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Newsletter of the Human Services and Justice Coordinating Committee
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2015 Provincial HSJCC Conference Newsletter 

 

Letter from the Co-Chair
It is my absolute pleasure to have the opportunity to co-chair the Provincial Human Services and Justice Coordinating Committee during this exciting time of growth and innovation, both within the HSJCC Network, but also in the broader mental health and justice landscape in Ontario. The 2015 Provincial HSJCC conference, “Mobilizing Communities: Promoting Resiliency, Sustaining Recovery and Restoring Justice” was, in my opinion, the very expression of this growth and innovation.
 
This year we had 435 delegates attend the conference, which is our biggest turnout to date. The passion and excitement of this group was not only expressed through the engaging presentations and guest speakers, but also through the informal conversations and networking that happened throughout the conference. On behalf of the new HSJCC Secretariat and my fellow co-chair Katie Almond, it was a pleasure to meet so many of you in person and learn about the work you are doing in your communities and how this work is truly making a difference in the lives of Ontarians. I left feeling inspired about the future of mental health and justice work in this province, and in the words of our keynote speaker Sheldon Kennedy, “there is hope, I can guarantee you that.”
 
We were fortunate to have an impressive and diverse group of guest speakers and presenters at this year’s conference including: Sheldon Kennedy, Dr. John Bradford, Inspector Chris Boddy, Justice Peter DeFreitas, Dr. Karen De Freitas, Const. Scott Logan, Yolanda Diston, Dr. Philip Klassen and Justice Heather Perkins-McVey. Additionally, the performance and talk given by the Robb Nash Project undoubtedly left us all with a feeling of renewed hope as we return to our work. It was an honour to welcome Ontario’s Minister of Community Safety and Correctional Services, Yasir Naqvi to the HSJCC conference. His comments helped galvanize the importance of moving forward together to improve services for justice involved individuals.
 

Thank-you for taking the time to complete the Priority Setting Exercise Questionnaire which was part of your conference package. We will be using this feedback to help the Provincial Human Services and Justice Coordinating Committee as we embark on the development of our workplan for 2016/17. Look forward to more correspondents on the workplan very soon. Lastly, thank-you to all those who attended and participated in our fifth biennial conference. You helped make it a success, and on behalf of the Provincial HSJCC, we hope that you enjoyed it as much as we did.
 
Michael Dunn
Co-Chair
Provincial Human Services and Justice Coordinating Committee
2015 HSJCC Conference - An Overview
Welcome to the 2015 Provincial HSJCC post-conference newsletter! We are happy to be able to provide our newsletter audience the chance to read about important outcomes and key messages of workshops and presentations that were provided at the 2015 events from November 16-18, 2015.
 
On behalf of the Provincial HSJCC, thank you to all presenters, planners and participants of the 2015 Provincial HSJCC conference! It was truly a remarkable event because of your passion and dedication to the clients you serve.
 
All conference presentations can be found on the HSJCC website here.
 
To help the planning of the next Provincial HSJCC Conference, we are asking you to please complete a survey to help us determine topics of interest for the next event in 2017. You can also let us know if you want to help plan the next conference program by participating in the conference planning committee through the survey.
 
Post-Conference survey link: https://www.surveymonkey.com/r/HSJCCPostConf2015
 
For a complete review of conference tweets including pictures of the event, please click here. 
Greetings from Ontario Ministries
The 2015 Provincial HSJCC conference kicked off with a welcoming message from the Ministry of Health and Long-Term Care. Sean Court, Interim Director of the Strategic Policy Branch, provided greetings to the conference delegates, stressing the importance of multi-sector collaboration as the key in addressing the needs of the most vulnerable clients within the province. Mr. Court said “what you are doing on the ground, is helping the lives of Ontarians,” an acknowledgement of the immense impact that HSJCC Network members are having through their dedication and compassion for the clients they serve.
 
