Youth Forensic Service Mental Health & the Law North Bay Regional Health Centre CARE with courage

Situated on the Canadian Shield, rugged geography QUICK FACTS Situated on the Canadian Shield, rugged geography 564,000 residents 415,000 km2 or approximately 42% of the Ontario's land Hudson Bay to Muskoka and from Sault Ste. Marie to the Quebec border JAMES BAY COAST HPW

Mandate Court ordered assessments of Fitness to Stand Trial and Criminal Responsibility as well as Treatment Orders for youth (ages 12-18) in Northeast Ontario. In accordance with Part XX.1 (mental disorder) of the Criminal Code of Canada, and referenced in Section 141.10 of the Youth Criminal Justice Act.

Catalyst for Action Caseload Demographic in NE 2012/13 Digital story 85 to 100 youth in courts; 63 males; 35 females; average age 16 4 youth may have required forensic psychiatric assessments (1 fitness and 2 criminal responsibility) complex needs + high risk offending behaviours common disorders: substance abuse, conduct, mood, personality, developmental disabilities Digital story

Overarching Principles Least restrictive & most developmentally appropriate milieu Minimize psychosocial & emotional impacts Mainly on an out-patient basis, face to face or OTN Inpatient admission = last resort Tailored / individualized consistent with clinical needs and safety avoiding additional displacement caused by the judicial process forensic assessments are available at the NBRHC when all other options have been exhausted

Assessment Service Algorithm Dynamic Emphasis on out of custody

Service Protocol NBRHC/MCYS North Region Flexible forensic assessment service delivery options Including in residential facilities (detention/custodial facilities) Outlines roles & responsibilities Service coordination b/w probation officer, facility & NBRHC Coordinator

Our Team Coordinator Collaboration between Forensic & Child/Adolescent Psychiatry Social Work Telemedicine Coordinator Consultations with other professional disciplines Outreach Team Partnership with community teams (i.e., Early Episode in Psychosis Service) Coordinator to oversee all referrals and provide information and system navigation and Assertive Outreach/Liaison will ensure OTN connections and appointment coordination. (i.e., psychology, behaviour therapy, social work, occupational therapy, youth service workers and nursing) Outreach team trained and poised to provide support and monitoring for any youth living in the community Collaborative model = with youth justice partners (court workers, youth detention/custodial facilities, community agencies)

Benefits early identification tool assessment reports provide courts with recommendations for appropriate treatment and rehabilitation options forensic assessment needs attended to in an individualized and timely manner youth found NCR or unfit be placed on a disposition order under the authority of the ORB Assessments serve as . . . early intervention and treatment thus promoting a more favourable prognosis for recovery reduce psychosocial and emotional impacts caused by improper sentencing. expediting the court process ensuring ongoing linkage to a forensic hospital, appropriate treatment and clinical services.

Outcomes alter / reverse trajectory clinical & risk management recommendations virtual, ambulatory, in situ, clinic approaches integrated partnerships = integrated service interface of child/adolescent + forensic psychiatry mobilize funding for incremental costs for all assessments system navigation/case management

Metrics referrals and source appropriate referrals to YFS diversions NCR vs Fitness treatment orders required in-patients admissions for assessment

“Adolescent forensic mental health services that view their role as existing solely within the walls of agencies and organizations have too narrow a vision” Youth Forensic Services Development, New Zealand

Contact Information Hélène Philbin Wilkinson Administrative Director Mental Health & the Law, NBHRC 50 College drive, North Bay, ON P1B 5A4 705-474-8600 ext. 2514 Helene.philbinwilkinson@nbhrc.on.ca Natalie Généreux Manager Outreach Services Mental Health & the Law, NBRHC 705-477-5108 Natalie.genereux@nbrhc.on.ca