Table 1

Mapping of Forensic Service Initiatives to Domains of Organizational Change (after Seeleman et al.)16

Organizational Commitment (policy and leadership)Fair and Just CAMH wide Equity, Diversity, and Inclusion (EDI) initiative
Clear reporting and investigating process for instances of oppression
Mandatory training for existing and on-boarding staff
Leadership training to lead and enhance initiatives
Equity in hiring and human resource processes
Leadership processes for need identification, action, and measurement
Staff/Workforce (competencies)Implicit Bias and Anti-Black Racism training
Cultural and religious awareness training (i.e., San'yas Indigenous Cultural Safety Training Program)
Cultural Formulation Interview (CFI) and Culturally Adapted CBT training
Adverse Childhood Experiences training
Clinical supervision through health equity lens
Incident debrief through health equity lens and race-based team conversations
Service Access and Delivery (provision and accessibility of services, resources, and support)Support patient engagement and empowerment through education and workshops
Implementation of the Cultural Formulation Interview and Culturally Adapted CBT
Team treatment plans include early access to culture-specific resources and integration of the CFI
Forensic Female Pathway
Faith-based meals and food practices, including an Indigenous dinner option
Culture-specific grooming services
Aboriginal Services provide access to traditional healing practices
Interpretation services for in-the-moment care
Translation of all written materials provided to patients
Culture-specific Peer Support
Promoting Responsiveness (to the needs of patients and families)Family engagement strategy, including family information packages
Patient-led experience sharing with teams
Leadership and team processes for identification of needs, determining action plans, and measurement of improvement
Community Outreach (education, collaboration, and access to resources)Community partnerships to build culturally specific resources (legal, social, psychological services) and inform service delivery
Promote and disseminate information through provincial and national forensic mental health organizations
Communication of cultural formulation in forensic reports and testimony
University partnerships to enhance training and improve access and care
Data Collection (what, when, and how to inform continuous improvement)System for rolling data collection
Disaggregated patient data
    Seclusion and restraint
    Length of stay
    Admissions and readmissions
    Violent incidents
    Pass usage
    Program participation
    Staff incident reports
Horizontal violence and oppression data collection
Patient and staff satisfaction surveys and focus groups
Pre- and post-surveys of training, programs, and service delivery
Staff retention and exit survey data
Measurement of therapeutic alliance
Trainee interest in forensic psychiatry
Audit of teaching modalities, documentation, and forensic reports from an EDI lens