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Ontario’s Community-Based Mental Health Responses for
Youth in Conflict With the LawMinistry of Children and Youth Services
Youth Justice Services Division
Mental Health Services PanelCanadian Criminal Justice Association
Pan-Canadian Congress 2011October 28, 2011
Quebec City
2
Ontario’s Community Based Mental Health Responses for Youth in Conflict with the Law
Focus: Profile of child/youth mental health in Ontario
including youth in conflict with the law
Drivers of Change supporting community based responses
Community-Based Services Profile
“A Closer Look”: 2 Examples of Community-Based Mental Health Programs
Youth Mental Health Court Worker Program Intensive Support and Supervision Program
3
Profile of Child & Youth Mental Health in Ontario
Ontario Children’s Mental Health Association observation that 1 in 5 (20%) of all children and adolescents experience mental health difficulties.
Approximately 30% of youth (defined by Canadian Mental Health Association as age 12-24) who have accessed concurrent disorder services are involved in the legal system and young people between the ages of 15-24 are three times more likely to have a substance abuse problem than people over 24.
Anecdotally, people working with youth in the justice system suggests between 40% to 60% of youth have mental health needs ranging from mild to severe (i.e.: Psychiatric, Anxiety, Mood, Sexual, Developmental and Conduct Disorders)
2010/11 admissions to open /secure custody/residential indicates that 18.2% of youth admitted into the system have an identified mental health need
24% of 430 youth sentenced to secure custody have an identified mental health need
4
Drivers for Change that Support Community Based Action
The Youth Criminal Justice Act: focus on prevention, diversion, rehabilitation, addressing the underlying causes of youth crime, and reserving custody for most serious offences.
Ministry of Children and Youth Services 2003
Research: Evidence Base Practices and Programs
Need for differential responses for youth with mental health needs in Justice system
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All Youth Justice Sentences Have a Component Served in
Community
a) R
eprim
and
b) D
ischa
rged
abso
lutely
c) D
ischar
ged o
n conditi
ons
d) F
ine <
$1,00
0
e) P
ay C
ompe
nsati
on fo
r loss
or da
mage
f) Mak
e res
titutio
n re p
rope
rty ob
taine
d
g) P
ay pu
rchas
er re
prop
erty
h) C
ompe
nsate
re lo
ss, d
amag
e or in
jury
i) Com
munity
Ser
vice O
rder
j) Ord
er of
proh
ibitio
n, se
izure
or fo
rfeitu
re
k) P
robat
ion
l) Inte
nsive S
upport an
d Super
visio
n Pro
gram
m) A
ttend a
non-resid
entia
l pro
gram
n) C
ustody a
nd Com
munity
Super
visio
n ord
er
o) C
ustody &
Conditi
onal Super
visio
n ord
er re
“pre
sum
ptive o
ffence
”
p) D
efer
red C
ustody a
nd Super
visio
n Ord
er
q) S
ente
nce le
ngth re
1st &
2nd d
egre
e murd
er
r) IR
CS
s) A
ny oth
er co
nditions
Least restrictive community based orders More restrictive & custody orders
May be supervised by MCYS Supervised by MCYS
Any sanction or any number that are not inconsistent with each other
Full Community Programming Partial
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Community Based Programs:Number of Youth Served and
Number of ProgramsDiversion
11,11910,386
10,390
10,438
10,268
4,649
59
9099 91
94 94
0
2,000
4,000
6,000
8,000
10,000
12,000
05/06 06/07 07/08 08/09 09/10 10/11
Includes: Pre-charge EJM, Post-charge EJS, YMHCW
# o
f Y
ou
th S
erv
ed
0
20
40
60
80
100
120
# o
f P
rog
ram
s
7
Youth Mental Health Court Worker Program
Program Design and Origin Program Rationale: What is the Goal and Why
Service Delivery Model How Does the Program Work
Program Trends/Observations Challenges and Lessons Learned
Moving Forward Next Program Steps
8
Youth Mental Health Court Worker Program Design and Origin
The 2004 Ontario Budget committed to expanding community mental health services to serve an additional 78,600 clients by 2007-08 and included $50.0M annualized funding in services to support diversion of youth and adults with mental health issues from the criminal justice and correctional systems
Flow through Model (moves clients briskly to services)
Facilitates the diversion of youth whose primary issues are related to mental health, not criminal behaviour
Supports MCYS continuum of integrated services
Supports continuity of service bridging youth who cross-over to adult mental health system
Expands and develops community partnerships
Client may enter auspice of Youth Mental Health Court Worker through any referral avenue: self referral, family/ caregiver, crown/defence attorney, judge, administrative staff, historical (known to court as consumer of services). Client eligible for supports at first opportunity regardless of charge election of court process, family supports, ward status.
