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Forensic Psychiatric Hospital

The Forensic Psychiatric Hospital is a 190-bed secure facility in Coquitlam, B.C., that treats people who have been found not criminally responsible for a crime or unfit to stand trial due to a mental disorder.
About
The goal of the program is to restore fitness to attend court proceedings and/or reintegrate patients gradually and safely into the community. The hospital also serves individuals who have been transferred temporarily from correctional facilities to be assessed or receive treatment for a mental illness under the Mental Health Act. The facility consists of 9 clinical units (5 secure, 3 closed and 1 open unit). 

Located in a peaceful, park-like setting, the Forensic Psychiatric Hospital supports patients with high quality, specialized clinical services, as well as a comprehensive range of vocational and rehabilitative programs.
Treatment

Clinical Program Model 

The Forensic Psychiatric Hospital delivers services to patients using a Clinical Program Model, which is currently best practice in health care. Services are delivered by health care teams to meet the specific needs of the patients. Patients are grouped by illness or other needs; this model allows the team to treat patients on units that meet the needs of the patients on that unit. It also allows the team to create a larger and more closely knit multi-professional team that include psychiatrists, family physicians, social workers, nurses, clinical pharmacists, psychologists and rehabilitation staff. Additional team members may include therapeutic leisure services staff, vocational services staff, occupational therapy staff, Forensic Regional Clinic staff, and a pastor. 

The 15 clinical programs at the Forensic Psychiatric Hospital include:

Ashworth 1 – Male remand unit 
Ashworth 2 – Specialized assessment and psychiatric intensive care program 
Ashworth 3 – Neuropsychiatry program
Ashworth 4 – Severe psychosis/intensive management program Dogwood East – Women’s program
Dogwood West – Geriatric/medically frail program
Elm North – Intensive rehabilitation program
Elm South – Intensive rehabilitation program
Hawthorne House – Pre-discharge program

Care plans 

Care plans are designed according to the needs of the patient. The clinical staff at the hospital are familiar with all available medications and work with patients to find the appropriate stabilization medication for them. The goal is to assist patients into a successful reintegration into the community. Programs include medically directed treatment plans, alcohol and drug counselling, occupational therapy, therapeutic leisure services and vocational services. A full-time teacher is available to assist patients with educational opportunities and a Chaplain is on hand to address spiritual needs of the patients as/if required. 

Community access 

The treatment team at Forensic Psychiatric Hospital begins the process of discharging a patient by first determining the person’s readiness for release and needs. As a person with a mental disorder goes through the legal system, their symptoms may prevent them from fully understanding the process. The staff at the hospital is aware of this fact and part of the treatment is to help patients work through this process to the best of their ability. Patients are referred to the Forensic Regional Clinic closest to their chosen geographical location. When the team determines the patient is ready, and when the appropriate disposition from the BC Review Board is in place, the patient may be granted limited community access. 

The patient is first given permission to go out into the community for a few hours on staff escorted leaves and eventually on unescorted leaves. Following this, the team will develop a “visit leave” plan in which the patient is allowed to leave the hospital on a trial basis for up to 60 days (the duration varies with each patient). Here again, the patient’s legal order must allow for this. 

The decision to release a patient back into the community is made by the BC Review Board. Conditions of release from the hospital may include conditions of residence (whether the individual needs supervised housing or not), what level of supervision needs to be in place, and abstinence from alcohol or drugs. Once the BC Review Board grants a patient a conditional discharge, the patient is discharged to the community under the supervision of their clinical team at their nearest Forensic Regional Clinic. When the BC Review Board grants a patient an absolute discharge, the patient’s care is transferred to the nearest community mental health team or Family Physician, depending on their treatment needs. 




Visiting
We encourage family members and friends to visit the hospital. More information about the hospital for family members is available under Forensic Psychiatric Services.  

Visiting hours

Tuesdays and Thursdays: 7 p.m. to 8:30 p.m.

Saturdays, Sundays and holidays: 
  • For Hawthorne House and the Cottages only, 11 a.m. to 8:30 p.m.
  • For all other units, 2 p.m. to 4 p.m. and 7 p.m. to 8:30 p.m.
Any visits outside the usual visiting hours must be arranged through the Nurse-in-Charge of the unit and the patient's treatment team.

