Let's Talk

Beyond the Drive

Accompaniment Support at the Ontario Regional Treatment Centre

BY David Champagne, Master of Social Work, Registered Social Worker and Veronica Felizardo, Master of Social Work, Registered Social Worker and PhD c.

From July 2006 to July 2007, Veronica Felizardo and David Champagne accompanied 28 offenders from the RTC(O) to the community.

Given the stigma that is still attached to mental illness, offenders with mental disorders face more than the usual hurdles upon their release into the community. First steps that are difficult enough, like finding housing, or accessing health services or applying for welfare benefits, or engaging in a lengthy round of appointments and interviews, may loom as insurmountable in the offender's mind.

Deemed especially vulnerable because of their illness, these offenders typically have a short attention span, low tolerance to change, cognitive impairment and little understanding of how to navigate through the system and make it work on their behalf - all of which can jeopardize their safe transition back into society.

Recognizing the need for advocacy and in the interest of public safety, RTC(O) clinical staff have been providing an Accompaniment Support Service since the late 1980s, currently championed by clinical social workers. In essence, two staff members, including at least one health care professional, accompany offenders being released into the community (i.e. conditional and warrant expiry releases) through their first, critical day out of prison, making sure appointments are kept, paperwork completed and the men connected with essential services (for example, housing, finances, health care and counseling).

Clinical Discharge Planning Services

Accompaniment support is a key component of the clinical discharge planning process. Based on the principle of "continuity of care," the goal is to develop a comprehensive, individualized plan to identify transitional and longer-term discharge needs of offenders with a mental disorder. Social workers at RTC(O), as a primary responsibility, develop release plans by consulting with offenders, family/community support systems and multidisciplinary teams, including representation from health and parole services.

Accompaniment Support

Accompaniment support is a voluntary clinical service that requires the offender's informed consent. Despite common perception, accompaniment support is not a "taxi service" and is much more than "a drive." It should not be confused with situations where an offender may require a security escort, nor is it the only possible option for an assisted release. On occasion, a family member or representative from a community agency may arrange to pick up the offender at the institution and accompany him on his release date. Such cases are rare, though, since these offenders are often alienated from family and community supports. In addition, the men frequently require more time and attention on their release date than members of their support system are willing or able to provide.

Accompaniment support plans are developed in consultation with institutional and community parole services to ensure a good fit with the community strategy and identified release conditions. Consultation with health care colleagues, including other social workers, nurses, psychiatrists, psychologists and occupational therapists, ensures that an offender's unique community integration needs are identified and factored into the plan.

There are numerous variables that influence the clinical discharge planning process. Intrinsic factors, such as the offender's motivation, cooperation, and symptoms of their disorder, must be carefully assessed and reviewed on a regular basis. Extrinsic factors, such as family and community supports, conditions of release and availability of resources, also have to be monitored, allowing for modification as required.

On the Day of Release

En route to the offender's release destination, those providing the accompaniment support, have an opportunity to talk to the offender about his prioritized discharge needs and to encourage him to follow through with his relapse prevention plan. During this time, offenders tend to be more forthcoming and receptive to intervention. Time spent together also provides the opportunity to observe offenders interacting with the public and to provide feedback on their interpersonal skills. For men who have served lengthy sentences or those who have had a "rough ride" inside, this is often an important transitional step in shedding their inmate label.

Staff providing accompaniment support must remain flexible, professional and compassionate when dealing with unexpected events where the release plan has to be modified. These situations, often upsetting to the offender, may arise prior to release (for example, incomplete paperwork, missing personal effects, complications with discharge medication) or throughout the day in the form of traffic jams, court delays, last-minute changes to pre-scheduled appointments or denial of services.

Having a professional at their side to help them navigate through the system enables offenders to access essential services at their first, crucial appointments in the community, often including housing, financial services, identification replacement and health care follow-up. In the case of a conditional release, there is an additional need to support the offender in complying with their legal obligation to report to community parole services and, if required, to complete an initial police report on their release date.

Above all, accompaniment support ensures the safe and timely travel of offenders with mental disorders from the institution to the community where they will be trying to make a fresh start. For those who are committed to making significant changes in their lives, accompaniment support as part of the clinical discharge planning process, is invaluable in empowering them to become responsible, law-abiding citizens. ♦