Mental Health and The Law

The Royal provides specialized services for assessment and treatment of adults with mental illnesses who have come into conflict with the criminal justice system under one umbrella, called the Integrated Forensic Program (IFP).

The IFP provides specialized services in assessment, treatment, rehabilitation and community reintegration of adults 18 years and older who may be (or have been found) unfit to stand trial as well as adults who may be (or have been found) not criminally responsible by the court on account of mental illness. Additionally, the Family Court Clinic conducts court-ordered assessments for youth in conflict with the law and provides psychiatric consultation to the Youth Mental Health Court.

The Forensic Program operates at three sites: Forensic Services for the Southeast Region, Forensic Services for the Champlain Region and a Secure Treatment Unit in Brockville that serves the province of Ontario. Each offers varying levels of security, supervision and privileges within structured treatment environments and each works to create a therapeutic milieu of supportive care that promotes safe reintegration into the community.

The IFP also manages specialty clinics, located at The Royal, that include a Sexual Behaviours Clinic, Family Court Clinic and Anger Disorders Clinic.

The range of mental health services offered by the IFP are numerous and include violence prevention; risk management; court diversion; pre-trial assessment and treatment; inpatient services; mental health courts; day treatment; case management; transitional housing and outpatient and community consultation services.

The program also has an active and on-going research component in order to increase its understanding of issues and to better help patients. The Forensic Research Unit is affiliated with the University of Ottawa Institute of Mental Health Research. Research is externally funded and peer-reviewed. Assessment and treatment of problematic sexual behaviours and aggression, as well as areas of mental health adjustment among forensic patients are currently being investigated.

Like many of the programs at The Royal the Integrated Forensic Program specializes in providing interdisciplinary treatment teams that consist of professionals from the fields of psychiatry, psychology, social work, nursing, medicine, occupational therapy, addiction counseling, vocational rehabilitation, pharmacy and recreation therapy as well as input from dietary, chaplaincy and education. The team develops individualized treatment plans to optimize risk management, patient mental health and well-being, that is consistent with public safety and within the limits of their defined dispositions.

Let’s look at what the IFP offers at each site.

Forensic Services – Southeast Region

This site operates 61 inpatient beds, located at the Brockville Mental Health Centre. Inpatient services include secure assessment and treatment, active forensic rehabilitation, and transition care for community reintegration. Outpatient services include outreach support and supervision programs for individuals throughout eastern Ontario.

Forensic Services – Champlain Region

The IFP Champlain, located at the Royal Ottawa Mental Health Centre, has two units with a total of 43 inpatient beds. The Secure Assessment Unit focuses on acute care, pre- and post-trial assessment and treatment. The Secure Rehabilitation and Community Unit provides short to medium term rehabilitation, illness management and recovery programming.

General Forensic Outpatient Services offers assessment, treatment, consultation, group and individual therapy, vocational assessment and referral, case management and outreach nursing, day treatment and support and referral.

Secure Treatment Unit

This facility is a medium secure 100-bed correctional hybrid centre and mental health centre located at the Brockville Mental Health Centre and is a one-of-a kind in Canada. The Secure Treatment Unit serves 30 other provincial correctional facilities from across Ontario. The facility was created when The Ministry of Community Safety and Correctional Services contracted The Royal to provide secure assessment, treatment and discharge planning to adult male offenders who have been provincially sentenced and have been diagnosed with a mental illness.

In keeping with The Royal’s interdisciplinary treatment protocol, teams at the Secure Treatment Unit provide specialized assessment and treatment in the areas of sex offending, dysfunctional anger, trauma disorders and a range of psychosocial rehabilitation modules that address individual resident needs. Throughout their time at this facility, patient treatment focuses on reduced recidivism that ultimately leads to ensuring successful reintegration into the community.

Specialty Clinics

Under the IFP, The Royal also offers three specialty clinics that are directed to individuals who either are (or could be at risk of being) in conflict with the criminal justice system. They include a Sexual Behaviours Clinic, Family Court Clinic and Anger Disorders Clinic.

The Sexual Behaviours Clinic offers services specifically for those who have been or are at risk of being in conflict with the law because of their sexual behaviour. The clinic’s goal are to provide assessment and treatment in order to manage the sexual behaviour-related problems, reduce symptom distress, as well as to increase psychosocial skills and coping strategies. Through treatment at this clinic, practitioners seek to improve overall patient well-being in order to maintain successful community living. Over the longer term, desired outcomes include reduced recidivism, prevention of hospital admissions and eventual discharge from the forensic program. Through this clinic, support is also available for the spouses and partners of individuals who have been or are at risk of being in conflict with the law because of their sexual behaviour.

To access this service, please print out this form and ask your doctor to fill it out and send it in (if you do not have a doctor, you can ask a doctor at a walk-in clinic). If you have any questions, please contact Lisa Murphy by email or phone at 613-722-6521 ext. 6374.

The Family Court Clinic provides assessment for courts involving children and youth in matters that pertain to the Child and Family Services Act, as well as the Youth Criminal Justice Act.

The Royal’s Anger Disorders Clinic offers specialized comprehensive assessments, consultations, treatment and management of individuals that have anger-related problems, whether or not they are in conflict with the law.

Youth Forensic Psychiatry at The Royal

The Royal plays an important role when youth are found to be in conflict with the law and enter the criminal justice system. The Family Court Clinic, offered through The Royal’s Integrated Forensic Program, is primarily responsible for providing court-ordered assessments for youth between the ages of 12 and 18. Assessments of ‘fitness to stand trial’ and of ‘criminal responsibility’ are undertaken by the Family Court Clinic to help inform the Court about the influence of mental health, behavioural, psychosocial and family-related problems upon a young person in conflict with the law.

The assessments include recommendations for interventions and treatment options that could be implemented in order to address the young person’s specific needs and help reduce the risk of recidivism. A multidisciplinary team comprised of a psychiatrist, psychological associate/psychologist and social worker conduct the assessment. The process includes a psychiatric assessment of the young person, interviews with the parent, guardian or parent-figure, psychological evaluations and other specific assessments or investigations of the young person as well as gathering of information from collateral professional sources with the consent of the parties involved. The final report, which is subject to confidentiality and disclosure stipulations, is released to the presiding judge.

The Family Court Clinic also provides psychiatric consultation services to the Youth Mental Health Court. An accused young person may enter this court if, in the opinion of the Crown, a mental disorder was a central feature of the case and the accused youth would benefit from the unique sentencing approaches available through the Youth Mental Health Court. The Youth Mental Health Court’s primary objectives include the facilitation of improved access to community mental health treatment services and positive outcomes for accused young persons with mental illness.

To contact the Forensic Treatment Unit (Southeast), please call the Brockville Mental Health Centre at 613.345.1461. Information about the Forensic Treatment Unit (Champlain) can be obtained by contacting the Royal Ottawa Mental Health Centre at 613.722.6521. To learn more about the Integrated Forensic Program Secure Treatment Unit, please call 613.341.2870.

The Ontario Review Board (ORB) conducts annual reviews of the status of every person who has been found to be not criminally responsible or who is unfit to stand trial for criminal offences due to a mental disorder. Information on the ORB can be found on its website at: www.orb.on.ca

Research initiatives and activities currently underway through the Forensic Research Unit can be found here.

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