Visitors

Each patient is limited to a maximum of 2 adult and 2 minor visitors at any one time. If more than 2 adults would like to visit the same patient at the same time, they must rotate turns. In exceptional circumstances and with prior approval from the unit and the treatment team, more than the above-stated number of visitors may be allowed.

Children

Children under 16 years of age must be accompanied by an adult and must be supervised at all times while visiting the hospital. Children are not allowed to wander unattended in any area of the hospital, are not allowed to play on the grounds and must behave appropriately at all times.

Smoking policy

For all visitors to the Forensic Psychiatric Hospital, please be advised that the buildings, grounds and parking areas are smoke-free. We kindly ask that you support our staff and patients by not bringing or sending tobacco or tobacco products to the facility.

General visiting regulations

  • On arrival, visitors are required to report to the Security Office (immediately to the right of the front entrance) to fill in the visitor registry and to confirm their identity and the specific patient to be visited
  • Security will issue a visitor tag in exchange for a suitable piece of identification, which will be returned at the end of the visit
  • The number of visitors can be restricted by the Nurse-in-Charge at any time
  • Cameras, video recorders or any other recording devices are not allowed in patient care areas
  • Devices that are able to access the Internet are not allowed at any time; a complete list of restricted items is available from the patient’s treatment team or the Nurse-in-Charge of the unit
  • Staff will use their discretion in determining the appropriateness of items brought by visitors
  • Visitors are only allowed to visit the patient who they identified at the Security Office
  • Visitors must remain in the area designated by nursing staff
  • The Nurse-in-Charge may terminate or modify visits for clinical and / or security reasons, and reserves the right to refuse visiting privileges pending a review
  • Visitors will not be allowed access if they appear to be intoxicated
  • Visitors and the items they bring to the unit may be electronically searched
  • The hospital is not responsible for lost or stolen property
  • Please note: The Forensic Psychiatric Hospital is equipped with closed-circuit surveillance cameras, and all visitors will be subject to observation by our security staff while on the premises.

Visiting on the Ashworth units

In addition to the above general regulations:

  • A maximum of 2 visitors per patient will be allowed at one time on Ashworth units
  • Visitors are not allowed to bring the following items to the Ashworth units: wallets, purses, handbags, backpacks, parcels / packages, bags, food, illegal substances, alcohol, knives or any weapons, glass or metal containers, medications, lighters or matches, or gifts for patients
  • Special arrangements for food can be made with the Nurse-in-Charge prior to visiting
  • Locked storage areas are provided for the safekeeping of handbags, etc., or if preferred, visitors may take these items back to their vehicle
  • All visiting in the Ashworth units will be supervised by nursing staff
Tab Heading

We also care for people who have been transferred temporarily from correctional centres to be assessed or treated under B.C.’s Mental Health Act.

Court-referred treatment for severe, complex mental health disorders

We are required by law to treat people found not criminally responsible or unfit to stand trial due to a mental disorder, and help them integrate safely and gradually back into their communities when and if possible. Our mandate to work toward community integration when possible comes from the BC Review Board, an independent tribunal under the Criminal Code of Canada.

Our clients and patients are among the most severely mentally ill people in B.C. All live with complex mental health issues, most often a psychotic disorder such as schizophrenia. For many, this is combined with a mood disorder such as post-traumatic stress disorder, or a personality disorder that makes them anxious, paranoid or fearful.

Concurrent disorders and other health challenges

Up to two-thirds of our clients and patients live with a combination of severe mental illness and addiction to substances — sometimes more than one substance. In the mental health community, this is called a concurrent disorder. For example, people with a concurrent disorder might have schizophrenia and an opioid addiction, or post-traumatic stress disorder and an addiction to alcohol.

People with concurrent disorders are vulnerable, often living with other challenges that can further complicate their illnesses and make recovery challenging:

  • A chronic disease
  • A history of poor health or dental care due to social barriers and stigma
  • A history of abuse, adverse childhood experiences, or other traumas
  • Unstable housing

Specialized care teams

To ensure these complex clients and patients receive the best care possible, our highly trained, specialized staff and physicians provide treatment, services and rehabilitation programs in a safe, secure environment.

