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Newsletter of the Human Services and Justice Coordinating Committee
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Human Services and Justice

December 2014

Message from the Co-Chair


It has been a great pleasure to be involved in the Provincial HSJCC since its inception in 2005.  I was part of the initial group of regional chairs that met to explore ideas about the role of a Provincial committee and to develop a funding model that would support the development of a network of committees.   I have enjoyed immensely the opportunities that this committee has provided, and in particular the chance to meet so many amazing and dedicated people from regions across Ontario, government representatives and other leaders, that share in the belief that if we work together we can accomplish great things.    

The past two years I have served as the co-chair of the committee and my term is coming to an end in January, 2015.  While it is with reservation that I leave the committee, I do feel it is time to step down and give someone else the opportunity to be in a leadership position as the HSJCC network continues to grow and gain momentum.  The work of the HSJCC network is widely recognized and valued.  Today we see many initiatives based on the model of collaboration and I believe much of this is rooted in the success of the Human Services and Justice Coordinating Committees. I believe that many of us, from our various backgrounds and sectors, first met at a local HSJCC meeting.  We can all be proud of the contributions we have made towards breaking down the silos that had long existed. 

There is an excellent team in place to support the work of the provincial committee and HSJCC network. Jenna, Dorina and Uppala from CMHA Ontario are outstanding and so committed.   The Knowledge Exchange Committee and the unbelievable commitment from Trevor Tymchuk keep us informed and reminded of why we do this work.  The steering committee structure provides guidance and support to the co-chairs.  Katie Almond is second to none as a co-chair and I have very much enjoyed working with her.  We know from our recent survey of regional chairs that many, many hours are dedicated to the work of the HSJCC.  Thank you all.

I would like to welcome Michael Dunn as the new co-chair to the PHSJCC.  Michael Dunn is currently the co-chair of the Simcoe-Muskoka Regional HSJCC.  Michael is the Director of Research, Evaluation & Quality Improvement at the Canadian Mental Health Association, Simcoe County Branch.  I am so pleased to have someone like Michael to pass on the co-chair responsibilities.

While I say my farewells as the co-chair and member of the Provincial HSJCC you can expect that I will still be lurking around looking for opportunities to collaborate.  For the time being I will be able to focus a bit more on my work at the Canadian Mental Health Association, Sault Ste. Marie Branch.  

Wishing each of you a very happy and safe holiday season. 
 

Sincerely,

Sandie Leith
Co-Chair, PHSJCC
sandie@cmhassm.com


On November 25, 2013, St. Joseph's Healthcare Hamilton, COAST program, introduced a Mobile Crisis Response Team (M.C.R.R.T) to the COAST service. This is a partnership with the Hamilton Police Service to provide direct, rapid support of persons in mental health and addiction crisis by partnering a uniformed officer with a mental health professional to attend to these individuals in their time of crisis.
 
In 2012, 1674 Persons in crisis were taken to St. Joseph’s Healthcare Emergency Department from the 3 divisions of Hamilton Police Service.  COAST responded to approx. 5000 requests for service but only accompanied 200 of these individuals for further psychiatric assessment in 2012.  Division 1 (Central Hamilton) typically brings 50% of those individuals or 827 people.  The goal of this project was to reduce the number of individuals (N = 827) brought to St. Joseph’s Emergency Room by Division 1 officers and to divert people away from the ER and towards community services whenever possible.   This increased service was also being sought by the community due to several tragic encounters by people with mental illness with police and to increase the number of police contacts with people with mental illness with a mental health professional present. All referrals would come directly through Police dispatch via 911 and the team whenever possible would be the first responder to the mental health crisis.

The M.C.R.R.T was mobile for a total of 175 shifts and responded to 562 individuals in crisis between November 25th, 2013 and July 31st, 2014.  (This number includes actual physical contact as well as telephone contact).

