Commissioner's directive 578: Intensive intervention strategy in women Offender Institutions/Units

Responsibilities

1. The Deputy Commissioner for Women:
   1. will provide policy guidance related to the Intensive Intervention Strategy
   2. has the authority to develop guidelines to provide operational direction pertaining to the Intensive Intervention Strategy.
2. The Assistant Commissioner, Health Services, will:
   1. provide separate, but complementary, policy guidance related to Health Services’ responsibilities for the management of inmates as it relates to the Intensive Intervention Strategy
   2. collaborate with the Deputy Commissioner for Women to align policies in support of the operational management of this strategy.
3. The Institutional Head will:
   1. make decisions related to admission by exception to the Structured Living Environment
   2. ensure an integrated strategy is applied to managing inmates classified as maximum security, inmates classified as minimum or medium security who require additional staff support and/or greater access to interventions and/or inmates with mental health needs, including addressing the specific needs of Indigenous inmates
   3. ensure the Standing Orders and/or Post Orders reflect the necessary operational procedures to manage inmates that fall under the Intensive Intervention Strategy.
4. The Manager, Intensive Intervention Strategy, will:
   1. be responsible for the overall administration of the Intensive Intervention Strategy
   2. chair the Interdisciplinary Team meetings for inmates residing within Structured Living Environments, Enhanced Support Houses and Secure Units. The Chair will be the final decision-maker
   3. provide mentorship and direct supervision to Behavioural Counsellors in their activities within the institution
   4. collaborate with the Correctional Manager, Intensive Intervention Strategy, Correctional Manager, Mental Health, Case Management Teams, Health Care Team members and other managers as necessary to ensure various interventions, operations and mental health services are managed in an integrated fashion and are complementary to each other
   5. assign staff members to ensure completion of Structured Living Environment admission/ discharge entries, recording of movements to/from the Enhanced Support House, entering of Reintegration Movement Plan levels, preparing of meeting documentation and completion of Interdisciplinary Team meeting minutes
   6. ensure Structured Living Environment entries, Enhanced Support House movements and meeting minutes are documented as appropriate on inmate files, including in the Offender Management System (OMS)
   7. ensure decisions on Reintegration Movement Plan levels for each inmate are entered in the “Reintegration Movement Plan for Women’s Secure Units" OMS screen.
5. The Correctional Manager, Intensive Intervention Strategy, will:
   1. provide mentorship and direction to Primary Workers with respect to operational and case management activities relating to their interventions with inmates managed under the Intensive Intervention Strategy
   2. collaborate with the Manager, Intensive Intervention Strategy, Case Management Teams, Health Care Team members and other managers, as necessary, to ensure various interventions, operations and mental health services are managed in an integrated fashion and are complementary to each other
   3. fulfill the duties of the Manager, Intensive Intervention Strategy, relating to the Interdisciplinary Team, including chair the Interdisciplinary Team meetings in their absence.
6. The Duty Correctional Manager will authorize movement to or from the Enhanced Support House outside regular business hours and record as appropriate in OMS, including activation/deactivation of the relevant flag and completion of the Casework Record.
7. The Institutional Health Manager or delegate will:
   1. functionally supervise Behavioural Counsellors’ interventions that are directly related to Dialectical Behaviour Therapy and/or other mental health treatment modalities, in accordance with the relevant provincial regulatory body’s regulations
   2. provide clinical expertise and guidance to the Interdisciplinary Team
   3. collaborate with the Manager, Intensive Intervention Strategy, Correctional Manager, Intensive Intervention Strategy, and Case Management Teams to ensure that mental health interventions are integrated with other types of interventions
   4. provide services and complete documentation in accordance with Health Services’ policies and procedures.
8. The Indigenous Liaison Officer, as appropriate, will:
   1. participate in Interdisciplinary Team meetings, and provide the team with information regarding offenders’ participation in a healing path
   2. assist the Elder to provide counselling, teachings, and ceremonial services to inmates
   3. liaise/consult with staff and Elders to provide advice and recommendations regarding interventions for Indigenous inmates, taking into consideration the impact of their Indigenous social history