Mr. Court also indicated that the Ministry was happy to provide support for the creation of the new Provincial HSJCC Secretariat. The Provincial HSJCC Secretariat is a dedicated team of four staff that will be a key resource in enhancing collaboration, innovation and integration within the human services and justice sectors by leading projects and initiatives aimed at improving systems. He outlined his excitement to be w
orking with the HSJCC Network on the upcoming project that will reduce wait times for police accompanied visits to hospital emergency departments, one of the priorities of Ontario’s Comprehensive Mental Health and Addictions Strategy.
 
The Minister of Community Safety and Correctional Services
(MCSCS), Yasir Naqvi, p
rovided an address from his Ministry regarding initiatives as they related to the HSJCC Network.  
MCSCS is working to change its protocols when it comes to people with mental illnesses entering the criminal justice system. That’s the message Minister Naqvi shared at the conference. 

In his speech, Minister Naqvi described Ontario’s current correctional systemas a ‘warehouse model’ and emphasized that this model must be replaced with a more holistic approach to dealing with offenders. He shared the commitment by MCSCS to ensure that mental illnesses be dealt with appropriately at the pre-charge stage in order to avoid                                                 
unnecessary entry into the criminal justice system, and applauded the                           
work of community organizations working hard on mental health for Ontarians. 
 
For more information on the second phase of Ontario’s Comprehensive Mental Health
 and Addictions Strategy, please click here.
 
For more information on MCSCS, visit their website.
Key Note Presenters:
Sheldon Kennedy
Sheldon Kennedy, a former NHL player and passionate child advocate, opened the 2015 Provincial HSJCC conference with a stirring address that reinforced the importance of hope and resiliency in promoting positive social change. 
 
Kennedy shared his personal experience of sexual abuse as a child and his journey of empowerment in overcoming the life-long affects of trauma.  He also stressed the importance of collaboration in detailing the important work of the Sheldon Kennedy Child Advocacy Centre, which provides wrap-around, interdisciplinary services for the victims of child abuse in Calgary and Southern Alberta.  His courage and tireless determination to protect the vulnerable deeply resonated with delegates and energized them for the duration of the conference. Sheldon’s message of cross sectorial collaboration to better address the needs of vulnerable clients spoke to the very core of the HSJCC Network, and the delegates appreciated
learning about the successes of Sheldon’s work Calgary.


For more information on the Sheldon Kennedy Child Advocacy Centre, please visit the organizational website here.  
 
Key Note Presenters:
The Iacobucci Report
Keynote speakers Dr. John Bradford and Inspector Chris Boddy provided an insightful presentation on the Iacobucci Report- an independent review conducted in 2014 by the Honorable Frank Iacobucci of the use of force by the Toronto Police Service (TPS) in dealing with people experiencing a mental health crisis.  Together, the presenters also outlined how emergency services can better ensure safe interactions in these situations. 
 
 With his
 extensive expertise in the area, Dr. Bradford outlined  for delegates the challenges and opportunities present in the  relationship between mental illness and safety.  Inspector  Boddy detailed the ways in which the TPS has responded to the recommendations of the Iacobucci  Report.  By providing a review of how the TPS has changed its training and operations to align with  these recommendations, Inspector Boddy enabled delegates  to better understand how police are working to enhance their services for vulnerable people in crisis situations.
 
The full Iacobucci Report, Police Encounters with People in Crisis, can be found here.
Key Note Presenters:
The Geriatric Patient- Lost and Wandering in the Forensic System
The delegates of the 2015 HSJCC Conference heard about specific issues relating to geriatric patients within the forensic system, a growing issue in Ontario and throughout Canada. A panel discussion was held containing some of the province’s experts on the issue of seniors and the criminal justice system.
 
The panel included: Justice Peter De Freitas, Dr. Karen DeFreitas (Ontario Shores), Constable Scott Logan (Durham Regional Police Service); and Yolanda Diston, R.N. (Durham Mental Health Services).
 
