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

Who Works in the Forensic Mental Health System?

Who Works in the Forensic Mental Health System?

The Forensic Mental Health System in Ontario: An Information Guide

The forensic mental health system involves people who know about both the mental health and the criminal justice systems.


Police make the community safe and enforce the law. Neighbours or strangers might call the police when a person scares them, or when they think a crime has been committed. Sometimes family members call the police as a way of getting help and proper care for their loved one.

Getting people "help"—treatment—is not always something the police can do. Please read the section "How Do People Enter the Forensic Mental Health System?" for more information.

Defence counsel

If you have been arrested, you should contact a lawyer as soon as you can. This person becomes your defence counsel. Your defence counsel can tell you what might happen to you once you have been arrested. You can ask for advice about what you should do.

If you don't have a lawyer and need to find one, or if you don't have a lawyer and need to apply for Legal Aid, read the section "What Happens after a Person Is Arrested?" for more information.

Duty counsel

Duty counsel are lawyers who work in the court. They will help you if you do not have your own lawyer yet. They are paid by Legal Aid and their help is free. Duty counsel can help with basic legal advice and court proceedings. However, they work with many people. They will not be able to get to know you or your case well. Often there is a different duty counsel in the courthouse every day. You will likely still need a lawyer to represent you.

Crown counsel

This person is the lawyer for the Crown, representing society and the public. Crown counsel is sometimes called "the prosecutor," "Crown attorney" or simply "the Crown." The legal system is "adversarial." This means that two different sides of the case will be presented—your side, argued by your lawyer, and the Crown's side, argued by Crown counsel. Crown counsel must show evidence of the alleged crime and present all the facts fairly.


The judge (and sometimes a jury of 12 citizens) listens to evidence given by your defence counsel and the Crown counsel.

The judge decides the following:

  • If you are in jail, the judge decides if you should be granted bail. With bail, you can live in the community until your court date. A justice of the peace may decide this instead of a judge.
  • The judge can decide if your mental health should be assessed.
  • Based on the assessment of your mental health, the judge decides if you are Fit to Stand Trial.
  • The judge (and sometimes a jury) decides if you are Not Criminally Responsible (NCR) because of your mental illness.
  • If you are criminally responsible, the judge (and sometimes a jury) can find you guilty.
  • If you are found guilty, the judge decides what your sentence will be.

Court Support Workers and Diversion Programs

Some courts have a Court Support Program. You might not know what kind of help you need or what services are in your area. Court Support Workers can help link you up with those services.

Court Support Workers are also involved in diversion programs. These programs are for people who have been charged with a minor offence. The idea is to keep people who have a serious mental illness and have also committed a minor offence out of the criminal justice system. Instead, the program "diverts" them, or links them, with resources in the mental health system.

Diversion can only happen before you have a trial. Ask your lawyer, duty counsel, a Court Support Worker or a member of your support network to refer you for diversion. The Crown has the authority to decide whether or not you are right for a diversion program.

To be diverted, the following conditions must be met:

  • The offence you are charged with must be a minor one.
  • You must volunteer to be diverted.
  • The Crown must decide you are right for a diversion program.
  • You must agree to follow a treatment plan that has been developed especially for you.


A psychiatrist is a medical doctor who has special training in assessing and treating mental illness. A psychiatrist can:

  • prescribe medications to treat symptoms of mental illness
  • see people for therapy or counselling
  • assess people who may have a mental illness. One type of assessment is a forensic assessment. A forensic assessment is for the court. Please read the section "Getting a Forensic Assessment" for more information.


Nurses look after the daily needs of people who need medical help. They monitor patients, give emergency care, help people with hygiene and other activities of daily living, and much more. Nurses work in jails, hospitals and community agencies. Sometimes nurses visit a person's home. Nurses are usually part of the multidisciplinary team. This is the team of professionals involved in assessing and caring for you once you are in the forensic mental health system.


A psychologist has specialized knowledge of mental problems. Psychologists often give tests to find out how people are functioning in areas like intelligence and personality. They can test for signs of brain damage. Psychologists can also see people for therapy and counselling. A psychologist might be part of the team involved in assessing and caring for you.

Social worker

A social worker can help you find housing, get financial support and contact other community supports. Social workers also organize and supervise visits with your family or others. Social workers are usually part of the team involved in assessing and caring for you. Ask your nurse or psychiatrist if there is a social worker on your team.

Recreation therapist

Recreation therapists help people to spend their free time in healthy ways. They help people to exercise the body by playing sports and keeping fit. They help people to exercise their minds by playing games and taking part in social activities. Recreation therapists are sometimes part of the team involved in assessing and caring for you. Ask your nurse or psychiatrist if there is a recreation therapist on your team.

Occupational therapist

Occupational therapists (OTs) can help you with everything from daily tasks to gaining employment skills. They help you to see your strengths and work on your weaknesses. OTs are sometimes part of the team involved in assessing and caring for you. Ask your nurse or psychiatrist if you have an occupational therapist on your team.

Patient advocates and Rights Advisers

Some Ontario hospitals have patient advocates. A patient advocate can help you make informed decisions about your care, treatment and legal rights. A patient advocate can also help you find lawyers and apply for Legal Aid.

Rights advisers give confidential advice about legal rights to people who are receiving psychiatric services.

The Psychiatric Patient Advocate Office (PPAO) offers these two services. The full range of services of the PPAO is not available in all Ontario hospitals. You can get in touch with a patient advocate or rights adviser in one of these ways:

  • Call the PPAO at 1 800 578-2343
  • Visit the PPAO Web site at to find out if there are services in your hospital
  • Visit a PPAO office in person. There are nine offices in Ontario. You can find the office nearest you on the Web site.
  • If you do not have access to a telephone and you are not allowed to leave the hospital unit, ask one of the staff members to contact the PPAO office for you.

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



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
Ten offices across Ontario