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PHSA leaders speak about improving care for incarcerated clients

Two BC Mental Health and Substance Use Services leaders recently shared what they learned during a challenging but rewarding transition year at the BC Health Leaders Conference in Vancouver.
Lynn Pelletier presents at the BC Health Leaders Conference
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​Lynn Pelletier presents at the BC Health Leaders Conference.

In October 2017, PHSA assumed responsibility for the delivery of health services in BC correctional centres from the Ministry of Public Safety and Solicitor General. 

Lynn Pelletier, the vice-president of mental health and substance use services for PHSA, as well as Dr. Nader Sharifi, the medical director for Correctional Health Services, presented to fellow health-care leaders at the conference about the transition process.

“This was far from just an administrative move,” said Pelletier. “It aligns with the World Health Organization’s recommendations, signalling that clients in correctional centres need and deserve health care of the same calibre as every other patient. It has also provided my team with an opportunity to help some of B.C.’s most vulnerable patients.” 

The decision to assign health-care services to the Ministry of Health may seem straightforward—but, as Pelletier noted, the process was far from simple. 

“This population is high-needs and high-risk. Ensuring they receive high-quality health care during and after their incarceration is a challenge—one that historically has not been met very well. I’m proud of what our staff have accomplished in a short period of time.”

The Correctional Health Services’ team’s top priorities were improving both health care quality and access for incarcerated clients, who are unique in a number of ways. 

“Incarcerated clients who present with mental-health problems at admission doubled between 1997 and 2010,” said Dr. Sharifi, who specializes in addictions treatment. “Today, sixty per cent of clients have a diagnosed mental health and/or substance use disorder—and these illnesses are often part of the reason they end up incarcerated.” 

The average client is incarcerated at a B.C. correctional centre for less than two months, providing only a short window of time to provide effective health care.

“Adding to the difficulty of making a difference in such a short time, our clients have faced a number of barriers to health care before they come to us,” said Sharifi. “Many have experienced trauma, poverty, injury, and chronic physical health problems. Few have family doctors. Some have no fixed address. We’ve had to craft care plans that would not only improve outcomes and decrease costs and recidivism, but also address these very real challenges.” 

Sharifi and Pelletier shared Correctional Health Services’ clinical services plan priorities, which were as follows:

  • Equivalency: Health services delivered in correctional centres will provide the same level of access, equity and quality as those services available in the community.
  • Autonomy: Legal responsibility for health care operations will remain autonomous from corrections administration and oversight. 
  • Integration: Our services will be integrated with the First Nations Health Authority and other regional health authorities to promote seamless transitions and ensure continuity of care.
  • Collaboration: Health services and BC Corrections will work collaboratively with one another to ensure individuals’ health needs are met.
Sharifi and Pelletier also provided several examples of how the leadership team has transformed the system of care and achieved results in the midst of aggressive timelines:

  • Improved care for patients suffering from mental-health and substance-use disorders.
  • Improved coordination of care transitions.
  • More access to virtual health services such as telemedicine.
  • Strong working relationships with BC Corrections.
  • Several new positions, including access and transition nurses, mental-health nurses, and concurrent disorders counsellors.
  • Increased resources to support opioid agonist therapy (OAT), including dedicated clinics.
  • Eliminating the waiting list for opioid agonist therapy. 
  • New bridges to community-based care through transition teams.
“This first year is only the beginning,” said Pelletier. “We have embraced the vision of creating a gold standard of service, and we have plans to continue to improve health services for these clients. There are still challenges to overcome—but always, we are hopeful, and we seek to provide our clients with the same hope.”

BC Mental Health & Substance Use Services; Correctional Health Services; correctional health; mental health
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