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Purpose: Forensic mental health programs (FMHPs) in Ontario, Canada provide rehabilitation and supervision services. However, models available to guide their delivery are primarily adapted from fields outside of forensic mental health. To partially fill this gap, this paper aims to provide a general review of the process a multi-professional team took to develop the Integrated Forensic Program [IFP]-Ottawa Model of Risk Management & Recovery. Design/methodology/approach: Working groups were initiated to identify the needs of patients in their local setting, conduct a literature review on care delivery models in forensic mental health and build a service delivery model specific to forensic mental health. Findings: The resulting model places patient engagement at its centre and encompasses eight domains of need that contribute towards the patient's recovery and the management of the safety risk they pose to the public, namely, the basic needs, diversity and spirituality, social, occupational, psychological, substance use, physical health and mental health domains. Practical implications: The IFP-Ottawa Model of Risk Management & Recovery provides a framework to which therapeutic group services for persons in FMHPs can be aligned. Originality/value: The leadership teams in FMHPs could use this framework and the method used for its development to ensure group services provided at their FMHPs are evidence-informed and coincide with their patients' specific needs. [ABSTRACT FROM AUTHOR]

Background: In 2018, Canada legalized recreational cannabis use with the purpose of protecting youth and restricting access. However, concerns have been raised that this objective has not been met as rates of cannabis use among youth aged 16–24 have not declined. Youth cannabis use is associated with various adverse effects including psychosis, anxiety, depression, suicidality, respiratory distress, cannabinoid hyperemesis syndrome, and intoxications. Service providers play a crucial role in addressing youth cannabis use. This study aimed to understand Ontario service providers' perceptions, practices, and recommendations on youth cannabis use. Methods: This mixed method study included a survey and two focus groups. The survey was distributed to mental health service providers serving youth aged 16–24 across Ontario who were given the option to participate in a focus group. The survey included closed and open-ended questions regarding perceptions, practices, and recommendations, while the focus groups explored these categories in greater depth. Descriptive statistics were used to analyze close-ended questions and interpretative content analysis was applied for open-ended questions. Focus group data were analyzed using thematic analysis. Results: The survey was completed by 160 service providers and 12 participated in two focus groups. Regarding perceptions, 60% of survey participants agreed with legalization, 26% had a strong understanding of medical versus recreational cannabis, 84% believed that cannabis has physical and mental health risks, and 49% perceived stigmatization. Less than half of the survey participants reported screening or assessing cannabis use, 16% stated they are highly familiar with treating cannabis use, and 67% reported that they rarely work with families. Subthemes identified in the focus groups under perceptions included normalization and stigmatization, harms for youth, and stigma, racism, and discrimination. Subthemes under practice included cannabis not being the primary focus, challenges with screening, assessment, and intervention, and referral to specialized services. Both the survey and focus group participants recommended increasing public education, enhancing service provider training, improving regulation and policies, reducing stigma and minimization, improving service access, and providing more culturally responsive services. Conclusion: Youth cannabis use in Canada remains a significant public health concern, necessitating a more comprehensive plan to protect Ontario youth and reduce associated harms. [ABSTRACT FROM AUTHOR]

Mental health reform in Ontario is moving in the direction of community-based delivery of mental health services. At the same time psychosocial rehabilitation is emerging as a field of professional study for those who work in the community with individuals suffering from a mental illness. This paper offers a reflection on how terms popularized in mental health such as empowerment and value ought to communicate an existential movement rather than reified technological jargon. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and profile of people with co-occurring mental and substance use disorders in relation to numerous demographic, diagnostic, and needs-related variables across a comprehensive system of mental health services using a standard methodology.Method: Data were collected on cases (n = 9839) sampled from specialty tertiary inpatient, specialty outpatient, and community-based mental health programs. Status with respect to co-occurring disorders was based on recorded diagnosis of substance use disorder and the substance abuse measure within the Colorado Client Assessment Record. The demographic and needs profile was compared across groups with or without co-occurring disorders within each level of care.Results: Overall, the prevalence of co-occurring disorders was 18.5%, and highest among clients receiving specialty tertiary inpatient care (28%), and within selected subpopulations such as younger adults (55%) and those with personality disorders (34%). There were few differences between groups based on co-occurring disorders in the specialty inpatient programs. For outpatient and community settings, the clients with co-occurring disorders were distinguished by a more impaired and complex needs profile and more likely to be young, single, male, and of low education. Across all levels of care, having a co-occurring disorder was strongly associated with antisocial and challenging behaviour, legal involvement, and risk of suicide or self-harm.Conclusion: The prevalence estimate of co-occurring disorders is likely representative of a multilevel system of care that serves a large, mixed urban and rural population. Results highlight the need to focus on specific subpopulations and sectors in pursuit of more integrated treatment and support for their mental health and addictions problems. [ABSTRACT FROM AUTHOR]