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Ambulatory Services at the Ontario Regional Treatment Centre

By Jean Folsom, Director of Psychology and Rehabilitation Services, Pat Onysko, Louise Kennedy, and Carolyn Kirkup, Ambulatory Services Nurses

Photo: Bill Rankin

Jean Folsom, Director of Psychology and Rehabilitation Services

The Ambulatory Services Program at the Ontario Regional Treatment Centre RTC(O), was the first of its kind in CSC. The program was established in 1987, following publication of a groundbreaking report, The Mental Health Disorders Needs Identification Study. The research confirmed what wardens had long suspected — that treatment services for mentally ill offenders were seriously inadequate.

At first, the program focused on providing routine follow-up mental health care with a view to reducing the number of admissions and readmissions to the RTC(O) from the offenders' parent institutions. It was, and still is, staffed with certified psychiatric nurses who go out to the institutions and also, occasionally, to the Community Correctional Centres.

Over the years, the focus has changed to that of maintaining offenders with mental health problems in their regular institutions. The program consists of four main activities:

• mental health teaching to both offenders and the non-mental health care staff who work with them;
• monitoring the effectiveness of psychotropic medication to determine whether the offender also needs to be seen by the psychiatrist;
• making referrals to the psychiatrist when warranted; and
• mental health discharge planning for offenders who are getting ready for release.

At some sites, all newly admitted offenders who are flagged as having mental health needs on the Offender Management System are screened by the Ambulatory Services nurse to see if those needs are current and whether further assessment or intervention is required. At other sites, the nurse provides a variety of services at the psychiatric clinics such as prioritizing referrals and attending the clinic along with the psychiatrist.

As active members of institutional mental health teams, the psychiatric nurses liaise between the RTC(O) and the institutions. They also act as a bridge between psychology departments and health care centres within institutions, to ensure smooth communication channels. Their own internal network allows them to have a good overall picture of offenders with mental health needs across the region.

In short, the Ambulatory Services nurses are the "glue" that holds mental health services together in Ontario Region. They provide a continuum of care from admission to release and on into the community. Feedback from both offenders and institutional staff has been extremely positive about the usefulness and effective of this unique service. ♦