Brain Injury Bail Navigator Program
| Principal Investigator: Dr. Flora Matheson Co-investigator: Dr. Arthur McLuhan Collaborator: Lucy Gudgeon, Elizabeth Fry Toronto |
| Up to 95 % of women involved in the criminal legal system have a brain injury, most often a result of intimate-partner violence. Brain injury alters memory, judgment, and communication, making it nearly impossible to decode legal jargon, remember curfews, or keep track of court dates. Symptoms of brain injury, such as cognitive-communication challenges, make it difficult to understand and abide by bail conditions imposed by courts, often resulting in breach charges, re-arrests, frequently keeping women in an endless cycle of incarceration. The result is a punitive system that punishes disability and trauma instead of recognizing and responding to these issues. In partnership with Elizabeth Fry Toronto, and with support from the Breaking the Cycle of Incarceration Network, our two-year pilot places a Brain Injury Bail Navigator inside the Toronto Regional Bail Centre to support women on bail by facilitating their connections to health, disability and brain injury services. As no such programs exist in Canada, The Brain Injury Bail Navigator program will build awareness of the challenges of managing conditions of supervision among women experiencing TBI and IPV, and fill a critical gap in health and criminal-legal system integration of care. Together with community allies, we are gathering evidence and building momentum to scale a model that keeps women safe, housed, and free. Our ultimate goal is to break the cycle of incarceration. Funded by the Northpine Foundation and the Meighen Family Foundation |
The Catch-22 Conditions of Community Supervision: Understanding the Gendered Nature of Violations, Sanctions, and the Challenges of Compliance for People With a History of Traumatic Brain Injury
| Principal Investigator: Dr. Flora Matheson Co-investigators: Dr. Arthur McLuhan, Dr. Angela Mashford-Pringle, Dr. Catherine Wiseman-Hakes |
| Most people released from custody have bail, probation, or parole conditions that they must follow for a specific period of time. Release conditions are often difficult to meet and are a challenge to re-entry. Maintaining those conditions in the context of other complex needs makes community re-entry even more difficult, particularly for people experiencing traumatic brain injury (TBI), financial and housing insecurity, mental illness, and substance use disorders. Gender differences in both TBI challenges and supervision experiences suggest the burden of conditions is particularly acute for women, who, for example, face competing supervision reintegration demands tied to familial roles and increased scrutiny of their sexual relationships and the intimate details thereof. To date, there are no studies on the everyday challenges of complying with conditions among people with a history of TBI. In partnership with the Breaking the Cycle Solutions Network members, this study will build awareness of the challenges of managing conditions of supervision among people experiencing TBI and inform evidence-based changes, as well as solutions, in community supervision policies, practices, and supports. Funded by the Social Sciences and Humanities Research Council |
Breaking the Cycle of Incarceration: Solution’s Network
| Principal Investigator: Dr. Flora Matheson Co-investigator: Dr. Arthur McLuhan |
| MAP launched 10 collaborative solutions networks with a common goal: to effect real-world social change by co-designing and demonstrating what works to address critical challenges in our communities. The Breaking the Cycle MAP Solutions Network is one such network (Research Lead: Matheson) and is focused on improving lives by reducing social inequities among people experiencing criminalization (https://maphealth.ca/breaking-the-cycle/). It is a collaboration between researchers, community agencies. The goal of the network is to generate knowledge to transform practice and policy to better support people with TBI who are involved with the criminal justice system and to build a sustainable solution, as conceptualized by the Network, to support this population in managing court-mandated supervision conditions. Project supported through the generosity of donors to the St. Michael’s Hospital Foundation |
Demystifying the ‘Black Box’ of Prisoner Re-Entry and Addressing the Mental Health and Substance Use Needs and Service Disruptions for People Released From Custody During the COVID-19 Pandemic
| Principal Investigators: Dr. Flora Matheson, Dr. Angela Mashford-Pringle |
| This study focuses on: (1) the extent and impact of the COVID-19 pandemic and public health response on mental health and substance use needs and services for justice-involved populations, including the related resilience of justice-involved persons, service providers, and the broader service network; (2) the exacerbation of disparities (e.g., health, social, structural) for justice-involved populations across gender and sexual identities; and (3) the generation and mobilization of evidence, including targeted agency- and system-level recommendations, to enable more efficient, effective, and equitable matching of mental health and substance needs and services for this population as the pandemic continues, when new waves emerge, and during future health crises. Funded by the Canadian Institutes of Health Research |
Assessing Mental Health and Substance Use Needs and Service Disruptions for People Released From Custody During COVID-19.
