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Welcome to St. Joseph’s Southwest Centre for Forensic Mental Health Care
The Forensic Psychiatry Program at Southwest Centre for Forensic Mental Health Care offers both inpatient and outpatient programs and services. Five inpatient units provide unique interventions throughout each individual’s journey of recovery, including different levels of security and privileges which balance autonomy and manage risk. The program’s mission is to enable persons with mental health disorders who have been in conflict with the law, to improve functioning so they may be successful in the community. Through longer term treatment, individuals receive the supports necessary to ensure the safety and security of themselves, staff members and the public at large. We support our patients in developing the skills and supports they need to live, socialize and work in their environment of choice. We believe that everyone has the capacity to learn, grow and recover. Recovery, in terms of mental illness, does not always mean the absence of the illness itself. As defined by the Mental Health Commission of Canada;“Recovery means living a satisfying, hopeful, and meaningful life, even when there may be ongoing limitations related to mental health problems and illnesses.” This Patient and Family Handbook is dedicated to providing you with information that you or your family members may need. If you have questions or concerns that we have not addressed, please feel free to ask any staff member. To view a virtual tour of Southwest Centre, including patient rooms visit St. Joseph’s Website: www.sjhc.london.on.ca/areas-of-care/mental-health-care/mental-health-care-forensic-program/ services
What is Forensic Psychiatry?
Forensic psychiatry is devoted to caring for people with a mental illness who have also come into contact with the criminal justice system. Staff and physicians within various forensic programs assist patients towards their personal recovery journeys and the realization of their hopes and goals. Through intensive work with our care teams, patients are able to develop the skills and supports needed to successfully reintegrate back into the community.
How Does the Forensic Mental Health System Work?
Forensic patients are individuals who have been declared either unfit to stand trial, have been found not criminally responsible on account of a mental health issue, or are referred for assessment by the criminal justice system. Forensic beds are managed under the jurisdiction of the Ontario Review Board (ORB).
What Happens When Patients Leave the Hospital?
Individuals who have made a transition back to community continue as outpatients and are followed by the forensic outreach team while remaining under the disposition of the ORB. Rehabilitation continues within the community and is individualized to support each patient’s successful reintegration into the community. Our team works closely with other community agencies across the region to link individuals with on-going supports once no longer under the jurisdiction of the ORB. If you are concerned about housing upon discharge, please reach out to your health care team to discuss options and resources available.
What You Can Expect
We will assist you by providing opportunities that will help you get well. We are committed to working with you in a mutually respectful and honest partnership as you move forward through your recovery. Treatment, rehabilitation and support plans will be developed with you to reach your identified goals. A member of your care team will review with you our admission process, what to expect during your stay and what a general day is like at Southwest Centre. Mealtimes, overall expectations, code of conduct, activities and any other questions you may have will also be discussed with you. Please bring a minimal number of belongings with you as storage space is limited.
Inpatient Units
Individuals who are inpatients of the Forensic Program reside in one of the below secure units:
• Forensic Assessment Unit: A secure environment which focuses on providing consultation and specialized assessments regarding fitness to stand trial, criminal responsibility and sentencing to the justice system. • Forensic Treatment Units: Two treatment units provide psychiatric stabilization and initiate longer-term integrated treatment, rehabilitation, and support to patients on
Ontario Review Board dispositions. The units operate under a model of psychosocial rehabilitation. Patient privileges are introduced gradually depending on each individual’s illness status, security needs/risk, and tolerance for less structure. • Forensic Rehab Readiness Unit: A unit that allows for increasing levels of privileges within a structured environment. Progress to this unit reflects improvement in the clinical status of patients and their changing Ontario Review Board dispositions.
Intensive engagement and initial rehabilitation take place on this unit with a focus on developing personal goals and initial steps toward community reintegration. • Forensic Rehabilitation Unit: On this unit the primary focus is on community reintegration, as well as building the skills and supports necessary for a successful transition out of hospital.