Of the 562 individuals seen, there were 155 who were apprehended by the M.C.R.R.T under Section 17 of the Mental Health Act for assessment at Hospital (37 youth were taken to McMaster University and were not included).  Of the remaining 407 individuals, 367 were immediately diverted/connected to other available services, 40 were apprehended on the strength of Mental Health Act Forms already in place and required no further assistance.  13 individuals were apprehended under Sec. 17 of the MHA (including 1 youth) and 8 were apprehended under other MHA forms. Officers participating in the program with M.C.R.R.T were questioned as to whether they would have apprehended the individual if the Mental Health Professional was not on-scene.  Officers advised they would have apprehended the individual an average of 70% of the time compared to M.C.R.R.T apprehending only 27.6% of the time. With the M.C.R.R.T strategy in place a reduction of 893 hours of officer’s time that would have been spent in Hospital waiting rooms had already been saved.

It has been proven based on these comparisons that the ability to have a client assessed in the field by the mental health professional greatly reduces the number of individuals being apprehended and taken to Hospital.  For the individuals who are apprehended only the M.C.R.R.T is required to remain at hospital.  With the close working relationship between hospital staff and the M.C.R.R.T mental health professionals the reduction in wait times is significantly reduced and is expected to continue to improve over time.

The M.C.R.R.T is meeting its objective of reducing the number of individuals being taken to hospital as well as reducing the number of hour’s uniform patrol officers are spending at hospital. The feedback from the front line officers, communications section and partners has been fully supported. It is expected that over time the M.C.R.R.T will continue to make a positive impact for the police, the individuals in crisis and ultimately the community as a whole.

Terry McGurk
Program Manager, COAST
St. Joseph’s Healthcare
tmcgurk@stjosham.on.ca

Link to this article on our website
HSJCC members attend National Correctional Services Healthcare Conference

Howard Sapers, Correctional Investigator of Canada, opened the conference by talking about current issues within federal corrections including the treatment and management of mental health issues as well as an aging population within pr­­­­isons that requires accommodation. He also went through two recent reports on chronic self-injury and prison suicide and announced that the government response to the Ashley Smith case should be made public before the end of 2014.

In the afternoon of the first day, Heather Lumley, Executive Director at St. Leonard’s Community Service in London, and Chair of the South West Regional HSJCC, spoke on gendered pathways to crime. This was research done in collaboration with the University of Western Ontario to explore the gendered effect of past trauma on pathways to criminal convictions and to study how female and male offenders differ in their involvement with the criminal justice system. The research found that female offenders experience higher rates of physical and/or sexual abuse histories whereas male offenders experience higher rate of emotional abuse and physical abuse as children. Results also showed that women and men entre the criminal justice system with different presenting issues in terms of mental health, substance abuse and financial and legal needs.

On the second day, Dorina Simeonov, Policy Advisor to the HSJCC (left) and Leslie Wight, Health Manager at the Algoma Treatment and Remand Centre (right) presented the HSJCC Info Guide Strategies for Community Service Providers for Engaging in Communication with Correctional Facilities in Ontario.

The presentation included:
  • Successful approaches to communicating with correctional centres;
  • Practical tips to facilitate communication; and
  • Key components for sharing information including a focus on confidentiality.
The conference also featured presentations from across Canada on how to better respond to individuals with mental health issues in the correctional context, evidence-based interventions, suicide prevention and effective practices for supporting people with Fetal Alcohol Spectrum Disorder (FASD).
If you are interested in learning more about this conference, click here. To view Speaker Presentations go to www.healthcareconferences.ca/P14C05  and enter the password: CR%S
 









 


Creating links to community supports in the City of Toronto

The Toronto Justice Service Collaborative (TJSC) spans the entire City of Toronto and is unique among Ontario’s Service Collaboratives—it is the only one tasked with addressing the needs of adults. It consists of roughly 200 organizations from across the city that are dedicated to improving connections between the justice system, health services, and social service supports for people leaving custody.

The TJSC is developing processes that link individuals being released from provincial remand, bail, and short term detention to coordinated and community-based supports and services that can help meet social determinants of health needs (i.e. housing, employment). The processes are being developed in response to the needs identified by the TSJC.

