Programmatic and Organizational Barriers and Facilitators to Addressing High-Risk Issues in Supportive Housing and Housing First Programs.

Risk management is an important component of service delivery in supportive housing and Housing First programs. However, there is no evidence on the implementation of risk management approaches in these settings. This qualitative study examined what service providers working in supportive housing and Housing First programs in Canada identify as the programmatic and organizational factors that affect the prevention and management of high-risk behaviours and challenges (e.

Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story.

Background: International studies show that adults with intellectual and developmental disabilities (IDD) are disproportionately represented in the criminal justice and forensic mental health systems; however, it is difficult to capture their involvement across systems in any one jurisdiction.

Aims: The current study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD.

Methods: This project utilised administrative data to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care and community mental health programmes.

Sexual health experiences of women and non-binary people with early psychosis: qualitative study.

Background: Women and gender-diverse people with early psychosis are at risk for suboptimal sexual health outcomes, yet little research has explored their sexual health experiences.

Aims: This study explored sexual health experiences and related priorities among women and gender-diverse people with early psychosis, to identify opportunities for improvements in sexual health and well-being.

Method: Semi-structured individual qualitative interviews explored how patient participants ( = 19, aged 18-31 years, cisgender and transgender women and non-binary individuals) receiving clinical care from early psychosis programmes in Ontario, Canada, experienced their sexual health, including sexual function and behaviour.

Experiences of Sexual and Reproductive Health Care Access for Women and Nonbinary People With Early Psychosis: Towards an Integrated Perspective of Service Users and Clinicians.

Objective: Individuals with psychosis are at elevated risk of adverse sexual and reproductive health (SRH) outcomes, and not receiving adequate SRH care. SRH is important for youth, yet little is known about SRH care access and experiences among those with early psychosis. This study explored SRH care experiences among women and nonbinary individuals with early psychosis.

Examining the Prevalence and Forms of Leveraged Treatment Pressure and Its Relationship to Personal Recovery: A Canadian Cross-Sectional Study.

Across jurisdictions, the use of 'leverage' to promote adherence to mental health treatment is widespread. However, little research exists on the possible association between the application of leverage and personal recovery. We examined the prevalence of various forms of leverage in a Canadian context and compared these rates with those in other jurisdictions.

Preparing social workers to address health inequities emerging during the COVID-19 pandemic by building capacity for health policy: a scoping review protocol.

Introduction: The COVID-19 pandemic has brought tremendous changes in healthcare delivery and exacerbated a wide range of inequities. Social workers across a broad range of healthcare settings bring an expertise in social, behavioural and mental healthcare needed to help address these health inequities. In addition, social workers integrate policy-directed interventions and solutions in clinical practice, which is a needed perspective for recovery from the COVID-19 pandemic.

The relationship between clinician leverage, patient experiences, and and the impact of stigma: a study in academic and community outpatient psychiatry settings.

Objective: Various methods are used to induce or pressure patients into being more adherent with treatment; collectively, we can describe them as leverage. Leverage strategies are common in psychiatric services, and may carry unintended, potentially negative effects. We examine their relationships to experiences and impact of stigma.

Examining the need profile of supportive housing applicants with and without current justice involvement: A cross-sectional study.

Objective: Permanent supportive housing has been identified as a possible intervention which could reduce the risk of criminal justice involvement (CJI) among people with serious mental illness who are experiencing residential instability and homelessness. However, the evidence evaluating the impact of supportive housing on CJI is mixed. Increasing understanding of the specific needs of people with justice involvement entering supportive housing may inform interventions which improve their criminal justice outcomes.

Service Users' Knowledge and Views on Outpatients' Compulsory Community Treatment Orders: A Cross-Sectional Matched Comparison Study.

Objective: Community treatment orders (CTOs) have been used in the treatment of some individuals with serious mental illness who fail to adhere to their psychiatric treatment, leading to frequent hospitalization. This article examines perceptions and knowledge of CTOs amongst outpatient service users in Toronto, Canada.

Method: Service users under a CTO were matched to a comparison control group of voluntary outpatients ( = 69 in each group).

Key steps for a mental health and addictions performance measurement framework for Canada.