   4. provide ongoing assistance and support to staff and Elders working directly with inmates following a healing path
   5. assist with documenting the impact of an inmate's Indigenous social history.
9. The Elder, as appropriate, will:
   1. participate in Interdisciplinary Team meetings
   2. provide counselling, teachings, and ceremonial services to inmates
   3. provide advice and recommendations, when requested, regarding culturally responsive interventions, taking into consideration an inmate’s Indigenous social history, and provide the inmate with the opportunity to participate, engage and/or re-engage in their healing path
   4. assist with interpreting the impact of an inmate’s Indigenous social history.
10. The Interdisciplinary Mental Health Team will:
    1. operate pursuant to the Integrated Mental Health Guidelines
    2. ensure a member of the team will be in attendance and provide input when admission and discharge referrals are reviewed at Interdisciplinary Team meetings.
11. The Interdisciplinary Team will:
    1. meet at least every two weeks to discuss the cases of inmates residing in Structured Living Environments, Enhanced Support Houses or Secure Units (may be separate meetings or combined), as well as overall interventions and operations for these populations, including making recommendations to the Institutional Head or other committees at the site, as appropriate
    2. make decisions related to the Reintegration Movement Plan off the Secure Unit (individual or group) for inmates classified as maximum security
    3. review referrals and make decisions, as required, related to moving inmates to/from the Enhanced Support House
    4. for inmates not followed by the Interdisciplinary Mental Health Team, ensure communication with Health Services to confirm continuity of care when transitioning to/from the Structured Living Environment
    5. review referrals and make decisions for admission and discharge from the Structured Living Environment, provided that a mental health representative from the Interdisciplinary Mental Health Team is in attendance. If the mental health representative is not present, defer the decision to the next meeting
    6. ensure documentation on the meeting outcomes is available to staff and managers to assist with ongoing management of inmates
    7. ensure all recommendations and decisions for Indigenous inmates take into consideration their Indigenous social history and that this is reflected in the documentation.
12. Behavioural Counsellors will:
    1. make appropriate referrals and collaborate with the Manager, Intensive Intervention Strategy, Correctional Manager, Intensive Intervention Strategy, Primary Workers, registered health care professionals, and Case Management Team members with regard to the interventions for inmates managed under the Intensive Intervention Strategy
    2. prepare and deliver skills training (group or individual) in support of mental health interventions, under the functional supervision of a registered health professional
    3. prepare and deliver group and individual sessions in support of the Correctional Plan and reintegration
    4. facilitate and coordinate a variety of activities that support personal development and skills practice
    5. compile information and complete identified documentation, including the Program Performance Reports, detailing information and observations from individual or group skills sessions, as well as other observations/interactions, which will support the Mental Health Team treatment plan and progress reports, as well as Case Management Team reports
    6. present cases to the Interdisciplinary Team and other institutional committees, as appropriate.
13. Parole Officers and Primary Workers will:
    1. complete referrals for admission to the Structured Living Environment and present these to the Interdisciplinary Team
    2. make other appropriate referrals for inmates managed under the Intensive Intervention Strategy
    3. share information and document interactions/observations to ensure an integrated approach to managing these inmates
    4. attend Interdisciplinary Team meetings to discuss inmates assigned to their caseload or residing in the unit where they work.
14. All staff will:
    1. support the ongoing activities and interventions that comprise the Intensive Intervention Strategy, including those that are gender and culturally informed
    2. share information and document interactions/observations related to inmates managed under the Intensive Intervention Strategy, in the appropriate format (i.e. Casework Record, Observation Report, Electronic Medical Record).
15. Staff providing services to Indigenous inmates will consult with institutional Elders or Indigenous Liaison Officers for decision-making and case planning to ensure that their Indigenous social history is considered when making decisions and referrals.