Care teams include the following:

  • Psychiatrists
  • Physicians, including other specialists
  • Psychologists
  • Social workers
  • Recreational and occupational therapists
  • Counsellors
  • Psychiatric nurses
  • Clinical security liaison nurses
  • Nurse practitioners
  • Health care workers
  • Peer support workers
  • Educators/teachers
  • Spiritual care practitioner
  • Indigenous Elder
  • Pharmacists
  • Forensic service officers

Our care is evidence-based, which means it is informed by research, and trauma-informed, which means that care teams make sure clients feel safe, secure and supported. Trauma-informed care is especially important for forensic clients as most of them have encountered stigma, trauma or adverse childhood experiences.

What Forensic Psychiatric Hospital clients and patients can expect

Clients and patients are grouped by unit based on their specific needs. All begin in our high-secure units. Most gradually move to our medium-secure units, if they are able. Eventually they enter a pre-discharge program if they are well enough.

Programs and treatment options include the following:

  • Psychiatric and neuropsychiatric consultations
  • Psychological consultations
  • Visits with a spiritual care practitioner or Indigenous Elder
  • Medication
  • Group counselling
  • Vocational and life-skills training
  • Peer support groups led by a peer worker (a person with lived experience)
  • Nutrition consultations
  • Recreational and occupational therapy including fitness classes, leisure activities, and visits with a therapy dog
  • Community outings

Community outings for Forensic Psychiatric Hospital clients and patients


We are required by law to help clients and patients integrate gradually and safely back into their communities when and if possible. Part of community re-integration involves community outings. To function outside the hospital, clients and patients must be able to practice the life and coping skills they learn at the hospital. For someone who has been very ill for a long time, or who has spent several years in treatment, even taking public transit or visiting a doctor’s office may require developing new skills. Community outings also help staff and physicians further assess treatment needs.


Community outings are not a "treat" or "time off for good behaviour." They are an important part of an individual’s mandated treatment processes.


While community outings are an important part of many clients' and patients’ treatment plans, public safety is equally important. We take every precaution to protect the public from clients and patients who may be disruptive.


All community outings are carefully planned, supervised and supported. Early community outings are always staff-escorted. As some clients and patients progress in their treatment and get well, they may be permitted short unescorted community visits.


For every community outing, whether escorted or not, we follow careful safety and risk protocols to make sure clients, patients and the public stay safe.

Several staff may escort a client or patient on a community visit, depending on their needs. Our escorting staffs are mental health professionals who are trained to manage people who may become disruptive.

 

 

The level of monitoring depends on the person. Very low-risk clients and patients may receive day leaves to attend community-based programs on their own, and processes are in place to confirm their attendance. They must return at a predetermined time.

 

 

Each client and patient at the Forensic Psychiatric Hospital receives an annual review hearing with the BC Review Board. The board decides whether they should remain at the hospital or be discharged. The board also decides whether they may be eligible for community outings.


It's important to note that the BC Review Board's decision relates only to eligibility for community access—not to whether a client or patient will actually be granted day leaves. Community outings for eligible clients and patients are granted at the discretion of the person-in-charge of the hospital, and only after a careful safety assessment. 

 

Many who are eligible for community access do not receive day passes for reasons including their illness, their readiness for community access, and public safety.

 

Before clients and patients are considered for a community outing, their treatment team thoroughly and carefully assess their clinical well-being and whether an outing might be risky. The impact of a client's or patient's presence in the community is also considered. We notify community and family members as appropriate. 

 

On the day of a scheduled outing, a nurse assesses the client or patient to decide whether they are stable and well enough to visit the community. If not, the outing is cancelled or postponed.


Questions about Forensic Psychiatric Hospital

Content

If someone fails to return on time from an authorized leave, even if they are only 15 minutes late, we initiate our unauthorized absence protocol. One of the first steps is notifying the local RCMP. They are responsible for letting the public know about the absence. We then work closely with the RCMP to make sure the client or patient returns safely.

