What this program does...

Forensic Psychiatry, a subspecialty of psychiatry, focuses on the relationship between psychiatry and the law, and deals specifically with a multitude of medicolegal issues including fitness to stand trial, capacity/competence, criminal responsibility, assessment of malingering, expert witness testimony, responsibility in civil actions, and risk assessment and management of violence. Our clinical staff who specialize in this area have strong clinical skills in the assessment and management of patients with complex clinical presentations, particularly with psychotic illnesses, addictions and personality disorders including Psychopathy. Fundamental to this subspecialty is expert knowledge of legislation that governs all acts pertaining to the assessment and treatment of patients as well as expertise in documenting and presenting clinical opinions and recommendations in the criminal and civil settings.

The  Forensic Psychiatry Program currently operates 114 inpatient  beds (22 Assessment and 92 Rehabilitation/Recovery). In addition, the Forensic Psychiatry Program has opened 4 Acute Stabilization inpatient beds designed to provide care to men detained in  the Hamilton Wentworth Detention Centre.

The Forensic Psychiatry Program offers a range of specialized outpatient services and clinics including: intensive case management, Aggression and Impulsivity Assessment Clinic, Sexual Behaviours Clinic, Brief Assessment Unit, and Alternate Care Pathways (OTN) services. The Program also provides Fitness to Stand Trail Assessment Clinic that operates in local detention centres and by videoconference.

How this program helps...

This program provides services to the courts and the legal community. We aid in the provision of assessments of Fitness to Stand Trial, Criminal Responsibility and risk assessment. We also manage the clinical care of individuals found Not Criminally Responsible or Unfit to Stand Trial and are now under the jurisdiction of the Ontario Review Board. We assist patients in their psychiatric treatment, helping them to work towards rehabilitation and recovery. We also actively manage any risk they may pose to the community.

Visiting Hours

St. Joseph’s Healthcare Hamilton wants to ensure that all visiting family and friends feel very welcome at our Hospital and included in the care of our patients when appropriate.

Visitors to the Forensic Psychiatry Program should contact the Unit Social Worker to arrange for convenient times and to review require visiting procedures.

Your Care Team

Head of Forensic Service and Academic Lead: Dr. Gary Chaimowitz
Clinical Director: Marilyn Dakers-Hayward
Senior Psychologist: Dr. Mini Mamak
Forensic Service Coordinator: Liane Taylor and Barb Benedict
Clinical Legal Counsel: Lauren Barney and Kathleen Robb
Nurse Educator: Heather Dunlop-Witt and Seonhee McDermott

Psychiatrists:
Dr. Gary Chaimowitz
Dr. Joe Ferencz
Dr. Susan Adams
Dr. Yuri Alatishe    
Dr. Olubukola Kolawole    
Dr. Yedish Naidoo
Dr. Satyadev Nagari
Dr. Sebastien Prat
Dr. Wesley Sutton
Dr. Rebecca Chauhan
Dr. John Bradford
Dr. Isabel Cote
Dr. Alana Courtright
Dr. Jonathon Duboff

Psychologists:
Dr. Mini Mamak
Dr. Heather Moulden
Dr. Bruno Losier
Dr. Peter Sheridan

Contact

St. Joseph’s Healthcare Hamilton
West 5th Campus
100 West 5th Street
Hamilton ON  L8N 3K7
Telephone: 905-522-1155 ext. 36262
Fax: 905-381-5605

If you are interested in more information on our services and programs, or are considering a rewarding career in Forensic Psychiatry, please contact Taralynn Filipovic at filipovt@stjoes.ca.

Referral Process

The Forensic Program’s clinical responsibilities and activities are defined by law, not by diagnosis. Referrals to the program come from the courts, the Attorney General’s office or from lawyers in the community. Additionally referrals will come to the program from other forensic programs within the province. Some of the specialty clinics provide consultations within their domains..

Outcomes and Evaluation

Targeted outcomes over the past year have focused on:

• Effectiveness of newly developed therapeutic programming incorporating recovery principles in patient driven goal attainment
• Effectiveness of the AIS (Aggression Incident Scale) and HARM (Hamilton Anatomy of Risk Management) in assessing and managing risk factors

Ontario Review Board

Our Forensic team of dedicated professionals works closely with our clients who are under the auspices of the Ontario Review Board with the goal of re-integrating patients back into the community. During this process our staff continues to work collaboratively with other inpatient programs and community partners and agencies to ensure that patients are reintegrated into their communities safely with the appropriate support services. To facilitate this support, we remain available for consultation following the transfer of a patient to another inpatient program and also provide out-patient services for those who still require monitoring and supervision.