Structured Living Environment

Admission Process

16. The Structured Living Environment will normally be used for inmates exhibiting at least one of the following behaviours:
    1. adjustment problems related to mental health difficulties
    2. difficulties with communication/life skills/activities of daily living
    3. other significant emotional or behavioural dysregulation
    4. disabilities necessitating a more supportive structure or environment.
17. Admission to the Structured Living Environment is a separate admission from the actual participation in treatment, and can occur:
    1. with or without an inmate’s consent in order to provide the inmate with appropriate accommodation within the institution based on their case-specific needs or in accordance with the Integrated Mental Health Guidelines
    2. during non-business hours without an Interdisciplinary Team review, with the approval of the Duty Correctional Manager, and the case will be formally reviewed the next working day during an ad hoc Interdisciplinary Team meeting
    3. by exception authorized by the Institutional Head for the purpose of managing specific case dynamics or for inmate population management reasons.
18. There are two types of referrals to the Structured Living Environment for intermediate mental health care. Referrals can be via self-referral by the inmate. In these cases, the Primary Worker and/or the Parole Officer will complete the Intake Referral for Structured Living Environment form (CSC/SCC 1241). Referrals by the registered health care professional are made using the Psychiatric Hospital and Intermediate Mental Health Care Referral.
19. In the case of an admission during non-business hours or an admission by exception, priority will be given to those cases with greater severity of need and every effort will be made not to disrupt the intermediate mental health care of other inmates.
20. The Duty Correctional Manager proceeding with an admission during non-business hours, or the Institutional Head or their delegate authorizing an admission by exception will complete the Intake Referral for Structured Living Environment form.
21. The completed form will be presented at the Interdisciplinary Team meeting. Admissions to the Structured Living Environment are entered in OMS within five working days of the admission.
22. Participation in mental health treatment and completion of documentation related to these activities will be in accordance with the Integrated Mental Health Guidelines.
23. Upon admission to the Structured Living Environment, staff will provide each inmate with information pertaining to the services offered, as well as the rules and behavioural expectations. Inmates who receive support and outreach will also be provided with information. This will be documented in a Casework Record.

Therapeutic Quiet Room

24. Use of the therapeutic quiet room is voluntary. The staff member facilitating the use of the therapeutic quiet room will follow GL 578-1 - Therapeutic Quiet Room.

Discharge Process

25. Discharge from treatment is managed in accordance with the Integrated Mental Health Guidelines and is a separate process from an inmate discharge from the Structured Living Environment. These processes may occur simultaneously or at different times.
26. An inmate’s case may be presented to the Interdisciplinary Team for discharge from the Structured Living Environment as a result of:
    1. a voluntary request by the inmate
    2. behaviours that disrupt the therapeutic milieu and treatment of other residents
    3. a lack of engagement/motivation in addressing their individualized treatment plan
    4. sufficient progress made by the inmate to allow them to reside in a regular living unit
    5. a transfer to another site or a release to the community on conditional or statutory release
    6. an increase in security classification to maximum security. Intermediate mental health care are available in the Secure Unit.
27. Movement to another living unit may occur prior to an Interdisciplinary Team meeting if an urgent situation presents itself that cannot be managed. In these cases, the formal discharge or re-admission to the Structured Living Environment will be discussed as soon as practicable by the Interdisciplinary Team.

Enhanced support house

28. The Enhanced Support House is multi-purpose and can be used:
    1. as an alternative to a transfer to the Structured Intervention Unit for inmates who do not present an increased security risk
    2. to assist inmates in transitioning to another house in the mainstream minimum/medium-security population
    3. to support an inmate transitioning from the Secure Unit to the minimum/medium-security population
    4. to strengthen skills of inmates preparing for/returning from community release
    5. to prevent a reclassification to a higher security level or interim placements in the Secure Unit
    6. for other purposes, as appropriate.
29. The Enhanced Support House may be used to manage inmates with:
    1. high intervention needs
    2. poor interpersonal skills
    3. history of frequent interventions by staff
    4. poor independent living skills
    5. lack of engagement/motivation
    6. few or limited coping strategies
    7. poor social skills
    8. poor coping with activities of daily living
    9. poor boundaries
    10. possible program resistance.
30. All inmates who are moved to the Enhanced Support House will continue to attend programs and employment assignments as part of the mainstream population.

