An Examination of the Mental Health Continuum of Care in CSC
Research Highlights: Most offenders with significant impairment due to a mental health disorder received the complete continuum of care.
Research at a glance - PDF
Why we did this study
The study responds to the Evaluation Report’s Management Action Plan Recommendation 10 on clinical discharge planning and community mental health services calling for CSC to: 1) conduct a review of the model of community mental health service delivery to ensure that community mental health services are being provided to offenders with the greatest mental health needs; and, 2) ensure that clinical discharge planning activities are tracked in electronic information systems.
What we did
Federal offenders assessed as having significant impairment related to mental health problems were selected to be included in a file review to determine the extent to which they received the continuum of care to address their mental health needs. All offenders included in the study had been released for at least two months and had a diagnosis of one of the following: major depressive disorder, bi-polar disorders, or any psychotic disorder. All had a Global Assessment of Functioning (GAF) score of 50 or less signalling serious or severe impairment. From this sample, the continuum of care was assessed for 40 offenders. Offenders were selected to ensure that women and Indigenous offenders were represented and men’s files were selected to ensure cases were distributed across regions and were among the most recent releases.
What we found
The review of files for the selected offenders revealed that the majority received health services while incarcerated. Further, the majority (86%) of those who still had mental health needs at the time of release had evidence of some form of planning to address mental health care while in the community, and all offenders with significant needs on release received community mental health services whether provided through CSC services or provincially funded heath services. All told, over two-thirds of offenders received the complete continuum of care.
A second goal of the study was to assess how well offender mental health care and clinical discharge planning services were recorded in electronic records. We found that during the period of the study it was difficult to easily access information relevant to assessing the continuum of care. CSC is in the process of fully implementing an electronic health record and planned amendments may improve data access and extraction.
Two potential solutions to improve electronic record keeping to allow for more efficient monitoring of the degree of support and services offenders with mental health problems receive throughout their sentence were identified.
- A systematic requirement to report mental health needs at various points in the sentence and enter this information into a single document would allow better access of the information to all members of the case management team. This is consistent with guidelines in place for discharge planning.
- An OMS flag alerting staff when to start development of the discharge plan could provide staff sufficient time to implement effective release planning.
What it means
Based on the purposive sampling examining a group of offenders with significant mental health needs, we determined that most had file evidence of having received the complete continuity of care. Nevertheless, this was only determined though examination of multiple documents. Clear, consistent and accessible record keeping is necessary to allow ongoing monitoring of the full range of care throughout the full period offenders are under warrant.
For more information
Stewart, L., Wardrop, K., Thompson, J., Wilton, G., & Wanamaker, K. (2018). An examination of the mental health continuum of care for a sample of federal offenders with serious impairment related to mental disorders. (Research Report R-410). Ottawa, Ontario: Correctional Service of Canada.
To obtain a PDF version of the full report, or for other inquiries, please e-mail the Research Branch or contact us by phone at (613) 995-3975.
You can also visit the Research Publications section for a full list of reports and one-page summaries.
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