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The Forensic Mental Health System in Ontario: An Information Guide Centre for Addiction
and Mental Health

Living in a Forensic Mental Health Setting

The Forensic Mental Health System in Ontario: An Information Guide

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Living under the authority of the Ontario Review Board (ORB) can be hard. You are trying to cope with a mental illness. You are dealing with the stress of the event that brought you into the system. Your freedom may be restricted. You may feel frightened, or powerless, or lonely. In a hospital, you also have to live with other people who have their own problems.

Talking about your concerns is the best way to resolve them. You can talk to the members of your multidisciplinary team, such as your psychiatrist, nurse or social worker. They will help you understand why restrictions have been imposed on you. You can also make a plan with your team to increase your privileges over time.

The controls on your behaviour and freedom are meant to ensure safety for you, other patients and the community while you are improving your health.

Where can I turn for help if I feel I am being treated unfairly?

If you cannot resolve a problem with your team, there are several people you can turn to. You, a family member or someone from your personal support network can contact one of the following people:

  • Most hospitals have client/patient relations co-ordinators. Ask any member of your team how to contact them. You can ask questions, make suggestions, or voice concerns about your care at the hospital.
  • Ask any member of your team how to contact the director of the forensic program at your hospital.
  • Contact the Psychiatric Patient Advocate Office (PPAO) at 1 800 578-2343 or go to the Web site at www.ppao.gov.on.ca. Patient Advocates do not work for the hospital.
  • Some hospitals have a Family Resource Centre or Family Council.

Getting help for other problems

Many people in the forensic mental health system face problems in their lives other than mental illness. Forensic and general psychiatric hospitals often have programs to help with:

  • drug and alcohol abuse
  • family problems
  • language difficulties
  • social skills
  • sexual problems
  • financial problems.

Based on your level of security, you may also be able to attend community programs outside of the hospital. Talk to your team about options and ideas for you.

Language and interpreters

If you are not comfortable speaking or reading English, or if you are deaf, ask for an interpreter. There is no cost to you. Courts and hospitals in big cities can usually book an interpreter for interviews and meetings. In rural areas, it might take longer to get an interpreter.

Human rights in the forensic mental health system

Some personal freedoms may be restricted while you are in the forensic mental health system. However, the Constitution ensures that all Canadians are protected against discrimination. Under the Charter of Rights and Freedoms, you have the right to be free from discrimination based on:

  • race
  • gender
  • sexual orientation
  • mental or physical ability
  • age
  • religion.

You have many other rights protected by the Charter of Rights and Freedoms, whatever your forensic status. Speak to your lawyer about those rights.

Your rights as a patient under the authority of the Ontario Review Board (ORB)

  1. Although rules and restrictions may be imposed on you while you are in the forensic mental health system, you have the right to be treated with respect. In turn, you will be expected to treat staff and co-patients with respect.
  2. You have the right to decide about your treatment unless you are:
    • deemed incapable of consenting to or refusing treatment, or
    • subject to a Treatment Order.
  3. You have the right to be involved in and asked about your treatment and care even if you are not capable of consenting to or refusing treatment.
  4. You have the right to limited confidentiality. That means that, usually, only the people assessing and treating you will have access to information about you. However, there are many exceptions. Other people will have access to your information if:
    • you give your consent for others to have access to your information
    • the hospital has to share information with authorities such as the ORB, the courts or the police
    • the staff treating you have a duty to warn or protect other people.
  5. You have the right to refuse to take part in a forensic assessment. However, the assessment will still take place using other available information.
  6. You have the right to reasonable access to an interpreter.
  7. You have the right to an ORB hearing once every year.
  8. You have the right to be present at your ORB hearing unless you are a danger to yourself or others at the time of the hearing.
  9. You have the right to speak or present evidence at your ORB hearing.
  10. You have the right to a lawyer. You have the right to confidential communication with your lawyer.
  11. You have a limited right to look at your clinical record. Talk to your psychiatrist or another member of your team about the limits to this right.
  12. You have the right to contact with a spiritual adviser of your choice.
  13. You have the right to a safe environment when you are staying on a forensic mental health unit in Ontario.
  14. You have the right to vote if you are an eligible Canadian citizen.
  15. You have the right to talk to a patient advocate, client relations co-ordinator or family advocate. You have the right to be informed of your rights.

The Forensic Mental Health System in Ontario: An Information Guide

  1. Introduction
  2. Who works in the forensic mental health system?
  3. What happens inside the forensic mental health system?
  4. The Ontario Review Board (ORB)
  5. Accepting or refusing treatment in the forensic mental health system
  6. Living in a forensic mental health setting
  7. Family, friends and the forensic mental health system
  8. Leaving the forensic mental health system

Conclusion

Glossary

Where to go for more information

CAMH Switchboard 416-535-8501
CAMH General Information Toronto: 416-595-6111 Toll Free: 1-800-463-6273
Connex Ontario Help Lines
Queen St.
1001 Queen St. W
Toronto, ON
M6J 1H4
Russell St.
33 Russell St.
Toronto, ON
M5S 2S1
College St.
250 College St.
Toronto, ON
M5T 1R8
Nine offices across Ontario