These processes will be piloted at two sites:
  • The Reintegration Centre (a multi-service hub located across from the new Toronto South Detention Centre that will act as a first point of contact for many individuals upon their release from the prison) and;
  • The College Park Courthouse’s Bail Court (a downtown courthouse that serves both men and women that has seen a sharp increase in cases involving people with mental health and addictions issues in recent years).
Partners in the community will receive referrals from these two locations and help coordinate supports and services. Data on the needs of individuals exiting the justice system will be collected to inform future policy and system planning efforts.

The ongoing development of the TJSC’s new processes is intended to complement the work and goals of the Toronto Regional HSJCCs and Local HSJCCs, who have experience and expertise in this area. For example, the TJSC may support a Toronto-HSJCC environmental scan of existing referral and service provision networks in the GTA. This scan will help identify gaps and expand access to organizations that are well-positioned to address the changing needs of a city that is becoming increasingly diverse.

The city-wide partnerships developed through the TJSC are helping to increase the system’s capacity for communication and collaboration between different sectors. For example, ‘health’ and ‘mental health’ are treated as provincial responsibilities and are typically funded with provincial dollars. However, many services that address a person’s social determinants of health needs are funded by municipalities. The TJSC is working to bring municipal partners (i.e. the Social Services Housing Association and the City of Toronto Community Development Unit) together to expand the range of services and supports available for people leaving custody.

In the new year, the TSJC will outline the new processes to be piloted in more detail and begin putting them into practice. For more information on the Toronto Justice Service Collaborative and other Service Collaboratives, please visit www.servicecollaboratives.ca
 

Featured Resources

Best Practices Guide to Medical and Psychological Reports Under Section 34 of the Youth Criminal Justice Act

Produced by the Crown Law Office - Criminal, Ministry of the Attorney General, with the assistance of the Centre for Addiction and Mental Health, the Ministry of Health and Long-Term Care, the Ministry of Children and Youth Services, and Legal Aid Ontario.


Mental Health Law in Ontario: An Overview
The mental health regime in Ontario is complex. It is governed by several different statutes that have each evolved over time to reflect changing attitudes to mental health and shifting policy intents. This Report provides a comprehensive description and analysis of the regime’s legislation – the Mental Health Act, Health Care Consent Act, Personal Health Information Protection Act, Substitute Decisions Act, and to a lesser extent, the Child and Family Services Act and Youth Criminal Justice Act. It describes key mental health law provisions in all other Canadian jurisdictions and select international jurisdictions.  It concludes with a chapter on implications for policy, strategy and research in Ontario.

 
Clubhouse International and the Clubhouse Model of Psychosocial Rehabilitation


The Clubhouse Model began in the mid 1940’s with the development of Fountain House in New York, New York. Today there are over 340 Clubhouses operating in 32 countries. Approximately 100,000 people living with mental illness access Clubhouse services annually.

Clubhouse International is a multi-national non-profit organization that helps communities around the world create sustainable solutions for mental illness by developing and nurturing new and existing Clubhouses.

Clubhouses are community-based centers that offer members opportunities for friendship, employment, housing, education, and access to medical and psychiatric services through a single caring and safe environment, so members can achieve a sense of belonging and become productive members of society.

Clubhouse International oversees the creation and evolution of rigorous quality standards (Clubhouse Accreditation); develops and delivers quality training and consultation to help Clubhouses achieve and maintain Accreditation; manages the Accreditation process; and coordinates ongoing research, advocacy and communications efforts aimed at improving public awareness of the effectiveness of our Clubhouse approach, now included in the US National Registry of Evidenced-Based Programs and Practices (NREPP).

The following excerpt is taken from the Clubhouse International Resource Guide:

What is a Clubhouse?

Clubhouses are a powerful demonstration of the fact that people with mental illness can and do lead normal, productive lives. Clubhouses are local community centers that provide members with opportunities to build long-term relationships that, in turn, support them in obtaining employment, education and housing, including:

•    a work-ordered day in which the talents and abilities of members are recognized and utilized within the Clubhouse; 
•    participation in consensus-based decision making regarding all important matters relating to the running of the Clubhouse;
•    opportunities to obtain paid employment in the local labor market through a Clubhouse-created Transitional Employment Program. In addition, members participate in Clubhouse-supported and independent programs;
•    assistance in accessing community-based educational resources;
•    access to crisis intervention services when needed;
•    evening/weekend social and recreational events; and
•    assistance in securing and sustaining safe, decent and affordable housing.