Forensic Outreach Program
The Forensic Outreach Team plays a crucial role in the safe and successful transition of forensic patients back into the community. Patients who have made a transition to the community are managed as outpatients through the Forensic Outreach Team and remain under the disposition of the ORB. The ORB annually reviews the status and progress of each patient as the individual transitions from an inpatient setting back to community living. Intensive rehabilitation efforts continue within the community setting where skill training and ongoing risk assessment and management take place. The team works closely with other community-based agencies across Ontario to link individuals with the appropriate on-going supports (e.g. ACT teams, residential treatment, group homes.) The outreach team provides ongoing forensic monitoring and risk management for these individuals and uses its forensic knowledge and expertise to assist the ORB in determining an individual’s suitability for absolute discharge from the forensic mental health care system.
Our Philosophy of Care
The St. Joseph’s Health Care London family upholds values of respect, excellence and compassion. At Southwest Centre, these values guide our efforts, direct our actions and support our mission. In everything we do, our goal is to help you to improve your health and quality of life.
We believe that quality of life embodies physical well-being, personally meaningful activities, maintaining links with friends and family, and looking ahead to the future. It is important for us to understand your values and wishes so that we can best assist you with making choices about your care. We encourage you to discuss this openly with your treatment team upon admission, during your stay, and before discharge.
Recovery Oriented Care
Our programs strive to provide a positive, respectful, culturally sensitive environment that understands the unique needs of every individual. Our care providers assist patients in their personal journey beyond the limitations of illness and toward recovery. Recovery oriented care is grounded in a treatment program which focuses on helping each patient live a full and meaningful life. St. Joseph’s works closely with patients and their families to identify goals and learn what is important to them on their journey to recovery. Recovery, in mental health care, is not defined by the absence of the illness (as an individual may always live with mental illness) instead it describes the ongoing management of the illness and symptoms. Management involves coping with mental illness and continuing to thrive in the community.
Southwest Centre programs operate under the Ontario Mental Health Act and the Ontario Public Hospitals Act, as governed by St. Joseph’s Health Care London.
Patient’s Bill of Rights
The Patient’s Bill of Rights has been developed to help promote the dignity and worth of all Southwest Centre patients. The patients, families and staff who have worked together to develop the Patient’s Bill of Rights wish it to be a living document which will grow, evolve and continue to create an organizational culture of mutual respect and trust. A full copy of the Patient’s Bill of Rights is also available upon request. Please speak to the staff on your unit or to your Patients’ Council representative.
The Ten Rights are:
• Every patient has the right to be treated with respect • Every patient has the right to freedom from harm • Every patient has the right to dignity and independence • Every patient has the right to quality services that comply with standards • Every patient has the right to effective communication • Every patient has the right to be fully informed • Every patient has the right to make an informed choice, and give informed consent to treatment • Every patient has the right to support • Every patient has rights in respect of research or teaching • Every patient has the right to complain
Statement of Patient and Resident Values
At St. Joseph’s Health Care London, we are diligent about finding new ways to improve the care we provide to patients. When you walk through our doors we want you to know we value you as an individual - and hope our care surpasses your expectations. Below you will find the Statement of Patient and Resident Values which was developed through discussion and input with those we serve:
Respect
• for my privacy • that I am part of my own care team along with the family support I see fit • for my time – waiting for appointments; waiting for call bells to be answered; not rushing my time with the doctor and team; receiving results in a timely way
Compassionate, Caring People
• who demonstrate genuine caring, recognizing that I am a person, not a diagnosis, case or number • who work as well-coordinated teams • with my best interests at the heart of all they do
• provided by highly qualified staff supported by the best technology • with the capacity to be flexible and act quickly when needed • and the information I need before, during and after my visit or stay • continuity across St. Joseph’s teams and the health care system
Family Charter of Rights
We value the role of families and essential caregivers at all St. Joseph’s sites and uphold the value of these individuals as partners in care, and the importance of the family voice. It is our wish to attend to issues of consent as an ongoing dialogue with our patients, and to work in collaboration with families at every juncture in the provision of care. The following statements are intended to reflect the needs and rights of families as partners in the delivery of mental health care for their loved ones at St. Joseph’s.
