Addiction can easily sabotage an offender’s return to the community and land him or her back in prison. CAMH is providing expert advice to a new Canadian Centre on Substance Abuse (CCSA) project that aims to break that cycle.
“This is a great opportunity to put all issues on the table,” says Wayne Skinner, Deputy Clinical Director, Addictions, in CAMH’s Ambulatory Care and Structure Treatment Program. He took part in the project kick-off in October and is providing expert advice on addictions and mental health to this national effort.
“There’s an obvious need for better release plans for offenders with addictions problems. There is a vital need to find better ways to help them return to the community and become socially reintegrated. Addressing vulnerability to addiction is really key to helping people involved with the criminal justice system successfully return to the community.”
Addressing a vital need: CAMH’s Wayne Skinner.
Funded by Correctional Services Canada (CSC), the project aims to successfully reintegrate offenders with chronic substance abuse history back into the community. Key partners include CSC, leaders from provincial corrections systems including Alberta and Saskatchewan, and non-profit groups committed to corrections: the John Howard Society, Seventh Step Society, and St. Leonard’s Society, and Native Counselling Services of Alberta.
“Problematic substance use is a big risk factor for re-offence and re-incarceration,” says Rebecca Jesseman, CCSA’s Senior Policy Advisor and Director, Information Systems and Performance Measurement.
A report by Canada’s Office of the Correctional Investigator found that more offenders are presenting with complex mental health, substance abuse and addictions issues. For example, upon admission 80 per cent of federally sentenced male offenders have a substance abuse problem and nearly two-thirds reported that they were under the influence of substances during the commission of their offence.
Substance abuse can also interfere with important factors in a person’s integration back into the community -- such as housing, employment and social supports.
Defining the problem
It’s a complicated problem.
Aspects of the corrections process itself may undermine a return to the community. For example, non-flexible bail conditions “may set up the offender to fail,” notes Rebecca. These include conditions such as a person simply setting foot in an establishment that serves alcohol.
Reintegration is the goal: Rebecca Jesseman and Lisha Di Gioacchino of CCSA.
When a person is denied bail and remanded into custody to await trial, there may be no programs available to help with substance abuse. Compounding that problem, the individual’s defense lawyer may want to downplay the substance abuse in advance of the trial, fearing that this may have a negative influence on the sentencing decision.
Another serious concern is continuity of care. A person who receives medication in prison – such as anti-depressants or anti-psychotics – may be vulnerable to substance abuse triggers and recurrence if this care plan is not maintained in the community.
Considering best practices
“We are seeing best practices but also some big gaps at the provincial corrections level,” says Rebecca.
Looking at best practices, Alberta’s Health Services integrates with that province’s correctional services. “This ensures a care pathway in the community when the offender leaves prison,” notes CCSA Knowledge Broker Lisha Di Gioacchino.
But this continuity of care doesn’t exist in many other provincial settings, she notes.
“We want to fill those knowledge gaps and change practices to improve lives for offenders with substance abuse problems,” says Rebecca. “Are there practices that are having a positive impact in one jurisdiction that we can adapt and apply in others? This will be included in our preliminary report.”
Rebecca notes that CAMH’s Wayne Skinner “is bringing invaluable clinical expertise on addictions and mental health to the project.”
The road ahead
The project will complete an environmental scan and best practices review and recommendations by spring 2016. The aim is to pilot test the recommendations in a provincial setting starting in year two of the project.
Wayne says he’s pleased to bring his perspective from working with clients with addictions and concurrent disorders to the project advisory panel. “The process requires we look at underserved populations such as Aboriginal people, women, youth, and people with acquired brain injury.”
“While there is much to learn, there are areas of promising practice, such as the drug treatment court programs operated by CAMH and other groups, and community-based programs like those offered by John Howard and St. Leonard’s,” says Wayne. The committee has deep commitment and broad expertise, and there is a strong consensus to identify promising interventions and pathways that lead to community reintegration, he says.
“The next step is to pilot and evaluate those options in the second phase of the project.”