Fitness To Stand Trial Clinic

The Fitness to Stand Trial Clinic is the result of an innovative, collaborative approach with our stakeholders to meet the needs of accused individuals, the Courts, and the Mental Health System by facilitating the completion of assessments of Fitness to Stand Trial in the local detention centre. Fitness assessments are completed weekly by staff of the Forensic Program and have proven effective in the following manner:

• Enables, in 75% of the cases, the completion of fitness examinations without a hospital admission
• Facilitates a rapid transition through the Court system by avoiding lengthy waiting periods for admissions
• Acts as a cost-saving method by eliminating unnecessary admissions and freeing beds for those who require them
• Assessments of Criminal Responsibility are also completed and generally require a hospital admission. On occasion, however, these assessments can be completed out-of custody (if the accused is already living in the community)

Education

The Forensic Program provides ongoing educational sessions for staff members by utilizing the expertise of program staff and invited guest speakers with expert knowledge pertinent to the delivery of our specialized services.

In addition, the Forensic team has developed presentations for stakeholders and other inpatient programs in relation to the services we provide, the legal system under which we operate, the type of risk assessment and management we utilize and risk management techniques other services can employ when addressing the needs of Forensic patients.

The Forensic program is associated with the McMaster University: Department of Psychiatry & Behavioural Neurosciences, Forensic Psychiatry Division.

Our Research Group

The Forensic Psychiatry Program (FPP) at St. Joseph’s Healthcare Hamilton (SJHH) is located within the West 5th Campus, an academic health centre affiliated with McMaster University. The FPP participates within clinical research activities associated with the Division of Forensic Psychiatry within the Department of Psychiatry and Behavioural Neurosciences at McMaster University.

The Research Group oversees clinical research activities conducted in the Forensic Psychiatry Program. It facilitates and supports research activity that is innovative in the pursuit of excellence in research, education and clinical care.

The FPP Research Group engages in scholarship and research to promote a culture of innovation and excellence in forensic care. It facilitates collaborations with researchers locally, nationally, and internationally. The research undertaken is diverse and inter-disciplinary. It strives to improve the understanding of criminal and aggressive behaviour in mentally disordered populations in order to advance risk assessment, documentation, risk management, and rehabilitation strategies.

In early 2014, the FPP underwent a significant expansion as we moved to a new innovative health care facility at St. Joseph's West 5th Campus. To meet the demands of the expansion of our program, the FPP Research Group is now actively involved in the recruitment of the skilled clinicians and researchers who will contribute to forensic research and improve forensic care in our community.

Core Research Group

The core Research Group is composed of an interdisciplinary team of professionals who are active in research on current issues in forensic psychiatry, psychology and nursing. We also offer opportunities for undergraduate and graduate students to learn about research. Students and volunteers are invited to contact the Research Group for academic and volunteer opportunities.

Clinical Chair Positions  

The Forensic Psychiatry program has added four Clinical Chair positions that will allow for a deeper understanding of and an improvement in the quality of clinical services and patient outcomes for this program.  

The successful candidates have extensive experience within their key areas and are committed to innovation in mental health care:  

• Chair in Forensic- Correctional Psychiatry – Dr. Andrew Olagunju 
• Chair in Violence Reduction – Dr. Mini Mamak and Dr. Gary Chaimowitz 
• Chair in Sexual Disorders – Dr. Heather Moulden 
• Chair in Recovery in Forensic Psychiatry – Dr. Sebastien Prat

Activities

Research Projects: There are numerous research projects underway in a variety of domains. Opportunities for collaboration and volunteer assistance are ongoing.

Risk and Recovery Conference: The FPP hosts the Risk and Recovery Conference in Hamilton, Ontario, Canada. International and local researchers and clinicians speak about current topics in forensic psychiatry. For information about this year’s conference, please visit www.riskandrecoveryconference.com. 

Radical Collaboration Research Day: Annual unique research day held in November

Forensic Psychiatry Institute: A week long institute held in August in Huntsville, a meeting designed to probe key forensic issues in depth

Journal Club: Regular journal club meetings are held. Participating members identify gaps in science and practice that inform research questions, promote scientific inquiry and disseminate evidence to inform practice, education and policy.

Research Newsletter: The research newsletter highlights scholarly and research activities in the FPP.

AIS and HARM Risk Assessment Tool:
The Aggressive Incidents Scale (AIS) and Hamilton Anatomy of Risk Management (HARM) are clinical rating tools that have been developed by Drs. Gary Chaimowitz and Mini Mamak. These effective tools are now utilized in numerous settings in Ontario. Ongoing research is being conducted into the efficacy of various versions of these innovative tools. The E versions of the tools provide for state-of-the-art risk management. www.AIS-HARM.com.

For information about the FPP Research Group, please contact:

Dr. Gary Chaimowitz

Email: chaimow@mcmaster.ca   

Tel: 905-522-1155 Ext. 35424