| Principal Investigators: Dr. Flora Matheson and Dr. Angela Mashford-Pringle |
People who are released from correctional facilities face significant mental health and addiction challenges – in addition to poverty, homelessness, poor physical health and discrimination as they return to the community. These issues have been amplified by the COVID-19 pandemic, as resources have been more difficult to access, particularly affecting the Indigenous, Black and 2SLGBTQ+ communities as they are over-represented in the prison system. In a collaboration between researchers, community service providers, people with lived expertise and knowledge users who support people released from incarceration, this study examines the challenges related to mental health and substance use for people released from custody during the pandemic and documents innovative adaptations in the mental health and addiction sectors that can inform present and future pandemic plans, preparations and responses to better address the needs of this population. Funded by the Canadian Institutes of Health Research |
A SWOT Analysis of John Howard Society’s Mobile Reintegration Services
| Principal Investigator: Dr. Flora Matheson Co-investigator: Dr. Arthur McLuhan When people leave correctional facilities, they face multiple barriers to successful community re-entry, including significant mental health challenges, substance use issues, and homelessness. The John Howard Society of Toronto developed the mobile reintegration trailer, a mobile service delivery model on the grounds of the Toronto South Detention Centre, Canada’s second largest jail. This project assesses the mobile service delivery model in terms of its strengths, weaknesses, opportunities, and threats. Funded by the Ontario Trillium Foundation |
An Evaluation of the Services Provided by John Howard Society Toronto, Reintegration Centre
| Principal Investigator: Dr. Flora Matheson When people leave correctional institutions, they often face a variety of challenges that make community re-entry and reintegration difficult, such as physical health conditions, mental health and substance use issues, homelessness, unemployment, and weak social support networks. The John Howard Society of Toronto’s Reintegration Centre opened in November 2014 to respond to these concerns. This mixed-methods process evaluation project examined how the Reintegration Centre helped clients navigate the first day of release from the Toronto South Detention Centre, with peer workers providing immediate supports for basic needs, such as clothing, food, transportation, and harm reduction kits, and warm referrals to other services to support re-entry and reintegration. Funded by the Ontario Trillium Foundation under the Local Poverty Reduction Fund |
Supporting Individuals With Traumatic Brain Injury in the Ontario Criminal Justice System; Building Bridges and Creating Integrated Approaches to Care With the John Howard Society of Toronto: A Pilot Study
| Principal Investigator: Dr. Flora Matheson Co-investigator: Dr. Catherine Wiseman-Hakes A history of Traumatic Brain Injury increases recidivism rates by up to 69%. Many people with TBI have a number of communication and cognitive challenges that, in the context of the criminal justice system, can be misinterpreted as defiance, rudeness, aggression, disengagement, or non-compliance. Most staff in the justice system do not have training in TBI and lack the knowledge, skills and confidence to recognize, or adequately manage these challenges. The John Howard Society of Toronto (JHS-T) is a non-profit organization committed to providing and developing programs that reduce the social, economic and personal costs of crime. Many of the JHS-T’s clients have a history of suspected or diagnosed TBI. To support the work of JHS-T, its front-line staff received formal training in how to screen and support clients with TBI. The project also created a network of collaborative care for JHS-T clients with TBI with the ABI-LHIN Navigator, the Acquired Brain Injury Network, and the Brain Injury Association of Toronto. The research team assessed the impact of the training and implementation of the network of collaborative care. A detailed final report can be found here. Funded by the Ontario Neurotrauma Foundation |
Traumatic Brain Injury and Criminalized Individuals: Identifying Best Practices for Communication Partner Training Across the Justice System
| Principal Investigators: Dr. Flora Matheson, Dr. Catherine Wiseman-Hakes, Dr. Angela Colantonio Histories of traumatic brain injury are common among people who become entangled with the criminal justice system, with estimates as high as 80%. Moderate to severe TBI is often associated with cognitive, communicative and behavioural impairments, leaving people vulnerable to misinterpretation, exploitation, and abuse. They may have difficulties engaging in complex social interactions, including encounters with the police and in court proceedings. This project focuses on communication challenges for people with TBI and how staff in the justice/forensic system communicate with people who have TBI. It is part of a larger study, Integrating Brain Injury, Mental Health, and Addictions Research Program, with Principal Investigator Dr. Angela Colantonio. Funded by the Ontario Ministry of Health and Long-Term Care |
The Relationship Between Traumatic Brain Injury, Incarceration and Prison Misconduct: Identifying Opportunities to Break the Cycle
| Principal Investigator: Dr. Flora Matheson Collaborators: Dr. Avery Nathens, Dr. Angela Colantonio, Dr. Rahim Moineddin, Karey Irons, Dr. Andrea Moser This study explores the relationship between traumatic brain injury (TBI) and correctional outcomes among people who experienced federal incarceration. The study was possible through a unique federal-provincial partnership between the Correctional Service of Canada (CSC) and ICES. This partnership allowed us to create a unique data repository, the first of its kind in Canada, which provides longitudinal health and correctional data for a cohort of 15,000 men and women in federal custody over a 13-year period. We produced a series of papers. In one paper, when linking correctional and medical records we were less likely to find a match for women, people of minority status, and those with more severe alcohol use. In a second paper, findings showed that young men and women aged 18-28 with TBI were 2.5 times more likely to be federally incarcerated than those without TBI. Findings of a third paper showed that people federally incarcerated with TBI were 14 times more likely to incur serious in-prison disciplinary charges than their non-TBI counterparts. Funded by the Ontario Ministry of Health and Long-Term Care |
Intellectual and developmental disabilities in Ontario’s criminal justice and forensic mental health systems: Using data to tell the story
| Principal Investigator: Dr. Yona Lunsky Co-Investigators: Dr. Anna Durbin, Dr. Fiona Kouyoumdjian, Dr. Elizabeth Lin, Dr. Flora I. Matheson This study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD. We used unique linked administrative datasets to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care, and community mental health programmes. Using a community-based participatory methodology, a project advisory group and people with lived experience co-designed the research and contextualized the findings, generating a series of policy and practice-focused recommendations. Adults with IDD were over-represented in all settings (ranging from 2.1% in federal corrections to 16.7% in forensic inpatient care). Most were young adults living in low-income neighbourhoods. Medical complexity and rates of co-occurring mental health conditions were higher for people with IDD than those without IDD in federal and provincial corrections. Funded by the Ministry of Community and Social Services |
J&E Lab 