The presentation was delivered with the understanding that seniors coming into contact with the law will only be escalating over the next decade or so as it is estimated that about 22% of Canada’s population will be considered seniors by 2022. The number of forensic senior clients are steadily increasing and the system needs to better adapt to this new client group that they will be serving. The panel was in agreement that the current systems and facilities that we have in both human services and the criminal justice system were simply not built for an aging population.
 
Examples were provided to illustrate the complexities of an aging population and their interactions with the justice and health care system such as: denial of in-home services due to a criminal record; long wait lists and exclusion criteria for seniors with a criminal record within long-term care homes; and ill equipped forensic facilities for the unique
needs of seniors. 
 
Senior related illnesses such as dementia pose challenges for police officers and judicial professionals. For example, often when police are called to a situation involving harm to another person or to oneself for an individual with dementia, the senior often does not recall the incident and does not understand the rational for a police service being called to their home.  In the court system, it was noted that the judiciary needs to fully understand what the legal options are realistically for a geriatric client – and take into consideration an individual’s full story and age-related mental health challenges to make the best action plan for a geriatric client. In unfortunate situations, the issues for seniors only amplify if they are incarcerated with a mental health condition.
 
Ultimately, the theme of this enlightening panel presentation was that collaboration amongst the health and the justice system needs to improve for service providers of all sectors to better meet the needs of an aging population. Some high level solutions provided during the panel discussion and comments from the audience included improved risk management and assessments for clients entering a long-term care facility; increasing senior related services within the forensic system; and improved release planning for seniors exiting the criminal justice system.
 
The aging population in Ontario and senior interactions with the criminal justice system has been a topic for discussion at all levels of the HSJCC Network from local, regional and provincial tables. Conference participants truly appreciated the insights, improved understanding, and suggested ways to address an expanding issue for many of our service providers and clients from the guest speakers. 
Key Note Presenters:
A Quality Standard for Forensic Mental Health Services in Ontario: What Matters Most?
The keynote speaker for Day 2 of the Provincial HSJCC conference was Dr. Phillip Klassen, the Vice-President of Medical Affairs at Ontario Shores Centre for Mental Health Sciences. As an active researcher and a well-published forensic psychiatrist, Dr. Klassen understands the importance of evidence based practice. His talk, titled “A Quality Standard for Forensic Mental Health Services in Ontario: What Matters Most?” was a great overview of the Quality Standard development process for schizophrenia in Ontario being lead by Health Quality Ontario. He highlighted the progress that has been made so far on developing quality standards for depression, dementia and schizophrenia.
 

  Dr. Klassen noted that there is a high degree of variability in      mental health service delivery across the province, however,      this means there is an opportunity for improvement, and  developing quality standards is a step forward in that direction.   The quality standards are intended to provide guidance for  quality service delivery and reduce variations across  the province, while maintaining flexibility to adapt approaches to unique community and organization conditions. Dr. Klassen also talked about the importance of working with different sectors, and given the multi-sectoral nature of the HSJCC Network, this resonated well with the audience. Lastly, it was recognized that we need to do more research and develop mental health programs and services that are tailored to the needs of the Aboriginal community.  
 
For more information on
 the development of Quality Standards in Ontario, you can read Health Qu
Key Note Presenters:
One Last Breath
“You’ve got one life. Don’t take it for granted.” That is part of the message speaker and musician Robb Nash is sharing with people across Canada. On November 17, Robb Nash and his band performed for everyone at the Provincial HSJCC conference and what a performance it was! People cried, cheered, clapped, and then cheered some more after listening to Robb’s inspirational story and his music.
 
The story of Robb Nash is not a typical one. When Robb was a teenager, he was pronounced dead at the scene of a horrific car accident. But the paramedics were wrong and he survived the accident. Fast forward to years later, part of his skull is now made out of metal and he is still undergoing surgeries. Overcoming his anger, self-doubt and depression, he has found the energy and courage to start the Robb Nash Project. Through the power of music and his story, the Robb Nash Project is inspiring young people to lead positive and purposeful lives.
 
