Message from Division Lead, Gary Chaimowitz
The St. Joseph’s Healthcare Hamilton Forensic Psychiatry Service/Division of Forensic Psychiatry at McMaster University is a provincial program that in large part deals with mentally-ill offenders who run into difficulty with the criminal justice system.
The forensic psychiatry program is one of 10 programs operated by nine hospitals in Ontario. We provide a variety of services, including court-ordered assessments of fitness to stand trial, criminal responsibility, and risk assessments. We also provide ongoing care and risk management for patients who fall under the jurisdiction of the Ontario Review Board. These patients have been found not criminally responsible or unfit to stand trial and remain a significant threat to the safety of the public.
We also provide an array of specialized services, including risk assessments, assessments of anger and impulsivity, assessments of sexual offenders, correctional psychiatry, neurolaw, forensic neurosciences, and civil medicolegal assessments.
The forensic psychiatry program is an academic program focusing on teaching and research in all related areas.
The Division of Forensic Psychiatry provides clinical services, education, and training in the myriad of areas where mental disorder and the criminal justice intersect, and in related, multiple ramifications. We provide assessments for the courts, for lawyers, and manage risk of individuals who may pose a significant threat to the public. We are actively engaged in research and education and are an integral part of supporting safety in the community.
The forensic psychiatry program has a very active education program, with students from all disciplines. Clinical clerks and residents are assigned to the forensic program, with many international forensic psychiatry fellows coming through our program. In addition, we run the Forensic Psychiatry Subspecialty Residency Program which is accredited by Royal College of Physicians and Surgeons of Canada.
We train all disciplines with high-quality teaching and training in areas of psychiatry, psychology, social work, nursing, occupational therapy, therapeutic recreation, and vocational rehabilitation. Additional learning experiences are available. Several of our psychiatrists and psychologists are order-in-council appointees to the Ontario Review Board, and the Consent and Capacity Board. These provide additional training experiences for trainees.
The Division of Forensic Psychiatry runs an annual mock trial with partners from the John Sopinka Courthouse, the Crown attorney’s office, and legal bar.
The internationally-recognized Risk and Recovery Conference is a three-day conference featuring keynote speakers from around the world, as well as profiling local researchers and educators. The conference attracts well over 200 registrants. It highlights the academic division of forensic psychiatry at McMaster University. The program also hosts a forensic psychiatry retreat every summer. This one-week retreat, in the beautiful Muskoka areas of Ontario, features a diverse knowledgeable set of presenters and offers a balance of academic learning and social events. It provides clinicians with an opportunity to engage in stimulating and thought-provoking discussions about relevant issues in a relaxing and rejuvenating setting. The retreat’s setting promotes another important goal, which is to attend to the well-being of forensic psychiatry clinicians.
In collaboration with the Forensic Psychiatry Institute, we run an internationally-recognized forensic psychiatry lecture series. This weekly lecture series highlights an array of speakers from around the world who give innovative lectures in four domains. The first week of every month is dedicated to introductory forensic psychiatry topics, followed by advanced topics, then innovations in forensic psychiatry, and the final week of the month profiles forensic psychiatry from around the world. We have recently entered in a collaboration with the World Psychiatric Association, hosting speakers from the World Psychiatric Association’s Forensic Psychiatry Section.
The forensic psychiatry program is composed of an active, multidisciplinary group of staff. The program covers six inpatient units, outpatient service, several specialized assessment clinics, with videoconferencing capability. The program has a forensic psychiatry assessment unit, where we conduct assessments of criminal responsibility, fitness to stand trial and risk. There are four forensic psychiatry units dedicated to patients who fall under the Ontario Review Board. These are patients who are considered a significant threat to the safety of the public and require ongoing rehabilitation and treatment.
We have an acute stabilization unit that provides dedicated services to correctional psychiatry patients who require additional psychiatric treatment. This innovative program operates in conjunction with the Hamilton-Wentworth Detention Centre and the Ministry of the Solicitor General.
We run several specialized clinics including an aggression and impulsivity assessment clinic, a clinic for sexual offenders, and a medical legal clinic. We also conduct civil forensic psychiatry assessments and host an outreach video psychiatry clinic.
The forensic psychiatry program conducts research in multiple areas, including areas of risk assessment, machine learning, big data, fetal alcohol spectrum disorders, epigenetics, and the microbiome.
We have developed two innovative risk assessment tools, including the Aggressive Incident Scale and the Hamilton Anatomy of Risk Management (eHARM). The eHARM has built in analytics and an aggregator to allow for analytic/data to better evaluate risk and quality indicators. The tools are described by Accreditation Canada as best practice. They have been presented internationally, with multi-site collaboration underway.
We have additional research projects in a variety of areas, including sex offenders within the Ontario Review Board, and fitness to stand trial.
The forensic psychiatry program also publishes the highly-regarded International Journal of Risk & Recovery several times a year.