Community Services
Crown Attorney elects to divert before court process
Youth elects to proceed with court process
Diversion at Sentencing
Stay/Withdrawal
Probation Services
Custody Sentence
When sentenced to Custody the Probation Staff and YMHCW cooperate to inform facility of youth mental health status. When custody portion completed client is re-linked with community services
Service Delivery Model
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Youth Mental Health Court Worker Program Trends and Observations
Average age of youth 16 yrs
Over 3000 youth served to date
20% year over year increase; Approx 1/3 of Youth outside age range; 1/3 Youth diverted out of system; 1/3 Youth elect to proceed at court.
Challenges: Success creates greater demand for community services.
Lessons Learned: Inclusive Communications Strategy; Court House Office Accommodations; Program Continuity: Implementation Guide.
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Youth Mental Health Court Worker Moving Forward & Next Steps
2011/12 expansion to 45 of 54 Ontario Courts service for approximately 95% of all youth matters in Ontario aged 12-17 as per YCJA
Next Steps
Provide support and linkages during the program operationalization roll-out
Promote continued partnerships education awareness (courts, community, child/youth mental health systems)
Continued support for community of practice network to promote problem solving and smooth operations
12
Intensive Support and Supervision Program
Program Design and Origin Program Rationale: What is the Goal and Why
Service Delivery Model How Does the Program Work
Program Trends/Observations Challenges and Lessons Learned
Moving Forward Next Program Steps
13
Intensive Support and Supervision Program Origin
1998Fed Youth Justice Renewal Initiative
2003 Youth
Criminal JusticeAct
April 1, 2004Ministry of Children And Youth Services
2005Intensive Support
& SupervisionProgram
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Ontario’s Intensive Support and Supervision Program
Design Research indicates that community programs are more likely to reduce
recidivism than custody (Andrews and Bonta, 1998; Lipsey and Wilson, 1997)
Program targets youth with behaviours more related to mental health/illness needs than criminogenic factors
Small target population with a high potential for improvement in the community, low potential in custody (Henggeler, 1989).
Offences significant enough to result in custody sentences, but with appropriate supervision and support, could be safely and effectively managed in their communities (cost effectiveness)
Mental health system often challenged to respond well to youth in conflict with the law
2010/11 fiscal program budget $3,393,281.00
15
Service Provider Evaluation in Cooperation Probation OfficerEligibility Criteria: Young person 12-17 years diagnosed mental health need DSM Axis 1 and require on going clinical intervention and continuous support; Voluntary consent; Family/ supportive persons; would likely receive a custody sentence without ISSP; can be safely supervised in the community
Service Delivery Model
Offence: Young person enters youth criminal justice system via offence that qualifies for custody. Anyone may alert court regarding program suitability.
Court: Referral for program suitability to service provider
Develop Program Plan
ClinicalProgramming
Yes ISSPAccessed as Condition of
Probation
NO
Community or Post Supervision Services
CourtDetermination on basis of plan, guilty plea and
consent
Withdrawal of Consent
Youth Justice Court Hearing
YCJA Sentences
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Intensive Support and Supervision Program Trends and
Observations
Average age of youth 16 yrs
Over 700 youth served to date
117 Average Annual Program Total
Average 22 per Program
Challenges: Staffing pressures, court & family challenges, Dual Diagnosed and Adult system challenges
Lessons Learned: Need for a communications strategy to respond to changes in program or court personnel, keeping them apprised of the program goals and criteria and reinforcing the corporate/service provider relationship including probation services and education sector
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Intensive Support and Supervision Moving Forward & Next Steps
Support Outcome Evaluation
Continue support for Community of Practice
Promote partnerships and education awareness (courts, community, child/youth mental health systems)
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Community Based Mental Health Responses for Youth
Continuing Priorities for Ontario
Continue broadening awareness of alternatives to custody for youth with Mental Health needs
Links with children’s mental health sector Cross-jurisdictional Education exchange Broad partnership/relationship building Relations with Agencies and Probation
Ensure youth are in the right system: mental health system not justice system
19
Community-Based Mental Health Responses for Youth in Conflict With the Law
Trish Moloughney
Director,
Planning and Program Development Branch,
Youth Justice Services Division,
Ministry of Children and Youth Services