Families have the right to:
• A mental health care program in which family involvement is valued and encouraged • Respect and understanding • Inclusion in the process of diagnosis, treatment and discharge planning of their loved one • Education about their loved one’s diagnosis • The best treatments, practices and therapies that maximize recovery and rehabilitation for their loved one • Feedback between caregivers and professionals • Information on community resources and how to access them • A healing environment free of stigma • Caring staff who understand that the whole family is impacted by their loved ones’ mental illness
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decides on appropriate action, and meets with the parties involved to resolve the situation. visitor, a leader should be informed of their concern. The leader investigates the situation, If a staff member feels they are being treated disrespectfully by a patient, family member or nancial obligations Protect personal property and fi Actively partner in their care Treat others with respect Patients, family members and visitors have the responsibility to:
determinethe facts, and to take any necessary action. an obligation to follow up by meeting with all affected parties in order to gather information to while in the facility. Once an issue or complaint is brought to a leader’s attention, he/she has
Patients have a right to bring forward issues or concerns regarding their care or experience Bring a complaint under this policy forward without fear of reprisal Dignity and independence Quality service that complies with this policy Be in an environment free from harm Be treated with respect • Patients, family members and visitors have the right to:
This policy encompasses bullying, disrespectful and abusive behaviour. support patient care deserve to be treated with honesty, courtesy, respect and dignity. of respect, excellence and compassion in all relationships. All those who receive, provide and This policy establishes guidelines to foster an environment which reflects the St. Josephs values
Civility in the Workplace Policy
Accommodation
Patient rooms are private and include a bed, wardrobe, desk and bathroom with shower. In most situations it is possible for you to bring in a few items to help make your space more comfortable (e.g. a favourite pillow). For safety, please have the staff on your unit check these items before taking them to your room.
Clothing and Laundry
Patients can wear their own clothes and each unit has laundry facilities. For those who are not able, staff will assist them with their laundry.
Meal Selections
Food and Nutrition Services is pleased to provide a 21day menu for inpatients at Southwest Centre that has been carefully designed for nutrition and enjoyment of breakfast, lunch and dinner, with the option to request additional menu choices upon request. In addition, a morning fruit bowl and an evening snack are available for all patients. The menu may include specials to celebrate major occasions and often reflects seasonal offerings such as local strawberries and asparagus when available. Food offered is also appropriate for a variety of diet needs including modified textures. Patients are encouraged to report food and nutrition requests to their nurse or ask for a consultation with the Registered Dietitian. A nutritional assessment can be completed, including diet customization to address your personal nutritional goals and needs. If you have any questions regarding your diet or nutritional needs, please contact the Registered Dietitian on your unit. Patients are able to eat in a communal dining room to promote companionship. Meal times vary; your nurse can provide you with a schedule upon request. We welcome feedback on meal items, which can be provided through periodic surveys or by passing your feedback along to a member of your care team.
Gifts
Family members are welcome to bring gifts for you. When they do, please make sure the staff are aware, so they can ensure gifts are safe for both you and others on the unit. Please be aware that there is the possibility of items disappearing. Therefore, gifts of significant monetary or sentimental value should be stored at home.
Storage
Storage space in our facility is very limited. If you have belongings that need to be moved or stored at the time you come into hospital it is your responsibility to ensure that you or your family members make arrangements ahead of time.
It is advisable that valuable belongings you are unable to care for be left at home. For security reasons, it is advised that large sums of money be deposited in the Business Office. The Business Office is open Tuesday and Thursday between 8:30 am to 12 pm. Please speak to the care team if you have further questions.
Facility Guidelines
Alcohol
Alcohol can significantly interfere with a patient’s treatment and rehabilitative efforts. Southwest Centre maintains a no-alcohol policy.
Cell Phones/Electronic Devices
Check with your care team for your specific electronic device guideline. Visitors - no cell phones are allowed on the units. If there is a special need (e.g. to take a photo of your loved one) please contact the unit leader
Photography/Videography
St. Joseph’s is committed to protecting the privacy of patients, visitors, staff and affiliates in accordance with Personal Health Information Protection Act (PHIPA) and the Freedom of Information and Protection of Privacy Act (FIPPA). Photography/ recording of patients by other patients and/or their visitors is strictly prohibited. If there is a special need (e.g. to take a photo of your loved one) please contact the unit leader.
Prohibited Items
The safety and well-being of all patients, staff and visitors is of utmost importance at St. Joseph’s. All patients and family members entering Southwest Centre will be searched at security to ensure they are not in possession of prohibited items that present a hazard to personal safety of patient or staff or to the therapeutic environment.
