Hamilton Psychiatric Hospital - Programs and Departments // Forensic Program

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THE FORENSIC PROGRAM
The Forensic Program provides psychiatric assessment and treatment for individuals with a serious mental illness who have come in contact with the criminal justice system.

At HPH, the Forensic Program currently provides a minimum-secure environment with 18 inpatient beds. The Program continues to work with clients involved in the forensic system in two key categories:

Conducting "fitness assessments" for clients referred by court officials within the HPH catchment area

Working with clients under the auspices of the Ontario Review Board

With the goal of re-integration of these clients back into the community, the Forensic Program continues to work collaboratively with other programs, particularly the Schizophrenia Services to ensure that patients are reintegrated into their communities with appropriate services. Currently, approximately 25 clients are patients of the Schizophrenia Service. In keeping with this focus, the program is endeavouring to actively expand their involvement in outpatient/outreach activities throughout the region.

Table #21 Forensic Program

1997/98
(actual)

1998/99
(actual)

1999/2000
(forecast)

Salaries
2,526,646

2,563,616

2,612,400

Benefits
729,949

628,427

463,700

ODOE
848,898

1,009,291

835,100

TOTAL
4,105,493

4,201,334

3,911,200

FTEs
58.4

59.0

59.4

Set-up Beds
18

18

18

Staffed Beds
NA

NA

18

Active Inpatients
21

17

18

Inpatient days
6,920

6,869

6,800

Avg. Length of Stay (LOS)
187

114

125

Inpt. Admissions
54

61

60

Inpt. Discharges
41

51

50

Registered Outpt. (Mar.31/98)
23

25

27

Outpt. Direct contact (registered and non-registered)
1,650

691

1,500

Outpt. Indirect contact (registered and non-registered outpatients)
2,025

519

1,500

*Outpatient contacts (direct and indirect) are understated due to failure to report statistics.

Table #22 Forensic Services Patient Activity 1998/99 by District

Brant

Haldimand-Norfolk

Halton

Niagara

Ham.-Went

NFA

Other

TOTAL

# Of admiss.
6

2

1

15

14

23

0

61

# Of disch.
5

2

2

13

23

4

2

51

# Outpt. registrations
0

1

0

1

7

0

1

10

#Separations
0

0

1

1

5

0

0

7

*NFA = No fixed address
* Other = outside of the catchment area

Program leadership staff continue to work with Ministry of Health planners to develop our regional component of the strategic plan for the Provincial Forensic System. The regional approach to service delivery outlined in the 1997 plan would ensure a continuum of care and service from medium-secure beds through to outreach activities. As a major partner in the Ministry Implementation Team-System, which is planning the implementation of the HSRC recommendations, and under the Ministry's recommendation, we will be planning a 70-bed program that will ensure that clients are serviced closer to their home community. Our region for Forensic Services has been expanded to include the current HPH catchment area and the districts of Dufferin/Wellington and Waterloo.

The Forensic Program continues to develop these initiatives:

The fitness-to-stand-trial clinic is a successful venture, which in the past year conducted approximately 53 out-of-hospital assessments. This service, the first of its kind in Ontario and a model for other communities, does most of its assessments while the patient is in custody or detention and awaiting trial, thereby avoiding admission and speeding up the process for the courts.

Program staff provide a leadership role in the Regional Forensic Coordinating Committee. This group is a collaborative effort of agencies working in the Ministries of Health, Community and Social Services, Attorney General and Solicitor General & Correctional Services. Designed to ensure coordination of services for this population, the group has been very successful at developing processes and programs that enhance quality services for populations served by the Forensic Program. Like the Fitness Clinic, the concept used for the Hamilton Region Coordinating Committee serves as a model for other regions in the province.

The outreach service for community follow-up of forensic patients is an effective service with increasing demand. In order to expand this aspect of the program and to meet the demand for further outpatient services, the Program will be seeking additional FTE assistance from the Psychology Department in this operating plan.