Many young people have come up to Robb after his concerts and handed over their suicide notes that they had kept in their pockets for a long time. Robb and his band changed the perspective of these young people: they are not cursed as they have been told by everyone. They are gifted. And they have so much to offer.
 

Numbers do not capture the impact of the       Robb Nash Project but, just as an idea, in 2012/2013, Robb and his band presented to more than 220 schools and almost 100,000 students. Driven by the motivation to make his story and music available to everyone, especially young people, his concerts are free to attend. Robb and his band have toured across Canada performing at more than 150 concerts each year in schools, detention centres, First Nations communities and other venues. Thank you to Robb Nash and his band for sharing their stories and music with us at the HSJCC conference. To find out more about the Robb Nash Project, check 
out: http://www.robbnash.com/
philanthropy.html.
 
If you are working with youth and would like to invite Robb and his band to your organiz
ation, you can reach him at info@robbnash.com
Key Note Presenters:
Mental Health Courts- Finding Institutional Resilience and Promoting Justice
Justice Perkins-McVey, of the Ontario Court in Ottawa and the East Region of Ontario, spoke about the effectiveness of mental health courts in Ontario and provided persuasive evidence to suggest that the current model should be improved. Although there is a lack of uniformity in how specialized courts operate in Ontario, studies show that there are some key elements instrumental to reducing recidivism and providing lasting rehabilitation to clients.

 Perkins-McVey noted that studies done on the issue showed that  a more structured mental health court yielded better results,  namely, a marked reduction in recidivism in graduates of the  program. A reporting program followed by a graduation  ceremony upon completion are some of the elements of a more  structured mental health court. Also noted was the importance of  acknowledging substance use and addiction, particularly the  need for early identification of substance use as self-medication for mental health issues.

Perkins-McVey provided an excellent foundation for addressing the state of mental health courts across Ontario. The HSJCC specialized courts project will benefit from this insight in going forward. 
Concurrent Sessions
The concurrent learning sessions at the Provincial HSJCC conference were an excellent opportunity for individuals working at the intersection of the human services and justice systems to come together and share information on relevant strategies, practices and tools. Similar to previous years, the 2015 Provincial HSJCC conference was packed with many informative learning sessions. 
Concurrent Sessions:
System Improvement through Service Collaboratives (SISC): Implementing Cross-Sectoral Initiatives within the Justice System to Support Children and Youth with Mental Health & Addiction Needs 
On Day 1 of the HSJCC conference, members from the System Improvement Through Service Collaboratives (SISC) and Justice Collaboratives hosted a learning session on “Implementing Cross-Sectoral Initiatives within the Justice System to Support Children and Youth with Mental Health and Addiction Needs”. The room was packed and those who attended the session learned about the SISC initiative, and how implementation science and a community-led process can be used to address system gaps. The SISC initiative supports 18 Service Collaboratives that focus on improving services for individuals with mental health and addictions issues who are at the transition points between hospital and community settings, health and justice systems, and youth and adult services.
 
During the learning session, members from three youth justice focused Service Collaboratives, Niagara, Kenora-Rainy River, and Champlain discussed the interventions they have implemented to address system gaps for mental health clients who are involved with the justice system in their local communities. These interventions include:
 
  1. A Youth Court implemented by the Niagara Youth Justice Service Colloborative that has become a platform to provide better services and support to justice-involved youth with mental health and addiction issues
  2. Trauma-informed training provided for community service providers by the Kenora-Rainy River Youth Justice Service Collaborative, and;
  3. An early intervention program developed by the Champlain Youth Justice Service Collaborative that focuses on navigation and coordination of services for youth between the ages 11 to 13 with suspected mental health and/or addictions issues, who are at risk of becoming justice involved.
To find out more about these three Service Collaboratives and others, please go to the following website: http://servicecollaboratives.ca/. Thank you to all the presenters, and we look forward to continue learning about the work of the Service Collaboratives.
 
