Mental Health and Justice

Mental health and justice (MHJ) services aim to provide support to individuals living with a mental illness and/or addiction involved in the criminal justice system. The Government of Ontario has invested in a continuum of MHJ services including pre-charge diversion programs, mental health court support and diversion programs, short-term residential crisis beds, MHJ supportive housing and case management.

CMHA Toronto has undertaken research to better understand the service needs of individuals living with mental illness and/or addictions who have criminal justice involvement. Our research has also examine the impact of MHJ services.

Understanding the Needs of People with a mental illness and criminal justice involvement

Examining the Need Profile of Supportive Housing Applicants with and without Current Justice Involvement: A Cross-Sectional Study

Frank Sirotich, Kamalpreet Rakhra
Psychiatric Rehabilitation Journal, 2021; Advance online publication.

This study compared the characteristics and support needs of applicants to support housing with and without justice involvement. The strongest predictors of having justice involvement were a history of physical assaults, homelessness, problematic substance use, male gender and younger age. Development of justice-focused supportive housing models may be considered where traditional housing and support services are supplemented with evidence-based interventions targeting factors associated with increased risk of recidivism.

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The Mental Health Needs of Justice-Involved Persons: A Rapid Scoping Review of the Literature.

Mental Health Commission of Canada, 2020.

In collaboration with the Mental Health Commission of Canada (MHCC) and CMHA National, CMHA Toronto undertook a scoping review of the academic and grey literature for the MHCC. This review highlights research on the prevalence of mental health problems and mental illness in the criminal justice system, experiences of justice-involved persons with mental health problems and mental illness, and promising practices and principles for mental health care.

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Racialized Populations and Mental Health Court Diversion: Needs Assessment

Irma Molina, Peer Program Evaluation Project, 2019.

The Racialized populations and mental health court diversion project was undertaken collaboratively by the Community of Interest (COI) for Racialized Populations and Mental Health and Addictions. Focus groups were conducted by CMHA’s Peer Program Evaluation Project to explore the experiences and needs of racialized individuals as they interacted with mental health court support services and diversion. Themes from the focus groups were used to inform stakeholder consultations through a think tank organized by the COI involving over 150 participants including persons with lived experience, service providers and government representatives. Five key recommendations emerged from the stakeholder consultations:
  1. Race-based data should be collected throughout the criminal justice system to better facilitate access to mental health court diversion for racialized individuals.
  2. More culturally competent and trauma-informed services within the justice system, including specialized training for police officers, are needed.
  3. Every member of the justice system, including judges, police officers, and mental health court support workers should be responsible for promoting mental health court diversion.
  4. Culturally-specific system navigators are needed to share information and resources with justice involved individuals.
  5. Mental health court locations and hours of operation should be expanded across the province.
For more information about this project, please contact Irma Molina at

Correlates of crime and violence among persons with mental disorder: An evidence-based review.

Frank Sirotich
Brief Treatment and Crisis Intervention, 2008; 8: 171-194.

The article is a review of the research literature exploring the demographic, historical, clinical and contextual factors associated with crime and violence among people living with a mental illness. It examines differences in finding across the research literature by taking into account methodological differences across studies.

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Examining the Impact of MHJ Services

Toronto Mental Health and Justice Safebed Program Outcome Evaluation -- In Progress

Undertaken in collaboration with the Mental Health and Justice Safebed Network, CMHA Toronto is leading this evaluation study of short-term residential crisis facilities in Toronto serving individuals living with mental illness who have current involvement in the criminal justice system. Safebeds offer short-term housing, crisis support and counselling, support with daily living skills to individuals who are homeless or at risk of homelessness.

For more information about this study, contact Frank Sirotich at

Lessons from a Canadian province: examining collaborations between the mental health and justice sectors.

Carolyn S Dewa, Lucy Trojanowski, Chiachen Cheng, Frank Sirotich
International Journal of Public Health, 2011; 57:7-14.

This study examined the factors that program developers perceived as important to the successful collaboration between the mental health and justice sectors in seven Ontario court diversion programs. The primary factors identified involved partnership development, adjustment to broader mandates and addressing ongoing challenges.

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The criminal justice outcomes of jail diversion programs for persons with mental illness: A review of the evidence.

Frank Sirotich
Journal of the American Academy of Psychiatry and the Law, 2009: 37:461-472.

Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement.

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