Grant: Operating Grant: Transitions in Care - Evaluation Grants

Individuals with schizophrenia are over-represented in Ontario's jails. They also have higher rates of return to jail. Ending up in jail is a tragic outcome for individuals with schizophrenia, and there is evidence suggesting that a substantial number of these individuals end up in jail because of poor access to mental health care. We will use unique linked data that includes information on all Ontario residents who were released from jails in Ontario in 2010, their involvement with jails in the 5 years prior to and following their release in 2010, and all their health-related information (physician visits, Emergency Department visits, and hospitalizations). Our team has done preliminary work showed that, in 2010, 3237 (7%) of all Ontario residents involved with correctional centres had a diagnosis of schizophrenia. We also showed that the majority of individuals with schizophrenia had no mental health contact during their jail period. Individuals with schizophrenia also had very high rates of recidivism (return to jail after release) compared to individuals without schizophrenia and very low rates of access to mental health care following jail release. These preliminary findings suggest very poor outcomes and fragmented care transitions. The CAMH Forensic Early Intervention Service (FEIS) was developed to systematically screen and manage individuals with severe mental illnesses in Ontario's jails. FEIS started in 2016 and is responding to some of the urgent issues we have discovered through our preliminary research. We will build on this early research to address the following questions: 1) Among all individuals with a diagnosis of schizophrenia in Ontario, what predicts whether or not someone ends up in jail? 2) What predicts whether or not someone has access to mental health follow-up after release from jail? 3) To what extent does access to mental health services prevent a return to jail? and 4) What are the early findings from the CAMH FEIS program?