Movement to and from the Enhanced Support House

31. Requests to move to the Enhanced Support House can come from the inmate or via referral from a member of the inmate’s Case Management Team, or any member of the Health Services team. Referrals will be reviewed by the Interdisciplinary Team as soon as practicable and decisions will be recorded in a Casework Record - Source of Information - Case Conference - Enhanced Support House.
32. In the case of movement after hours by the Correctional Manager, they will complete a Casework Record - Source of Information - Case Conference - Enhanced Support House detailing the rationale for the movement. An ad hoc Interdisciplinary Team meeting will take place on the next working day to review the decision to move the inmate. Interdisciplinary Team meeting minutes will be completed, as required.
33. Movement from the Enhanced Support House can be initiated by the Interdisciplinary Team or at the inmate’s request. When a request is initiated by the inmate, the Interdisciplinary Team must review and determine appropriate house placement as soon as practicable, which can include maintaining the inmate in the Enhanced Support House.
34. In exceptional circumstances, the Correctional Manager may facilitate a movement out of the Enhanced Support House outside of regular business hours and complete a Casework Record - Source of Information - Case Conference - Enhanced Support House. In such cases, an ad hoc Interdisciplinary Team meeting will take place on the next working day to review the decision to move the inmate.
35. When an inmate is moved to an Enhanced Support House as an alternative from the Structured Intervention Unit, the ESHA OMS flag will be activated. When the inmate moves from the Enhanced Support House, the flag will be deactivated.
36. When an inmate is moved to an Enhanced Support House for other purposes, the ESHO OMS flag will be activated. When the inmate moves from the Enhanced Support House, the flag will be deactivated.

Secure unit

37. Normally, only inmates classified as maximum security are housed in the Secure Unit.
38. Upon admission to the Secure Unit, staff will provide each inmate with a copy of the Secure Unit Handbook and will explain the unit rules and expectations.

Reintegration Movement Plan off the Secure Unit

39. In addition to the interventions, services and activities offered within the Secure Unit, inmates in this unit will have access to shared spaces (e.g., gym, recreation facilities, health services, spiritual and vocational areas) as well as activities and interventions provided outside the Secure Unit as deemed appropriate by law, policy and their specific case.
40. Upon admission to the Secure Unit, the Checklist - Reintegration Movement Plan off the Secure Unit (CSC/SCC 005-T) must be completed for each inmate within one working day.
41. The Checklist - Reintegration Movement Plan off the Secure Unit must be completed for each inmate and/or reviewed at the Interdisciplinary Team meeting at least every two weeks. More frequent review can occur as necessary. The final decision-maker will be the Interdisciplinary Team Chair.
42. The Interdisciplinary Team’s final decision to assign, maintain, change or end a Reintegration Movement Plan (Annex B) must be entered in the "Reintegration Movement Plan for Women’s Secure Units" OMS screen at least every two weeks.
43. Group movements off the Secure Unit will be managed in consideration of individual Reintegration Movement Plans and as described in Annex B.
44. Access to services (e.g., for a ceremony or religious services) and interventions off the unit that require modification to the Reintegration Movement Plan parameters (e.g., where sight and sound supervision cannot be maintained or restraint equipment needs to be removed) is approved by the Interdisciplinary Team Chair and documented. In these cases, operational, technical and/or supervision requirements will be clearly outlined.
45. Movement to and from Health Services will be conducted in accordance with the assigned movement level. However, in order to ensure the inmate’s privacy with regard to health matters, the inmate will not normally remain in restraints or be under the direct supervision of the accompanying staff member.
46. With the exception of paragraphs above, Reintegration Movement Plan levels will be assigned and managed as described in Annex B.
47. Inmates are not required to start at Level 1 of the Reintegration Movement Plan, as the Interdisciplinary Team will determine the appropriate level based on all available information.
48. There is no minimum timeframe during which inmates are required to remain at one particular Reintegration Movement Plan level prior to being considered for another Reintegration Movement Plan level.
49. If an inmate remains at the same level for a period that exceeds three consecutive months, the decision will be reviewed by the Assistant Warden, Interventions. The decision is recorded on the Checklist - Reintegration Movement Plan off the Secure Unit (CSC/SCC 0005-T), in the OMS Reintegration Movement Plan screen and shared with the inmate as soon as practicable.
50. If an inmate remains at the same level for a period that exceeds six consecutive months, the decision will be reviewed by the Deputy Warden. The decision is recorded on the Checklist - Reintegration Movement Plan off the Secure Unit (CSC/SCC 0005-T), in the OMS Reintegration Movement Plan screen and shared with the inmate as soon as practicable.
51. Individuals responsible to accompany the inmate off the Secure Unit may be different from the individual(s) assigned to provide supervision at the destination. All individuals assigned to move the inmate to/from the destination or to supervise the inmate at the destination off the Secure Unit will ensure they adhere to the decision related to supervision requirements.
52. When Secure Unit inmates are engaged in interventions off the unit, their movement schedule will be accessible to other frontline staff. Primary Workers assigned to the main institution’s unit supervision or multi-function posts will increase their monitoring of the areas where inmates classified as maximum security are located.

