Enhancing Forensic Services: Program Evolution and Impact Analysis
Explore the transformation of forensic services under the guidance of Dr. Jeffrey Waldman and Ken MacKenzie, highlighting the implementation of standardized processes and program evaluations. Learn about the intersectoral forensic mental health program's participant flow and the evolution of Criminal Code Review Board cases, reflecting the growing demand for these crucial services.
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Presentation Transcript
Changes in Forensic Services Jeffrey Waldman, MD FRCPC, Forensic Psychiatrist Medical Director Forensic Services Ken MacKenzie, MSW, BSW,BA WRHA Director Crisis & Forensic Services
Prior to March 2013 No data No standardized processes No program evaluation other than Mental Health Court program evaluation by contracted researcher.
A Framework to Understand Diversion of the Mentally Ill out of the Criminal Justice System(Menetz & Griffin 2006) Note: Retrieved from, Use of sequential intercept model as an approach to decriminalization of people with serous mental illness, Psychiatric Service (2006), 57, 4, 544-549), downloaded October 12, 2013
INTERSECTORAL FORENSIC MENTAL HEALTH PROGRAM PARTICIPANT FLOW Alleged Offense Occurs Accused is arrested, hospitalized; or cautioned Individual Appears in Bail Court SPMI Suspected Individual is held in Custody or Released on Recognizance Clinical Assessment for Fitness at Court Individual is Hospitalized Forensic Assertive Community Treatment Team Winnipeg Mental Health Court Docket Room 303 Law Courts Building PX3 Inpatient Ward Court Ordered Assessment for: Fitness (if necessary); Criminal Responsibility Risk Assessment Treatment for Mentally Disordered Accused Forensic Mental Heatlh Program Probation Services with Consultation from FMHP Criminal Code Review Board of Manitoba Courtroom 312 Law Courts Building Community Mental Health Program with Consultation from FMHP Absolute Discharge from the CCRB Graduation from FACT Program Referred to Regular Community Mental Health Program; Probation Period Ends Discharged to Community With Conditions Detained In Hospital PX3/SMHC Absolute Discharge
Forensic Services Number of Criminal Code Review Board cases 120 100 80 60 40 20 0 2010 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 no. of CCRB cases 2002 2003 2004 2005 2006 2007 2008 2009 2011 2012 2013 2014 2015
The Demand on PX3 140 120 placed on wait list 100 80 patients taken off of wait list 60 number of inmates transferred to PX3 40 average number of days on wait list 20 0 2010 2011 2012 2013 2014 2015
Demand-Number of Court Ordered Assessments 160 140 120 100 80 60 40 20 0 2010 2011 2012 2013 2014 2015
Fitness Clinic Key processes in assessing an accused s fitness to stand trial in Winnipeg Issue of the accused s fitness is raised in bail Court Judge may issue a decision Bail Court Judge issues Assessment Order Section 672.11 Likely Fitness cannot be restored and is referred to Criminal Code Review Board of Manitoba within 45/90 days Custody in hospital for Treament as per 672.58 Accused is assessed by psychiatrist at 408 York Fit Unfit Fitness hearing at Courtroom 303-408 York Case resumes Fitness is restored and matter is returned back to Courtroom 303 Thursday 1:00 PM Accused is assessed by Forensic Mental Health Program for Initial Disposition Fit Unfit Accused appears before the Manitoba Criminal Code Review Board for Initial Disposition Accused is returned to Court Conditional Discharge Detained in hospital Fit Accused appears before the Manitoba Criminal Code Review Board for Annual Review If assessed as low risk for violence and permanently Unfit stay of proceedings CCC 672.851 (1) I & ii Lack of prima facie case Acquittal is entered Crown brings forward Prima Facie evidence Prima facie case made
Other Program Evaluation Expansion of the National Trajectory project (awaiting funding) Provincial replication of the National Trajectory Project (awaiting funding) Daily Dispensing (MPAN Funding, awaiting ethics) Fitness Clinic (MPAN funding, awaiting ethics) Ongoing evaluation of MHC
If time-other cool initiatives Standardized operating procedures Standardization of assessment reports AIS and HARM DBT Transition away from using Corrections officers Educational sessions for stakeholders More to come