The following items are not permitted to be brought into the facility:
• Alcohol, alcohol-based products/solvents • Illicit or illegal drugs, drug paraphernalia, unlabeled/unidentified medications or supplements • Weapons, ammunitions or objects that are intended to be used as a weapon or ligatures • Glass or metal containers (including vases or glass or metal food or beverage containers) • Sharp objects such as knives or scissors • Aerosols, flammable, corrosive or explosive liquids, substances or devices • Pornographic materials including publications, film and images Other items may also be prohibited depending on your unit. As part of routine safety protocols, belongings are checked on admission and again when returning from passes. Belongings brought in by family or friends are also checked.
In the event that an item brought into hospital is deemed to be a prohibited item, these will be removed, sent home with family, discarded, or sent to our local police department for safe keeping. You may retrieve the items upon discharge
Illegal Substances
The use of any illegal substance or other drugs not prescribed by your doctor can be dangerous; therefore, it is a Southwest Centre policy for patients to refrain from the use of illegal or nonprescribed substances. Possession of illegal substances may result in legal action.
Staff ID Badges
All staff and volunteers are required to wear a photo ID badge that includes a title description of their position and unit/department. If you are unsure if an individual is authorized to be on site, please check with your care team.
Personal Attire
As a part of the recovery process it is important to be active each day. We encourage each person to be awake and dressed by 10 am and we ask that nightclothes are not worn in public areas.
Passes and Leaves of Absence (LOA)
Passes to leave the unit/grounds and facilities are available on a case-by-case basis and depend on one’s ORB disposition and assessment by the clinical team. Discuss these options with your care team.
Patient Bracelet
All patients will be assigned a bracelet to wear during their stay. This bracelet is an important part of your care experience. Each bracelet will be programmed to provide access to areas of the building, based on your pass level. If your pass level allows you to leave your unit, and you find yourself at the unit entrance with another patient who does not have passes, the door will remain locked for the safety of the other person. If this happens, please notify a member of your care team to assist you. As with all hospital property, it is important to treat the bracelet with care as they can be easily damaged. The bracelet will be removed by your care team upon discharge, or for an approved extended leave of absence, when a member of your care team will assist you. Please do not attempt to remove the bracelet without the assistance of your care team. If you have any questions about your pass level or bracelet, please do not hesitate to speak to a member of your care team.
No Latex
Allergic reactions to natural rubber latex range from mild to life-threatening. Please help to keep Southwest Centre safe for patients, staff and visitors by not bringing in balloons, gloves or other products made with latex.
Scent Free Policy
In recognition of the potential health concerns associated with scented products, we are committed to promoting a scent-free environment. Please refrain from using products containing fragrance such as perfume, aftershaves and hairspray.
As a health care agency, St. Joseph’s Health Care London is committed to providing a safe and smoke free environment to all of its patients, staff and visitors. St. Joseph’s has established a non-smoking policy, which governs this facility and grounds. There are many clinical reasons to not smoke including smoking can interfere with some medications. St. Joseph’s is focused on patient health and well-being and supports your right to make choices but while you are in care at Southwest Centre please note it is a smoke free environment which includes the building, grounds and parking lot. Your health care team will discuss with you and assess your individual needs and can discuss any smoking addiction aids you may need. Inpatients who smoke are encouraged to give tobacco products to a friend or family member for safekeeping. As well there will be storage available for patients who have community passes. Outpatients and patients attending day programs will be asked not to bring any tobacco products for their appointments and treatment. These products may be left in vehicles on hospital property, but may not be used on hospital property. The non-smoking policy applies to tobacco in any processed or unprocessed form that may be smoked, inhaled, or chewed, including but not limited to snuff, chewing tobacco, snus, cigarettes, contraband cigarettes, cigarillos, cigars, pipe tobacco, hookah pipe, herbal cigarettes, or any products which can be smoked legally or otherwise (i.e. marijuana). Vapes and e-cigarettes are also prohibited on hospital property.
Smoking compliance (Visitors)
Visitors are expected to abide by the policies and restrictions on tobacco use including not smoking on the Southwest Centre hospital grounds. Visitors are not to bring any tobacco products to patients at St. Joseph’s. If the visitor fails to comply, he/she will be escorted off the St. Joseph’s property by security services.