Regional Psychiatric Centre - Assiniboine Unit

53. Intermediate and psychiatric hospital beds are available for inmates classified as minimum, medium and maximum security, in the Assiniboine Unit at the Regional Psychiatric Centre (Prairie region).
54. Managers and staff are responsible to ensure that the Intensive Intervention Strategy (with the exception of the specific infrastructure models of the Structured Living Environment, Enhanced Support House and Secure Unit), as well as operational policies and interventions for inmates are integrated into the model of the Assiniboine Unit.
55. Admissions, treatment and discharges at the Assiniboine Unit will be completed in accordance with Policy Bulletin 651 on CD 800 - Health Services and the Integrated Mental Health Guidelines.

Support and Outreach Services

56. Support and outreach services are available to inmates with mental health needs who reside in any area outside of the Secure Unit and Structured Living Environment at a women offender institution (excluding the Okimaw Ohci Healing Lodge).
57. The purposes of the support and outreach services include:
    1. preparing for and supporting the transition of an inmate with mental health needs from maximum security to medium security
    2. supporting the inmate’s stability, both emotionally and behaviourally, to maintain their residence in a housing style accommodation or in a culturally-focused setting (including Pathways)
    3. supporting inmates to maintain stability while awaiting admission to the Structured Living Environment or Assiniboine Unit or upon discharge from these specialized units
    4. helping obtain or maintain a lower security classification
    5. allowing access for group and individual support activities, which may include specialized treatment modalities such as Dialectical Behaviour Therapy.
58. Inmates managed for a period of time (as determined by the Interdisciplinary Team) under the support and outreach services of the Intensive Intervention Strategy will be tracked via the Structured Living Environment Admission/Discharge screen in OMS under the Reason for Admission “Outreach” and through the Health Services’ Electronic Medical Record.
59. All interactions and observations related to outreach activities will be communicated on a need-to-know basis and documented in the appropriate format/system (i.e. Casework Record, Observation Report and Electronic Medical Record).

Commissioner,

Original signed by:
Anne Kelly

Annex A: Cross-References and Definitions

Cross-References

• CD 001 - Mission, Values and Ethics Framework of the Correctional Service of Canada
• CD 087 - Official Languages
• CD 566-3 - Inmate Movement
• CD 566-4 - Counts and Security Patrols
• CD 566-6 - Security Escorts
• CD 568-1 - Recording and Reporting of Security Incidents
• CD 577 - Staff Protocol in Women Offender Institutions
• GL 578-1 - Therapeutic Quiet Room
• CD 700 - Correctional Interventions
• CD 701 - Information Sharing
• CD 702 - Indigenous Offenders
• CD 710-1 - Progress Against the Correctional Plan
• CD 710-2 - Transfer of Inmates
• GL 710-2-3 - Inmate Transfer Processes
• CD 711 - Structured Intervention Units
• CD 720 - Education Programs and Services for Inmates
• CD 726 - Correctional Programs
• CD 735 - Employment and Employability Program
• CD 750 - Chaplaincy Services
• CD 767 - Ethnocultural Offenders: Services and Interventions
• CD 768 - Institutional Mother-Child Program
• CD 800 - Health Services
• CD 843 - Interventions to Preserve Life and Prevent Serious Bodily Harm
• Integrated Mental Health Guidelines

Admission by exception: an admission into the Structured Living Environment (not into treatment) that does not meet the normal criteria for admission.