To inform the development of a pan-Canadian Mental Health and Addictions (MHA) performance measurement framework, we undertook a rapid review of the recent Performance Measurement (PM) literature and solicited input from 20 MHA policy and measurement experts. Six key steps for framework development were identified: recognizing and acknowledging key issues, developing shared language and understanding of key concepts, defining overall scope, defining framework dimension/domains, selecting indicators and using systematic engagement and consultation processes with stakeholders. Subject matter experts underscored the need for a comprehensive engagement process which would honour multiple stakeholder viewpoints and attend to key issues in the codesign of features of the PM framework.

Mental health and addictions policy priorities and performance measurement frameworks.

To inform the future development of a pan-Canadian Mental Health and Addictions (MHA) performance measurement framework, we undertook a review and comparison of current provincial/territorial MHA policies and performance measurement frameworks. Most did not have performance measurement approaches that were explicitly linked to policy actions but eleven acknowledged the importance of performance measurement. Among the provinces with a framework, there were few performance domains in common.

Coercion in Outpatients under Community Treatment Orders: A Matched Comparison Study.

Objective: Since the deinstitutionalization of psychiatric services around the world, the scope of outpatient psychiatric care has also increased to better support treatment access and adherence. For those with serious mental illness who may lack insight into their own illness, available interventions include coercive community practices such as mandated community treatment orders (CTOs). This paper examines the perceptions of coercion among service users treated with a CTO.

Mental Health Disorders and Publicly Funded Service Use by HIV Positive Individuals: A Population-Based Cross-Sectional Study in Ontario, Canada.

We compared use of community and hospital-based mental health and addiction (MH&A) services by adults with and without HIV. This population-based study examined the probability and intensity of MH&A service use by individuals with (n = 5095) and without HIV (n = 2,753,091) in Ontario, Canada between 2013 and 2014. Adults with HIV were more likely than HIV-negative adults to use MH&A primary and psychiatric care, and to have MH&A emergency department visits and hospital admissions; they also used more of each service.

Unmet needs among men with human immunodeficiency virus in community mental health care: a cross-sectional study.

While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario.

Examining the need profiles of patients with multiple emergency department visits for mental health reasons: a cross-sectional study.

Objectives: Study objectives were to: (1) provide an estimate of the prevalence of repeat emergency department (ED) use for mental health reasons among individuals enrolled in intensive case management programs; and (2) to identify socio-demographic, diagnostic, and service need characteristics associated with repeat ED visits among this service population.

Methods: The study utilized administrative health data from community mental health organizations in Toronto, Canada on a sample of 2274 individuals enrolled in intensive case management programs. Patients with 2+ ED visits for mental health reasons within the prior 6 months were compared with individuals who had no ED visits or one visit on the basis of demographic, diagnostic and service need characteristics.

Unmet Needs of Adults in Community Mental Health Care With and Without Intellectual and Developmental Disabilities: A Cross-Sectional Study.

The cross-sectional study compared the clinical and need profiles for clients with and without intellectual and developmental disabilities (IDD) in seven mental health case management programs in Toronto, Canada on March 31, 2013. Unmet needs in domains within four broad clusters were measured by staff using an internationally utilized tool, the Camberwell Assessment of Need. Among the 2560 clients, 8.

Predictors of unmet need for medical care among justice-involved persons with mental illness.

Objective: This cross-sectional study examined factors associated with unmet need for care from primary care physicians or from psychiatrists among clients enrolled in mental health court support programs in Toronto, Ontario.

Methods: The sample included adults admitted to these programs during 2009 (N=994). Both measures of unmet need were determined by mental health court workers at program intake.

Lessons from a Canadian province: examining collaborations between the mental health and justice sectors.

Objective: The objective of this paper was to identify the factors that program developers perceived as important to the successful collaboration between the mental health and justice sectors in seven Ontario, Canada, post-booking programs.

Methods: Semi-structured telephone interviews with developers of the programs in each region were conducted. Key informants were identified using a snowball technique.

The criminal justice outcomes of jail diversion programs for persons with mental illness: a review of the evidence.

Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement. A structured literature search identified 21 publications or research papers for review that examined the criminal justice outcomes of various diversion models.