Backgrounder - Mental Health

The Government of Canada continues to place a high priority on mental health initiatives, both in the population as a whole and within the Justice system. Below are some of the key initiatives in this area.

Health Portfolio Investments

In 2007, the Government of Canada invested $130 million to establish the Mental Health Commission of Canada (MHCC) to act as a catalyst for improving the mental health system and changing the attitudes and behaviours of Canadians regarding mental health issues. The Commission is a non-profit, arm’s-length organization which has been increasing the dialogue across Canada as well as reducing the stigma associated with mental illness. The MHCC launched Canada’s first mental health strategy, Changing Direction, Changing Lives: The Mental Health Strategy for Canada, in May 2012, established the Knowledge Exchange Centre, and established the Mental Health First Aid Program in Canada. An additional $110 million was provided to the Commission in 2008 for the At Home/Chez Soi projects to examine how best to help people who are homeless and living with a mental illness. 

Through the Public Health Agency of Canada, the government invests more than $112 million each year in community-based health promotion programs specifically for at-risk children. These programs include Aboriginal Head Start in Urban and Northern Communities, the Community Action Program for Children, and the Canada Prenatal Nutrition Program. All were established to support the emotional, intellectual and physical development of children, and to promote mental health and/or reduce the risk factors for mental health problems affecting children and their parents.

The Government has also invested $27 million over five years through the Public Health Agency of Canada to support mental health promotion projects in more than 230 communities. These projects focus on reducing health inequalities, promoting positive mental health, and developing protective factors, such as coping skills, in children, youth and families.

The Government of Canada invests approximately $260 million annually in First Nations and Inuit mental health and addictions programs. This includes suicide prevention projects in more than 150 First Nations and Inuit communities, and 58 drug and alcohol treatment centres across Canada. These programs have been developed in close collaboration with Aboriginal communities to meet their specific needs. 

In Budget 2011, the Government of Canada committed to allocating up to $100 million to Brain Canada to help establish a Canada Brain Research Fund to support the very best Canadian neuroscience and accelerate discoveries to improve the health and quality of life for Canadians who suffer from brain disorders. The Government of Canada contribution is to be matched by resources raised by Brain Canada.

In addition, Economic Action Plan 2012 included funding to the Mood Disorders Society of Canada to establish a network that will connect more than 80 researchers from across the country to focus on improving mental health outcomes related to depression, suicide prevention and post-traumatic stress.

Since 2006, the Government of Canada has invested $374 million in mental health research through the Canadian Institutes for Health Research (CIHR). An example of CIHR’s investments is its work with the Graham Boeckh Foundation, which is providing $12.5 million to launch the Patient-Oriented Network in Adolescent and Youth Mental Health. This research network will improve the care provided to young Canadians with mental illness by taking research findings and using them in practice and policy.

 

Initiatives related to the Justice system specifically

Federal, Provincial and Territorial Ministers of Justice and Public Safety
Mental health issues have been a focus of cooperative work among Federal, Provincial and Territorial Ministers of Justice and Public Safety. In May 2011, a “Mental Health and Justice” Symposium was held in Alberta. At a meeting in November 2012, the Ministers acknowledged that persons with mental health issues present significant challenges for the justice system and especially for correctional systems, and agreed that close collaboration is required between jurisdictions in order to better address the needs of the mentally ill.

The Correctional Services Canada Mental Health Strategy
Improving capacity to address the mental health needs of offenders is a key priority for the Correctional Service of Canada (CSC) and improvements to the mental health continuum of care are being implemented.

CSC is currently implementing critical aspects of the Mental Health Strategy, including building capacity in federal institutions and supporting offenders to return safely to communities. The Strategy elements include:

• mental health screening at intake for offenders;
• primary mental health care in institutions;
• intensive care at treatment centres;
• intermediate mental health care; and
• preparation for reintegration and transition into the community.

In support of the implementation of this strategy, CSC is also providing front-line staff with training on the fundamentals of mental health. From December 2007 to March 2012, approximately 8,000 CSC staff working in both the institutions and in the community received the Fundamentals of Mental Health Training. An additional 480 non-CSC staff and community partners also received the training.

Correctional Services Canada Mental Health Service System
Institutions have put in place an inter-disciplinary team of mental health professionals to provide essential mental health services and supports.

Five accredited Regional Treatment Centres across five regions provide care for male offenders with the most serious mental health conditions who require in-patient treatment beds. The Treatment Centre in the Prairies is a secure forensic psychiatric inpatient facility operated by the Correctional Service of Canada in a unique affiliation agreement with the University of Saskatchewan in Saskatoon, and with an exchange of service agreement with the province of Saskatchewan. The Institut Philippe-Pinel, a provincial psychiatric facility in Quebec, also has units for intensive mental health treatment of women offenders. As an alternative to intensive care, the Pacific Region has implemented a pilot project of the Complex Needs Unit (CNU) at the Regional Treatment Centre (Pacific). The CNU was opened in November 2010 as a national resource to address the needs of male inmates who persistently self-injure.

For minimum- and medium-security female offenders with mental health needs, separate units (Structured Living Environments) have been established at each of the five women’s facilities. These units provide a more intense level of mental health services. Dialectical Behaviour Therapy, which has been demonstrated to be an effective intervention for certain mental disorders, has been implemented in these institutions.

Correctional Services Canada Action Against Suicide and Self-injury
CSC is fully committed to implementing appropriate and effective measures to prevent suicides and self-injury from occurring, and has undertaken a wide range of initiatives to address this important issue, including:

• Staff training and education: staff training is designed to increase awareness and specific skill sets to identify and intervene with offenders at risk for self-injury or suicide.
• Providing suicide prevention information to inmates: the provision of educational information to offenders designed to increase awareness of suicide prevention.
• Screening: comprehensive screening of offenders for suicide risk at the time of admission to federal custody, and throughout incarceration, facilitates the identification of the need for in-depth assessment and intervention during periods of elevated risk for suicide and self-injury (for example, at intake, when being transferred, when admitted to segregation, etc.).
• Assessment, monitoring, and treatment: in-depth assessment for inmates at risk for self-injurious or suicidal behaviours allows for the determination of appropriate intervention and monitoring.
• Reviews and partnerships: findings from National Boards of Investigation into inmate suicide and self-injurious behaviour, as well as results of empirical research and collaboration with external partners, contribute to knowledge available for managers and operational staff. Findings of National Boards of Investigation further address issues of policy non-compliance and identify gaps, thus facilitating the development of action plans to mitigate challenges at the local, regional and national levels.

CSC has implemented the Regional Suicide/Self-Injury Prevention Management Committees (RSPMC) initiative as part of its ongoing commitment to improve its ability to address the mental health needs of offenders. RSPMCs support front-line staff in the management of self-injurious offenders while encouraging and assisting institutions to share best practices and innovative clinical approaches.

Under the RSPMCs, senior operational management meet monthly to monitor incidents of self-injurious behaviour within CSC institutions, placing particular focus on repeat self-injurious behaviour.

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Department of Justice Canada
March 2013