You requested a brief presentation.
I'm a criminologist. I joined CSC almost three years ago. Before that I was associate deputy minister for the public safety department in charge of correctional services of Quebec. I have also worked for almost twenty years in the community and in Quebec.
Ladies and gentlemen, thank you for your invitation to have me appear before the Standing Committee on Public Safety and National Security.
Your work on mental health and addiction has recently brought you to visit quite a few institutions across Canada, particularly in the Quebec Region. You visited the Regional Mental Health Centre, within Archambault Institution, and the Special Handling Unit, within the Regional Reception Centre. All of these visits have certainly given you a good idea about our work and achievements in the areas of addiction and mental health interventions with incarcerated offenders. However, inmate custody is only one component of the Correctional Service’s mission, and we are pleased to be able to speak with you today about the tools available to the Correctional Service in the community to ensure effective and safe reintegration of the parolees under its supervision.
The Correctional Service places a great deal of importance on the continuum of care of offenders, from incarceration until the end of parole and even beyond. The availability and accessibility of community resources are important factors in assessing and managing an offender’s risk, and the Correctional Service therefore considers them to be directly linked to public safety.
Initially, three other community workers were also to take part in today’s session to present the addiction and mental health services they provide to offenders in the community. Although they were unable to accept your invitation, we are pleased to see you are interested in community services, given the importance of the partnership with these agencies that enables us to fully carry out our mandate in the community.
We have many community partners; together this creates a real safety net around parolees and former inmates based on each one’s estimated degree of risk. While the police do certainly contribute to this safety net, community organizations, groups of volunteers and all the community support provided are also indispensable to true public safety. This network of resources, their operations and effectiveness are unfortunately not well known; this is why I will focus mainly on these aspects during my brief presentation. We will then be available to answer any questions from your members, and that is why Ms. Perreault, psychologist and manager of the Institutional Mental Health Initiative, and Andrée Gaudet, associate director and parole supervisor for the entire Montreal and South Shore area, will be able to supplement the presentation and answer your questions.
Before going into the details of the mechanisms the Correctional Service uses to provide the continuum of care in the community, I believe it would be appropriate to quickly review the organization of our mental health services. You saw at the Regional Mental Health Centre that we provide intensive specialized mental health care to inmates from institutions across the region. They are referred there when the services available in each institution are no longer adequate to meet their offenders’ mental health needs. These may be particularly acute suicidal or self-injury cases, a psychiatric emergency, or a need for psychiatric assessment or long-term specialized treatment. Each institution has services to meet their inmates’ mental health needs.
The Institutional Mental Health Initiative, which was rolled out almost two years ago, focused on mental health intake screening. We now have a computerized mental health screening system at intake and for the subsequent exhaustive assessment of mental health needs, and the delivery of primary mental health care. In this respect, the tangible impact of the Initiative in the Quebec Region has been to put in place mental health teams in all institutions, that is to say 12 teams at a number of locations in Quebec. These teams are made up of mental health professionals, psychologists and mental health nurses. It has also helped develop initial findings on the prevalence of mental health needs in our inmate population, which is 15% at intake for men and 58% at intake for women.
It has also made it possible to provide primary mental health care services to 19% of the male inmate population, or roughly 575 offenders in Quebec; to provide mental health training to our correctional staff at Joliette Institution and the Regional Mental Health Centre; to develop interdisciplinary clinical management plans in complex mental health cases, in particular repeated acts of self-injury and, of course, to follow up implementation of these plans.
Lastly, in a pilot project, through the Institutional Mental Health Initiative, we have rolled out a tracking system for mental health services provided in two institutions, Donnacona and Joliette, in order to better identify our needs for developing new mental health services.
Starting on April 1, all institutions in the Quebec region will have this system, which means that we will able to say exactly who and how many people have received mental health services, and when, something we have been unable to do until very recently.
Let us now go back to our continuum of services. Institutions facing problematic mental health cases that exceed their local capacity may refer these cases to the Regional Mental Health Centre. Now, while the Correctional Service has access to highly appropriate expertise and facilities, certain cases require even greater care and are then referred to the Institut Philippe Pinel de Montréal, which has been a partner of the Correctional Service for over 30 years. IPPM is the second level of referral for women offenders. It is a national unit that serves all regions of the Correctional Service.
Under the binding contractual agreement we have with them, IPPM has up to 12 beds available for sex offenders, specialized treatment for sex offenders who also present mental health needs, 12 other beds for women offenders, and three beds for offenders with acute mental health needs. In all cases, inmates staying at either the Regional Mental Health Centre or IPPM eventually return to their home institution. In fact, the link between the local case management team and the care team where the inmate or woman offender is referred to is never broken, in accordance with the principles of the timely sharing of information and of the continuum of care.
The special needs of offenders with mental health problems are considered during their incarceration, including as part of their preparation for returning to the community. When it comes time to make concrete reintegration plans, new professionals join the case management team. Another mental health initiative, this one in the community, plays a major role in planning the release of offenders with mental health needs. Clinical teams working with this initiative, nurses and social workers, are involved in organizing transitional mental health care several months prior the first potential release date.
Case management teams and workers from both mental health initiatives work together to identify mental health needs and support needs to ensure safe release. Essentially, their work involves identifying the best place for an offender to begin his return to society, by balancing off the intensity of his needs with the individual’s resources and environment. Once the place—the resource—is identified, they then begin the real groundwork: they discuss with the resource, contact the surrounding services, the police, community health centres and community agencies, and inform the offender, thereby preparing him for his transition into society.
Currently, the Community Mental Health Initiative is monitoring 76 parolees. Of course, a greater number of offenders are presenting mental health needs upon release. However, only a fraction of these cases require supervision under this initiative. These 76 offenders currently monitored under the Initiative present supervision needs that go beyond what the regular release procedures are able to provide. Measures taken by the Community Mental Health Initiative are similar to but more intense than what is done when releasing cases with minor or no mental health needs.
In order to fulfill its mandate to ensure the successful transition of offenders, the Community Mental Health Initiative has forged ties with community partners whose mission is to work with, support and defend the human rights of people with mental health needs. These ties are intended to make these resources available to offenders with mental health needs. The areas targeted by these ties between the Correctional Service and specialized community mental health resources range from psychiatric supervision, adherence to pharmacological and/or psychosocial treatment and housing needs, to job skills through supervised workshops and support for day-to-day activities.