Smoking Compliance (Inpatients and Outpatients)
Patients who do not comply with St. Joseph’s smoke free policy are to be respectfully reminded of the policy and requested to extinguish the tobacco product immediately. A member of the patient’s clinical team will review the smoke free policy with the patient and the patient will be offered appropriate counselling, therapies and support following each occurrence: • First Occurrence: The patient will have unescorted grounds passes removed for a minimum of 24 hours and will be advised that subsequent violations will result in a longer suspension of passes. • Second Occurrence: The patient’s unescorted grounds passes will be suspended for a minimum of three days. The patient will be advised that in the event of a subsequent violation, the hospital will need to consider greater consequences for repeat occurrences. • Third Occurrence: The patient will have his/her unescorted grounds passes suspended for a minimum of seven days and until the team is confident the patient will follow the policy. The clinical team will decide what access to the grounds the patient will have when the set period has lapsed, and will gradually expand these passes based on compliance with the policy. Discussions and events related to any tobacco issues will be documented in the patient’s clinical record.
Visits from family members are encouraged and anticipated by patients. To support patient/resident and family-centered care, St. Joseph’s does not have specified visiting hours. Family caregivers are welcome based on patient/resident wishes balanced with the care needs, well-being, safety and security for all.
Quiet hours
Quiet Hours are in place from 10 pm to 7 am to promote rest and well-being of all patients. Family caregivers are asked to connect with a member of the health care team on the unit ahead of time to make arrangements if they plan to be with a patient/resident during Quiet Hours.
During these hours, in order to help us create a calm space, please:
• Speak in hushed tones • Silence electronic devices • Dim overhead lights
*Please Note: Temporary Visitor restrictions due to COVID-19:
The information in this section regarding visiting, may not be applicable during the pandemic. Due to COVID-19, we have limited the number of people coming into our building. Our visiting hours and processes have been updated to protect everyone from possible exposure to COVID-19, while balancing the well-being of our patients. Please speak to your care team or visit www.sjhc. london.on.ca for the most up to date information on visiting and family presence during the pandemic.
Family caregivers are welcomed as partners in care
At St. Joseph’s, we believe in working together to provide the best patient/resident care possible. Family caregivers are important members of our team. As a family caregiver:
• you are a valuable partner in planning for care and transitions, often adding key details about a patient/resident’s medical history or situation; and • your pressence can reduce anxiety and provide comfort for you and thepatient/resident. Your input is valuable and can help to maintain consistency and safety of care.
Who is a family caregiver?
A family caregiver is someone – a family member, friend or neighbour – who provides important personal, social, psychological and physical support,
Calling ahead
It is a good idea for visitors to call the unit before visits (24 hours), as your loved one may be on a community outing, or temporarily not feeling well enough for visitors. Advanced planning will also allow staff to ensure your visit is well-timed and a private space booked if available. If visitors are unable to keep a scheduled visit, please call the unit so patients are notified.
Designated Visiting Areas
Whether you prefer a private location or a setting in the downtown area, there are many places throughout the hospital for visits. Please refer to the map for locations.
For the health of our patients, staff and volunteers please DO NOT VISIT if you are feeling unwell (i.e. those who are experiencing any of the following within the last 48 hours: fever, cough, runny nose, sore throat, skin rash, vomiting or diarrhea).
Video Surveillance and Metal Detection
For your personal safety and protection video surveillance is used within Southwest Centre. In rare cases a serious incident may be recorded for legal purposes. All visitors and patients coming into the centre will walk through a metal detector. Visitors will be asked to lock up their personal belongings at the front entrance in a locker.
Visitor Access Card
Visitors will be provided an access card that will allow them access to the areas where they are visiting.
Right to Search
Visitors and patients may be asked to empty their pockets upon arrival. Staff members on the units also have the right to search patients returning to the units if there is any concern that contraband may be entering. The safety of everyone is of utmost importance. During all searches, the privacy of the patient is paramount.
Prohibited Items
Unsafe items are not permitted inside the hospital. Items such as but not limited to include: glass, bottles, cans, all contraband including cigarettes, illegal substances, lighters and weapons of any kind. (Please review the section on prohibited items and illegal substances pg: 16-17)