The full presentation on the justice-related SISC implementation initiatives can be found here
Concurrent Sessions:
Northeast Regional Justice Outcomes Project
For conference delegates that attended the session on the Northeast Regional Justice Outcomes Project, the speakers proved that “data is sexy” through an engaging presentation on an innovative practice within their region. Through a partnership effort in the Northeast Region of Ontario, organizations within this area have come together to create a database that documents outcomes for people within the criminal justice system that have utilized court support and diversion programming through mental health and addictions service providers.
 
This project initiated with the identification of an issue: that although organizations providing court support and diversion programming in Northeastern Ontario were working together, there was no way to tell how well these programs were operating because of a lack, of common definition of success. Different organizations had a different interpretation of what was meant by success in various areas such as diversion and release from custody programming.
 
To tackle this issue, multiple organizations within the Northeast Region came together to support the creation of an online portal where justice-related outcomes for mental health programs are now being tracked. The portal was created by Stratim, a consulting firm specializing in strategy and measuring organizational performance through tools and other services.
 
Some outcomes that are measured in the Northeast Regional justice programs include:
  • Diversion Success rates: How successfully are people diverted from the criminal justice system and into the mental health system?
  • Admission Aversion Rate: How many inappropriate admissions to forensic units are avoided?
  • Diversion Recidivism: How many people while on mental health diversion were known to reoffend within the diversion period?
The data that is collected through the portal includes demographic information, associated agency, court, and a unique reference number only known to the agency working with the client. There are no personal identifiers added to the portal, making the data anonymous. Data is collected using existing professional tools such as the Ontario Common Assessment of Need (OCAN) and is integrated using current practices.
 
Over the first two years of implementation, trends are starting to emerge for justice involved clients of mental health and addictions programs within the Northeast Region. For example, youth recidivism rates are higher in Sudbury and Nipissing, and involvement with a justice program for Dual Diagnosis clients leads to increased success rates for bail releases.
 
Towards the end of the presentation, the speakers indicated that their portal is still new in their area, but it is showing great potential to improve outcomes for clients involved in the criminal justice system. A key theme from presenters is that this initiative required commitment from all levels of the system (Local Health Integration Networks, mental health and addictions agencies, and front line staff) and there needs to be a commitment to find common language to work with when defining measures early on in the process.
 
The full presentation on the Northeast Regional Justice Outcomes Project can be found here. The Provincial HSJCC also has hosted a webinar on this topic which can be viewed by clicking here.
 
For more information on StratIM please visit their website here. 
Concurrent Sessions:
Reintegration Centre Inception and Development: Mobilizing Community
Conference delegates heard from representatives of the John Howard Society of Toronto, CAMH, the Toronto South Detention Centre and Cota speak about the Reintegration Centre - a collaborative and comprehensive network of services provided by multiple organizations and housed under one roof.  The Reintegration Centre is designed to quickly and effectively mobilize community resources in assisting men leaving the justice system to rehabilitate and reintegrate well back into their communities.
 
 With multiple service providers  working together in a close  relationship with and close  proximity to the Toronto South  Detention Centre, the  Reintegration Centre has had  success providing support to  recently discharged men with  complex service needs.  The  Reintegration Centre connects individuals with services relating to substance use, relapse prevention, harm reduction, mental health services intake and case management, pre-employment skills, anger management and housing. This service delivery is enhanced by the inclusion of peer support workers. 
 
The full presentation on the Reintegration Centre can be found here. 
Concurrent Sessions:
Traumatic Brain Injury and the Criminal Justice System 
This workshop highlighted the socio-demographic and health-related facts of people with traumatic brain injuries (TBI), also referred to as acquired brain injuries (ABI), in the criminal justice system. The presenters gave statistics on risk factors as well as facts on correlating factors of substance use and mental illness, which complicate assessments and treatment of all issues. An estimated 16-18% of Canadians with TBI have never sought medical attention. This is a staggering number given the model of our healthcare system and is also of great concern given that there is an increased risk for incarceration among people with TBI.

