Indeed. I wasn't speaking about this as a program in prisons. I should clarify that. I'm talking about a substantial body of research that has been done with people with severe, persistent mental illness who also have substance use problems.
The problem with those populations is that one of the great factors that predict relapse is their return to substance use. Yet traditionally programs were mainly oriented to doing mental health treatment and not very interested in dealing with substance use issues.
What happened when they created integrated treatment teams, which included addiction treatment expertise and worked with individuals, was that they found that the longer they were actually able to retain people in treatment the better the health outcomes. The clients' draw on other parts of the health care system—emergency resources and the like, the need for hospitalization—and their involvement with the criminal justice system were reduced. On the positive side, their ability to be doing pro-social things, like part-time work or the like, and maintain housing in a stable way and to have better community and family connections were enhanced.
So the model of care was integrated. It does require a directed kind of investment. The result is that you make a savings over time.
The research that led Ontario to do it is worldwide right now, but a lot of the work was actually done in the United States, where there's a lot of really helpful knowledge. Canada is now building some of this knowledge base about integrated treatment as well. Again, it's for people with severe mental illness and addictions, and it's about using integrated strategies that do a better job of keeping them out of hospital and functioning better and actively as members of communities.