Let's Talk

Community Supervision of Offenders
with Mental Disorders

Forging Steps Towards Safer Reintegration

BY G. Chartier, Communications Officer, Communications and Citizen Engagement Sector

Dr. Andrea Moser, Manager of Community Mental Health Initiatives in CSC's Health Services Branch, National Headquarters

In the past decade, the Correctional Service of Canada (CSC) has seen a substantial increase in the number of offenders coming into the federal correctional system who are suffering from mental disorders. Since 1997, the number of male offenders presenting a mental disorder at intake increased from seven to 12 percent. In addition, 25 percent of woman offenders are currently presenting with mental health issues at intake.

To meet this challenge efficiently and effectively and to ensure the safety of communities across Canada, parole offices and Community Correctional Centre (CCC) staff have worked at developing local community partnerships while nationally, CSC is working to provide new staff and training.

The result is a nationwide initiative with positive local results.

Increase in the Population of Offenders with Mental Disorders

The term "offenders with mental disorders" includes not only mental illnesses such as bipolar disorder or schizophrenia but also disorders such as Fetal Alcohol Spectrum Disorders, Alzheimer's Disorder, Attention Deficit Hyperactivity Disorder (ADHD), personality disorders, as well as problems resulting from head injuries and other disorders that influence the functioning of an individual. This group of offenders is the population in CSC custody that has shown such a dramatic increase in numbers over the past decade.

"This increase puts the pressure on CSC to provide services," says Dr. Andrea Moser, Manager of Community Mental Health Initiative in CSC's Health Services Branch. A psychologist by training, she has worked as a Manager in the Reintegration Programs and Health Services Branches at National Headquarters for the past 10 years, but started her career at the Regional Treatment Centre in the Ontario Region of CSC providing psychological services to offenders with mental disorders.

"We are legislated to provide health services to offenders and to promote the safe reintegration of offenders into the community. We have to keep in mind their mental health needs because that can certainly contribute to their reintegration back into society and in several cases may be related to how they ended up in the correctional system initially," Dr. Moser says.

Forging Steps to the Community

One of the people reaching out to offenders with mental disorders is Parole Officer Sue Bruff at the St. John's Parole Office in Newfoundland and Labrador. Because that province doesn't have a federal penitentiary, Bruff often travels to the mainland CSC institutions in the Atlantic Region to meet offenders with mental disorders who will be discharged back into the community.

Ms. Bruff is part of a multidisciplinary case management team that is comprised of other staff from CSC, including a senior parole officer, a contract psychologist, psychiatric nurses from Ambulatory Services, as well as a team of community mental health professionals from Stella Burry Community Services (SBCS), a local community organization with deep ties in Newfoundland and Labrador.

Named after a pioneering teacher and social worker from Newfoundland, SBCS provides housing, counseling, education and employment services. It is a vital community partner in the safe reintegration of offenders with mental disorders in communities throughout the province.

One of the services provided is in the form of support workers who provide the one-on-one service to help offenders enhance their basic living skills, such as cooking, budgeting, shopping, medication management, attending appointments and advocacy.

"When their sentence ends, the SBCS continues to work with them over the long term," Sue Bruff says. "So there's a reduction in psychiatric admissions and jail admissions once they've got the supports in place."

Community partnerships such as Stella Burry and Waterford Psychiatric Hospital, and provincial government departments in St. John's as well as the John Howard Society, St. Leonard's Society, Salvation Army and other community organizations across Canada, help to meet the mental health needs of offenders in the community.

"The Waterford Hospital staff know the kind of work we do and have developed a short-term stay strategy within their overall planning. We know we can go through their emergency system and get someone to see the offenders quickly. A short-term stay might be all a particular offender needs. The person might just need his medication adjusted a little bit," says Clara Rendell, Director of the St. John's Parole Office and CCC Newfoundland, in the Atlantic Region of CSC.

Community Mental Health Initiative (CMHI) Funds New Positions Across Canada

One of the primary components of the Community Mental Health Initiative (CMHI), launched in 2005, is enhanced discharge planning for offenders with mental disorders when they leave CSC institutions. Fourteen Clinical Social Workers (Discharge Planners) are being hired across the country to provide comprehensive discharge planning services to offenders being released from the regional treatment centres as well as regular men's and women's institutions. In addition, 15 Clinical Social Workers and 15 Community Health Nurses are being hired to provide mental health services to offenders with mental disorders on supervised release. This will help offenders to connect with community support and lay the groundwork for services that offenders will need when they are released.

"The in-depth discharge planning work done by the Clinical Social Workers complements and does not replace what the Parole Officer is doing in that case," says Dr. Moser. "Better discharge planning will assist their reintegration into the community," she says. "At the same time, we have to look at what is available in the community in terms of services."

"The Clinical Social Work and Community Mental Health Nursing positions work directly with offenders with mental health issues who are released," says Dr. Moser. "There will be a dialogue between the discharge planners, the institutions and the community site to which they will be released to promote a smooth transition between the institution and the community."

Clara Rendell says that because of the CMHI, the St. John's Parole Office has been able to hire a full-time community mental health nurse and a full-time social worker. She adds that the CMHI is also providing funding for a contract psychiatrist who holds clinics once a month.

St. John's Parole Office Working with the Community

However appropriate and effective the services to offenders with mental disorders may be during their incarceration, additional challenges are faced during reintegration back to the community.

Having started work as a Parole Officer in St. John's, Ms. Rendell has seen the efforts made over the years while working in the community with mental health offenders.

"We started out — it must be eight or nine years ago — identifying a particular need," she says.

Ms. Rendell and her colleagues saw a gap in services when offenders with mental disorders were going back into the community. "These were the individuals who had a number of agencies involved with them prior to their sentencing — five or six very likely," she says.

"It is also important, she says, to recognize that offenders with mental health problems will need service in the community beyond the end of their sentence. By the time they are off their federal sentence, they may have gained supports needed beyond their sentence."

To meet this challenge, CSC has partnered with local agencies to ensure that after an offender is discharged or the sentence ends, supports remain for that individual.

"We have said that this is a continuum," says Ms. Rendell, "that you have to start while the person is still in the institution."

Training an Important Factor for Front-line Staff

Clara Rendell, Director of the St. John's Parole Office and CCC Newfoundland, in the Atlantic Region

Training is an important factor for CSC front-line staff who work with the new community health specialists to provide information and effective tools for dealing with offenders with mental disorders.

To that end, CSC has piloted a two-day training for front-line community staff that will be rolled out over the next year.

"The hope is that we can provide training to more staff," says Dr. Moser. "Staff can benefit from greater understanding of mental health issues and how to work effectively with offenders with mental health issues."

Building Capacity in the Community

Parole Officer Sue Bruff at the St. John's Parole Office in Newfoundland and Labrador

"One thing we want to do with this initiative when we place new staff in the community is capacity building," says Dr. Moser, "to build the bridges between CSC and the other organizations that provide mental health services in the community."

"So that kind of link to the community when you work with a mental health population is really important," says Ms. Rendell. "It's making those connections."

"It's having an understanding that we're all working toward the same goal here — how can we work on it together?"

"We're getting there," she says. ♦