Justice
November 5, 2012
Provincial Government Releases External Review of Psychiatric Services in
Corrections;
Minister Outlines Plan to Implement Recommendations
The Honourable Darin King, Minister of Justice, today released an external peer review of psychiatric services in Newfoundland and Labrador Corrections and outlined the Provincial Government’s plan to implement the recommendations to improve mental health and addictions services in correctional settings.
The review was prepared by Dr. Philip Klassen, a forensic psychiatrist and Vice-President of Medical Affairs at Ontario Shores Centre for Mental Health Sciences. Dr. Klassen’s report was commissioned by the Department of Justice and was received on September 19, 2012. It concluded that Dr. David Craig, the psychiatrist providing psychiatric services in provincial correctional facilities, “meets the standard of care, where that standard is comparable service provision in other provinces.” It is also stated in the report that Dr. Craig “is clearly practicing to an acceptable standard,” and that “Dr. Craig’s prescribing practices are very typical of the prescribing practices seen in correctional settings.”
“The Department of Justice engaged in a peer review to seek a thorough, independent and objective review of psychiatric services in correctional settings in our province,” said Minister King. “We accept Dr. Klassen’s recommendations, and will immediately work to implement them in collaboration with the Department of Health and Community Services. I am confident this will further enhance the delivery of mental health and addictions services in the provincial corrections system.”
Dr. Klassen acknowledged that correctional mental health services can be improved in Newfoundland and Labrador and elsewhere, and made five recommendations:
- Formally extend the recovery model of care to correctional mental health care;
- Provide guideline driven services;
- Enhance communication with inmates/patients and community stakeholders;
- Contract for service provision with an academic mental health service; and,
- Consider adding mental health services to the correctional Balanced Scorecard.
Further information on each of the recommendations is provided in the backgrounder below.
“I have met with Dr. Craig to discuss the review and he advised me that he will cooperate fully in implementing these recommendations,” said Minister King. “This work will build on the important investments made by our government in recent years which have resulted in the further enhancement of our provincial corrections system.”
A copy of the review is available at -
www.justice.gov.nl.ca/just/publications/NLCorrections_Review_Klassen.pdf
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Media contact:
Tansy Mundon
Director of Communications
Department of Justice
709-729-6985, 693-1865
tansymundon@gov.nl.ca
BACKGROUNDER
Response to Recommendations of External Peer Review of
Psychiatric Services in
Corrections
Recommendation 1: Formally extend the recovery model of care to
correctional mental health care.
The department accepts this
recommendation and will work with the Department of Health and Community
Services to ensure that the recovery model of care is utilized for mental
health and addiction services that are provided in a correctional setting.
In addition, the department will partner with the Department of Health and Community Services to ensure that lead staff working in correctional settings, participate in a new mental health and addictions training program which is currently under development.
Recommendation 2: Provide guideline driven services.
The department
accepts this recommendation. In addition to the guidelines and standards
that practicing professionals bring into correctional centres from their
respective professions, the department has begun work to review, in
conjunction with the Department of Health and Community Services, existing
clinical practice guidelines relating to mental health services in
correctional settings. While the final guidelines are yet to be developed,
examples of items that might be included in a set of clinical guidelines
could include charting/recording standards, how often to assess patients,
who to collaborate with, and how to taper medications.
Recommendation 3: Enhance communication with inmates/patients and
community stakeholders.
The department accepts this recommendation and
will work with the psychiatrist(s), allied health care providers and
community organizations that are involved in the delivery of mental health
and addiction services, to enhance communications with inmates and patients,
as well as community stakeholders. The department will make available
additional written and resource materials to inmates and their families
(where appropriate) about various health issues and about services available
in the institution and in the community. Enhanced linkages will be made with
community stakeholders through the planning process for the release of
inmates into the community and through the continued work of the Canadian
Mental Health Association's in-reach project (Justice Project), which
provides a continuity of mental health services from the prison to the
community.
Recommendation 4: Contract for service provision with an academic mental
health service.
The department accepts this recommendation and will work
to develop a small rotation of psychiatrists to provide on-site services in
correctional facilities. The current psychiatrist is the Director of the
Resident Psychiatry program at Memorial University’s Medical School and
currently operates within an academic environment, has access to colleagues
for consultation, and teaches medical students. Dr. Craig is well-positioned
to broaden an academic consultative approach. The department will expand the
network of psychiatrists providing services. This model would enhance the
quality of mental health and addiction services in correctional facilities
by providing a source of consultation and support for psychiatrists and it
would also serve to build capacity within the specialty of forensic
psychiatry locally.
Recommendation 5: Consider adding mental health services to the
correctional Balanced Scorecard.
The department accepts this
recommendation to identify the goals, related activities and outcomes in the
correctional setting to ensure accountability on this recommendation. The
balanced scorecard is a performance monitoring framework that originated in
business but has more recently begun to be applied to health care services.
The department has accountability legislation and processes in place and
while it will not specifically develop a balanced scorecard model, it will
be fully accountable for performance measures related to these commitments.
Goals will be developed and inputs, activities, indicators and outcomes will
be monitored and measured. Through this ongoing monitoring function,
adjustments will be made as necessary to make any required improvements.
These will be developed in conjunction with the mental health care team in
the department and with partners in the Department of Health and Community
Services where appropriate.
Provincial Government Investments in Corrections
Since the release of
Decades of Darkness: Moving Towards the Light, in 2008, the Provincial
Government has invested approximately $8 million to improve corrections,
including the enhancement of mental health services to inmates of all
provincial prisons.
This includes:
- The provision of psychological services, and the provision of mental health training for all staff;
- The hiring of a full-time psychologist, an addictions coordinator and a second nurse at Her Majesty’s Penitentiary;
- Programming enhancements including: addictions counselling, drug awareness, violence prevention, employment training, structured leisure activities, mental health improvements and women’s programming. Some of these have occurred through strong partnerships with the Canadian Mental Health Association (CMHA), the John Howard Society, Turnings and Stella Burry Community Services;
- A multi-disciplinary team has been operational at HMP for the last two years. The team is consultative in nature and includes a psychologist, nurse practitioner, general practitioner and the psychiatrist, representatives from the frontline security staff, classification and the Canadian Mental Health Association (CMHA). The team meets regularly to engage in case conferencing and to discuss aspects of mutual concern relating to mental health clients;
- The hiring of an Fetal Alcohol Spectrum Disorder (FASD) project coordinator, a full-time Aboriginal Correctional Liaison/Training Coordinator and Aboriginal Prison Liaison positions at the Labrador Correctional Centre;
- The hiring of an Aboriginal Prison Liaison position at the Newfoundland and Labrador Correctional Centre for Women; and,
- The Justice Project offered by CMHA-NL. The program provides in-reach services for those inmates at HMP who have been diagnosed with mental illness. It provides a continuity of mental health care services from the prison to the community. CMHA social workers have a strong presence at HMP and carry an active caseload of up to 25 clients. CMHA workers collaborate with classification and other institutional staff members, as well as the psychiatrist, to help those with mental illness to cope with imprisonment and prepare for release. The program is jointly funded by the Departments of Justice and Health and Community Services.
Biography for Dr. Philip Klassen
Dr. Philip Klassen is a forensic
psychiatrist and Vice-President of Medical Affairs at Ontario Shores Centre
for Mental Health Sciences. He is also an Assistant Professor in the
Department of Psychiatry and the Department of Medicine at the University of
Toronto, and has previous experience working in a correctional centre as a
consultant psychiatrist for the Kingston area penitentiaries.
2012 11 05 3:15 p.m.