 

 

We've made many safety, security and protocol improvements in recent years. As a result, we see very few unauthorized absences: Over 2,200 community outings took place in 2018, and someone was late in only five cases. All five returned shortly after we initiated our protocol.

 

We’re in the process of implementing a detailed action plan to improve care and keep staff, physicians, clients and patients safe. More information is available on our Forensic Psychiatric Hospital Improvements page.

The BC Review Board decides whether to release someone back into the community. Each client or patient receives an annual hearing, after which the BC Review Board will make one of three decisions: custody, a conditional discharge, or an absolute discharge.

A conditional discharge may include supervised housing, levels of monitoring, and abstinence from alcohol and other substances. Those who receive a conditional discharge continue to receive treatment at one of our Forensic Regional Clinics.

 

Those who receive an absolute discharge continue to receive care from their family physician or their nearest community mental health team. 


Information for families and loved ones

We work together with families and their loved ones to provide respectful, compassionate, safe care that is sensitive to their values, cultural backgrounds and beliefs. 

Families are often the first to know when their loved ones are distressed or experiencing emotional difficulties. We encourage you to communicate any concerns you have about your loved one to their treatment team. 

Our patient and family handbook provides a helpful overview of what patients and family members can expect.

We encourage family members and friends to visit their loved one at the hospital:

  • Tuesdays and Thursdays from 7-8:30 p.m.
  • Saturdays, Sundays and holidays, 2-4 p.m. and 7-8:30 p.m.
  • Patients in Hawthorne House, our pre-discharge unit, as well as in the Community Transition Cottages may receive visitors on Saturdays, Sundays and holidays between 11 a.m.-8:30 p.m.
  • Each client or patient may have two adult and two minor visitors at any one time. If more than two adults would like to visit the same person, they must rotate turns. More may be allowed in exceptional circumstances and with prior approval from the patient's treatment team.
  • The nurse-in-charge may terminate or modify visits for clinical or safety reasons, and reserves the right to refuse visiting privileges pending a review. They may also restrict the number of visitors for clinical or safety reasons.
  • When you arrive, report to the security office (immediately to the right of the front entrance) to fill in the visitor registry and confirm your identity as well as the patient you are visiting.
  • Security will issue you a visitor tag in exchange for your ID, which they will return to you at end of your visit.
  • Cameras, any recording devices, and devices that can access the internet are not allowed in patient care areas.
  • Staff will use their discretion in deciding whether items that visitors bring are allowed.
  • Visitors must remain in the area designated by nursing staff.
  • You will not be allowed access if you appear to be intoxicated. You and the items with you may be electronically searched.
  • We are not responsible for lost or stolen property.
  • The Forensic Psychiatric Hospital is equipped with closed-circuit surveillance cameras, and all visitors will be subject to observation by our security staff while on the premises.

Ashworth units, our high-secure units, have additional visitor regulations for safety reasons:

  • Ashworth patients may have only two visitors at a time.
  • Visitors may not bring wallets, purses, handbags, backpacks, parcels/packages, bags, food, illegal substances, alcohol, any kind of weapon, glass or metal containers, medications, lighters, matches, or gifts onto the unit. We provide some locked lockers for your belongings.
  • If you would like to give a patient food, make special arrangements with the nurse-in-charge before the visit.
  • All visits to Ashworth will be supervised by nursing staff.
 

Children under 16 must be accompanied and supervised by an adult at all times while visiting the hospital. Children are not allowed to wander unattended in any area of the hospital, are not allowed to play on the grounds, and must behave appropriately at all times.

 

All buildings, grounds and parking areas at the Forensic Psychiatric Hospital are smoke-free. Please support our staff and patients by not bringing or sending tobacco or tobacco products to the facility.

 

All patients and families have the right to be provided information in a language they are able to understand. The Provincial Health Services Authority provides interpreting and language services to the Forensic Psychiatric Hospital. If you would like an interpreter to be present when you meet with your loved one’s treatment team, please advise them before the meeting.

 

SOURCE: Forensic Psychiatric Hospital ( )
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