In Canada, there are 20 Clubhouse Programs operating and together they make up the Clubhouse Canada Coalition.

On World Mental Health Day (October 10, 2014) 10 Clubhouse programs from across the country participated in a Flash Mob event. The Flash Mob events were conducted to bring awareness to Clubhouses across Canada as well as to break down stigma against mental health. A Canada wide Flash Mod video has been prepared and can be viewed at:

https://www.youtube.com/watch?v=JkFJn5OYpdQ

This year, additional recognition of the Clubhouse Model was received when Clubhouse International and Fountain House, New York received the 2014 Conrad N. Hilton Humanitarian Prize of $1.5 million. The Conrad N. Hilton Foundation presents the annual award, the world’s largest humanitarian prize, to organizations that are doing extraordinary work to alleviate human suffering. An independent international jury makes the selection. “On behalf of Clubhouse International and our 340 member Clubhouses around the world, who share in this recognition, I want to express our sincere and deep appreciation to the Hilton Foundation and everyone associated with the Conrad N. Hilton Humanitarian Prize,” said Joel Corcoran, Executive Director of Clubhouse International. “It provides the opportunity and inspiration for us to dramatically scale up our work fostering sustainable Clubhouses. It gives us the great hope of reaching many more individuals living with mental illness everywhere that would otherwise be exiled to a life of isolation and despair, who will now have access to hope, opportunity, dreams, and a future rich with purpose and respect.”
 
Submit articles and events to the Editor, Trevor Tymchuk, at trevor.tymchuk@hsjcc.on.ca
Webinar:
Fetal Alcohol Spectrum Disorder and Justice-Related Services

Held November 26, 2014, this webinar can be viewed at your convenience.

The slides for the presentation can be downloaded from the HSJCC website.

You may also be interested in FASD and Justice: Summary of Activity in Ontario and FASD: A Call to Action in Ontario.
 
Justice Richard D. Schneider on Changes to the NCR Legislation

The Downtown Toronto Human Services and Justice Coordinating Committee (DT- HSJCC) presented a Lunch N’ Learn Session with The Honourable Mr. Justice Richard D. Schneider.
Held October 29, 2014.
 
Watch at the new HSJCC Vimeo page.

Research of Interest

The association between neuropsychological performance and self-reported traumatic brain injury in a sample of adult male prisoners in the UK
Neuropsychological Rehabilitation: An International Journal

Assessment Practices and Expert Judgment Methods in Forensic Psychology and Psychiatry
Criminal Justice and Behavior

The prison adjustment of Canadian Aboriginal offenders
Australian & New Zealand Journal of Criminology

High Users of Emergency Departments in Quebec Among Patients With Both Schizophrenia and a Substance Use Disorder
Psychiatric Services


 
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Upcoming Events


Best Practices in Dementia Care: Learning to Give Care, Without the Fight
Ottawa, January 6, 2015

3rd Annual Mental Health Law for Children and Youth
Toronto, January 28, 2015

Youth Justice Intensive Rehabilitative Custody and Supervision (IRCS) Regional Forum
London, January 28, 2015

Gaps in health care for individuals with developmental disabilities and mental health or addiction issues
Webinar, February 12, 2015

Ontario Shores’ 4th Annual Research Day - Advancing Recovery Research: Patients, Partnerships and Peers
Whitby, February 24, 2015

National Canadian Forensic Nursing Conference
Vancouver, February 25-26, 2015

Shadows of the Mind Film Festival
Sault Ste. Marie, February 25 - March 1, 2015

Uniting the 8th Fire Prophesy for Culturally Appropriate Aboriginal Mental Health and Addiction Services
London, February 26, 2015

6th International Conference on Fetal Alcohol Spectrum Disorder
Vancouver, March 4-7, 2015
 
Funded by the Ministry of Health and Long-Term Care
 
         
With the Support of the Canadian Mental Health Association, Ontario Division
Copyright © 2014 Human Services and Justice Coordinating Committee, All rights reserved.


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