Mental Health Action Plan For Federal Offenders


The Government of Canada is developing an Action Plan to ensure that the needs of the significant number of offenders with mental health needs are better met. This Mental Health Action Plan for Federal Offenders lays a foundation for a full Government response, anticipated in fall/winter 2014, to the recommendations of the Ontario Coroner's Jury into the death of Ashley Smith.

The Action Plan will continue to evolve as the Government progresses in its review and analysis of the Jury's recommendations.

The Government's Action Plan is focussed on five Pillars for Action:

1. Timely Assessment

Safe, gradual and successful community reintegration for offenders begins on day one of any sentence. The first step in understanding each offender's specific needs begins with an individualized assessment, including an intake assessment to assess and prioritize risk factors, and mental health screening to identify signs and symptoms associated with serious mental illness. From these comprehensive assessments, CSC is able to develop a Correctional Plan unique to the risk and health needs of every offender, men and women, young and old, to help guide the development of programs and other interventions, and an intervention strategy that includes necessary mental health programming, throughout an offender's sentence.

2. Effective Management

For CSC, Case Management and Institutional Supervision consists of the monitoring, intervention, assessment and documentation of inmates' progress during their sentence in meeting the objectives of their Correctional Plan. Institutional Parole Officers and Primary Workers are responsible for presenting recommendations to the Parole Board of Canada (PBC) regarding the conditional release and detention of offenders, following comprehensive risk assessments, based on ongoing correctional interventions and evaluations, with input provided by all members of the Case Management Team.

3. Sound Intervention

For more than a decade, the Correctional Service of Canada (CSC) has developed research-based programs designed to reduce the likelihood of offenders committing new offences following release. These include correctional programs, education programs, and social programs, and the policies that provide the framework for the ongoing delivery and management of these programs. A commitment to sound intervention strategies ensures that offenders receive the right programs at the right time in their sentences and that correctional programs are offered to those who need them most on a priority basis.

From a mental health perspective, there are 3 types of intervention:

4. Ongoing Training and Development

Every employee in the Correctional Service of Canada has a critical role to play in achieving the Service's mission and mandate. And that includes not only maintenance of essential training programs, but also continuous professional development of knowledge and skills that will facilitate improvement in both individual and organizational performance.

5. Robust Governance and Oversight

A robust governance structure is necessary to support and continually improve services provided to inmates, and to ensure that laws and policies are applied fairly and consistently. Strong governance and oversight tools also provide greater integration of all aspects of the management of offenders, including correctional operations, reintegration, physical health care and mental health care services.

Government Action Plan
CSC Priority Activities
1. Assessment
Implement more comprehensive mental health screening conducted at all intake sites, including all 5 women's sites.
An audit will be performed to determine whether the CSC has established procedures to ensure that appropriate essential mental health services within professionally accepted standards and applicable legislation and appropriate treatment options are in place for those offenders who have been identified as the most chronic and complex cases of self-injury.
Leverage external resources for assessment of inmates with complex needs
2. Management
Clarified that any item used by an inmate to inflict or attempt to inflict self-harm required an appropriate, safe and reasonable intervention in order to seize/retrieve the item.
Reinforced the importance of oversight of conditions of confinement and of offenders in administrative segregation.
Complete a comprehensive review of current research and operational practices of segregation.
Increased interactions with offenders through increased counts and security patrols, and emphasis on dynamic security
Reinforced through policy that inmates on high or modified suicide watch will not be transferred to an institution other than a treatment facility unless the attending mental health professional deems the transfer would reduce the risk
In 2008, CSC began increasing the bed space capacity of women's institutions, and by the end of 2014 will have added 152 new beds. Importantly, this figure includes 50% more capacity in the Structured Living Environments.
3. Intervention
Implemented measures to further enhance in-house expertise by creating the position of National Psychiatrist and implementing regional and national committees to provide support to sites in the management and treatment of complex cases. 
Implemented a full suite of correctional programs for women offenders that are gender-informed and developed specifically for women. These programs target problematic behaviours linked to crime in two program streams – one for Aboriginal women, the other for non-Aboriginal women.
Developed short and long term strategies on service, support and accommodation needs for women offenders with significant mental health and/or behavioural needs.
Introduced interdisciplinary mental health teams at mainstream institutions (including women's sites) This included introducing additional mental health professionals such as social workers, occupational therapists, mental health nurses to complement the existing psychology departments
Implemented the Critical Response and Incident Management Plan, and Interdisciplinary Management Plan for immediate needs and long term response interventions respectively.
Implement a case consultation process for complex cases which includes both internal and external representation. In 2013-14, nine complex case consultations were completed by CSC's National Psychiatrist.
Pursue additional new partnerships to build external capacity for psychiatric care for complex needs women offenders
Develop a standardized national approach to the use of the Peer Support Program in Women Offender Institutions
Engage external stakeholders in mental health, corrections and law in further developing the Government's Action Plan and assisting in its review of the Coroner's Jury recommendations into the death of Ashley Smith
Initiate, expand and enhance high quality, external research examining addictions and mental health
4. Training
Developed and delivered training on Fundamentals of Mental Health
Developed and delivered Ethical Leadership and Leading Through Values
Developed and Implemented An Updated Administrative Segregation Handbook for Staff
Updated Dialectical Behavioural Training (DBT) for staff and managers
Launched the Responsivity Portal, the Mental Health Resource Kit section
Design and develop training material, using Ashley Smith as a case study, to provide learning opportunities for staff and managers
5. Governance and Oversight
Strengthened functional and leadership in all areas of health service delivery.
Developed and promoted the Correctional Service of Canada Mental Health Strategy
Developed and promoted the Mental Health Strategy for Corrections in Canada. The Strategy establishes the core elements of mental health services in a correctional environment. It was developed in collaboration with the Mental Health Commission of Canada
Establish a Governance framework that will lead the study and assessment of the recommendations and develop a Government response.
Engage local community partners (i.e. Citizens Advisory Committees) to solidify their support
Review Recommendations from the Ashley Smith Coroner's Inquest and engage mental health professionals and stakeholders, to inform a Government Response by December 2014
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