Karim Mamdani

Ontario Shores

Karima Velji

Sanaz Riahi

Serious About Schizophrenia - Recovery is Possible

Forensic psychiatry is a subspecialty of psychiatry. It focuses on assessing and treating people with severe mental illness who have become involved with the criminal justice system. Psychiatrists in this field are trained to assess these people and to help them recover from their active symptoms and start on their recovery journey.

At Ontario Shores, the Forensic Assessment Unit (FAU) assesses individuals living with schizophrenia to determine their fitness to stand trial and criminal responsibility. The role of the psychiatrist here is to meet with the person awaiting trial and gather as much information as possible regarding their history and current status. This information comes from the person as well as other collateral sources such as family members and other hospitals and clinicians to enable the psychiatrist to assess the individual as comprehensively as possible. 

Individuals who are found not criminally responsible or unfit to stand trial are transferred to one of the rehabilitation units for treatment. The psychiatrists on these units have two broad goals from day one until discharge day: to reduce the patient’s risk to the public and to help them get better to live the kind of life they want to lead.

To reach these goals, they will assess the patient and prescribe medication which is usually necessary. It works like a balancing act: prescribe medication and make sure it works effectively but also make sure the patient is willing to take the medication and wants to follow the plan. Throughout the whole journey, there is a strong focus on quality. All clinicians adhere to quality standards and attempt to follow the most recent treatment guidelines where applicable. 

As well, the psychiatrist and the treatment team will involve the patient in group treatment settings to educate them on how to better manage their illness and ultimately reduce the risk of relapse. The patient is also encouraged to get involved in educational and vocational programs that aim to reintegrate them back into society. This participation allows the patient to take some control over their own life and outcomes.

During the patient’s treatment course, there is a strong focus on working with their family members and encouragement of therapy between the family and patient to develop positive relationships to foster better outcomes. The psychiatrist along with the clinical team helps the family members and caregivers navigate them back into society. 

Each year, patients participate in an Ontario Review Board (ORB) hearing where the psychiatrist will present evidence to let the board outlining the patient’s risk to society and offer recommendations for effective management of that risk. The entire treatment team is involved in the crafting of these recommendations to ensure the most positive outcomes for the individual. 

Once the individual is deemed not a risk to society, they are discharged from the hospital and ensured they are cared for before they leave.

“When patients are admitted to the assessment unit at Ontario Shores they are very ill and may be aggressive. One of my favourite parts about my job is to see their persona change into a calm nature - it’s amazing to see the changes in these individuals once they’ve received treatment. There’s a perception that people with schizophrenia are animals who commit terrible crimes when the vast majority of them are lovely people who are just trying to deal with a difficult illness” - Dr. Karen Defreitas, Psychiatrist.

SERIOUS ABOUT SCHIZOPHRENIA - Ontario Shores worked with Ipsos Marketing to gauge society’s views on schizophrenia in honour of the specialty mental health hospital’s upcoming 100th anniversary. Click here to learn more about the study which inspired this #MindVine series, which looks at the chronic brain disease from multiple angles.