure of specialized, evidence-based programming that addresses the complex needs of offenders who have mental illnesses and/or addictions, and coordinating with provincial and local human service and justice providers to enhance service continuity, will serve to lower the risk of recidivism, increase public safety, and improve the quality of life of persons with mental illness who are re-integrating into society from the federal correctional system.
Thank you for this opportunity to speak on some of efforts of community mental health organizations to address the needs of persons in the criminal justice and correctional systems who have mental illness and to outline potential strategies this committee may consider in its deliberations.