One of the main problems for people with TBI inside correctional institutions is the lack of appropriate attention and care given to their complex issues. Rules-based environments are highly aggravating environments and often increase negative behaviour in these individuals. TBI can often mimic other illnesses or addiction, which may lead to counterproductive tactics by correctional staff.  What works to address some general inmate behaviour may be extremely detrimental to TBI inmates and prevent them from achieving rehabilitation. More attention and specific programs are therefore needed to address this population in an effort to address their very specific needs and relieve the pressure on the correctional system in housing people with serious medical and mental health issues.

There are some programs making positive strides to address the specific needs of people with TBI and to intervene at an early stage (often childhood, when many brain injuries occur), and before incarceration occurs. People such as Crystal McCollom, who is the Regional ABI System Navigator for the March of Dimes Canada and also sits on the regional HSJCC for Northeastern Ontario. 

The full presentation on Traumatic Brain Injury and the Criminal Justice System can be found here.  
Concurrent Sessions:
Meeting the Needs of Aboriginal Women in Ontario Corrections Through Programs and Services 
At the 2015 Provincial HSJCC conference, a concurrent session on programming for Aboriginal women involved in provincial Correctional Services was delivered to delegates. An overview of the cultural-specific programs for incarcerated and community-supervised Aboriginal women was provided by Lori Ann Kruger, Aboriginal Program Analyst and Donna McLeod, and Advisor to the Aboriginal Services unit of the Ministry of Community Safety and Correctional Services (MCSCS).  The purpose of these programs is to help promote successful community reintegration once an Aboriginal woman is released from custody, with a major goal of this initiative being the reduction of recidivism. 
 
The presenters informed participants of some key statistics on Aboriginal women and crime that outlined the high rates of violence and victimization of this population within their diverse communities. They noted that Aboriginal women account for about 20% of incarcerated women within provincial correctional facilities. The average sentence for this population is 1-3 months, and probation lasts about 12-18 months. Aboriginal women in custody identify as Non-status First Nation, Metis, and Inuit, with the majority identifying as Status First Nation. The presenters provided a very clear picture of individual and collective circumstances that contribute to Aboriginal women’s pathways into the justice system such as violence, poverty, mental health and substance related issues.
 

By developing an understanding of pathways to crime for Aboriginal women in Ontario, MCSCS created programming for Aboriginal women to ensure success in community reintegration once an individual is released from custody. The program promotes path ways out of crime grounded in the the Seven Grandfather Teachings, Four Aspects of Balance (Mental, Emotional, Physical and Spiritual), and the Life Cycle (Infant, Youth, Adult, and Elder) perspectives of Aboriginal culture and teachings.
 
The initial orientation program is called Understanding the Journey, a small group program of 10 sessions that provides foundational understandings of Aboriginal teachings, creates an environment to better understand participant’s personal circumstances and experiences, and encourages further rehabilitation for those that identify deeper personal needs that should be addressed.
 
The second program discussed by the presenters is entitled The Healing Journey. This is a longer, small group program that focuses on assessing current needs of participants, and looks at developing skills to promote positive thinking and behavior patterns, with the goal of reducing recidivism.
 
The full presentation on MCSCS’s programming for Aboriginal Women can be found here.
Concurrent Sessions:
FASD & The Criminal Justice System: A Poor Fit
Lynda Legge and Sheila Burns from the Fetal Alcohol Spectrum Disorder Ontario Network of Expertise (FASD ONE) provided delegates with an illuminating overview of the characteristics of Fetal Alcohol Spectrum Disorder and how the justice system is ill-suited to the service needs of those affected by it. 
 
FASD can effect the function and skill development of a person. Youth and adults with FASD are much more likely than non-affected peers to be justice involved and experience high rates of recidivism.  The presenters explained that change is needed to provide cross-sectoral service that responds better to the unique needs of FASD-affected persons.  Such tailored responses could ensure that more positive outcomes for FASD-affected persons are achieved in the human services and justice sectors.     
 
The full presentation on FASD & the Criminal Justice System can be found here.
 
The HSJCC hosted a webinar with FASD ONE Justice Action Group in November 2014 and can be viewed here.
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