Behavioural Counsellor: a staff member who works with inmates at a women offender institution/unit, under the direct supervision of the Manager, Intensive Intervention Strategy, but who fulfils certain duties under the functional supervision of a registered health care professional.

Correctional Manager, Intensive Intervention Strategy: a Correctional Manager position unique to women offender institutions/units and whose incumbent oversees the management and supervision of correctional operations components of the Intensive Intervention Strategy.

Direct supervision: the basic characteristics of direct supervision are the assignment of tasks; the observance, review and evaluation of performance; the administration of line personnel functions (e.g., selection, discipline, grievances, privileges, etc.). Assuming the direct supervision of an employee involves being responsible for the employee and the work they perform.

Enhanced Support House: a voluntary short-term supportive mainstream environment for inmates classified as minimum or medium security who require additional staff support and/or greater access to interventions. As the Enhanced Support House is considered a mainstream accommodation option, there is no change in the conditions of confinement.

Functional supervision: the supervisor or manager is responsible for a project or recurrent activities that involve tasks performed by persons over whom they have authority to give direction in regards to that project or activity even though they are under the direct supervision of someone else.

Group movement: a movement off the Secure Unit where more than one inmate is involved.

Intensive Intervention Strategy: a management strategy that addresses the risk and needs of inmates who:

• require additional support and interventions through accommodation in the Enhanced Support House
• are classified as maximum security and require additional structure and supervision in the Secure Unit (excluding the Structured Intervention Unit), and/or
• have mental health needs and require the structure and support provided by the specialized accommodations offered by the Structured Living Environment and the Assiniboine Unit at the Regional Psychiatric Centre in Saskatoon.

As part of the Intensive Intervention Strategy, inmates residing in the other mainstream residential living accommodations can be provided with support and outreach services via the Structured Living Environment.

The Intensive Intervention Strategy is a collaborative approach between interventions, operations and Health Services to support the diverse needs of the inmates managed under this strategy.

Interdisciplinary Mental Health Team: a team chaired by the Chief, Mental Health Services, Clinical Manager or delegate, with team members that may include mental health staff, health care staff, Parole Officers, Correctional Managers, Elders, and ad hoc members as required. The Interdisciplinary Mental Health Team discusses current clinical, operational and case management issues/concerns, short-term/long-term goals, and the roles and responsibilities of all staff intervening with the inmate, in order to respond effectively, and provide advice and support to the inmate.

Interdisciplinary Team: an intervention body chaired by the Manager, Intensive Intervention Strategy, and comprised of the Correctional Manager, Intensive Intervention Strategy, registered health care professionals, Parole Officers, Primary Workers, Behavioural Counsellors, Elders, Indigenous Liaison Officers and/or ad hoc members as required.

Intermediate mental health care: care provided to inmates who do not require admission to a hospital, or do not consent to hospital admission, and whose needs exceed the level of care provided through primary care. For minimum and medium-security women offenders with mental health needs, intermediate mental health care is available in the Structured Living Environments, which exist in each of the five women’s institutions. Intermediate mental health care is also available for maximum-security women in the Secure Units and for all security levels at CSC's Regional Psychiatric Centre in Saskatoon, Saskatchewan.

Manager, Intensive Intervention Strategy: an interventions manager position unique to women offender institutions/units whose incumbent oversees the administration of the Intensive Intervention Strategy, including but not limited to planning and administering finances, directing the work of the Interdisciplinary Teams, and directly supervising Behavioural Counsellors.

Registered health care professional: an individual registered or licensed for the practice of health or mental health care in Canada and preferably in the province or territory of practice (certain positions however, require registration in the province or territory of practice).

Reintegration Movement Plan: a framework that establishes the supervision, escort and restraint requirements for the movement of inmates off the Secure Unit, excluding the Structured Intervention Unit, to access shared spaces within the mainstream minimum/medium population (e.g. gym, recreation facilities, Health Services, spiritual and vocational areas) as well as participate in activities and interventions provided off the Secure Unit.

Secure Unit: a mainstream population unit in women’s institutions that provides accommodation for inmates classified as maximum security.

Sight and sound: means in close enough proximity for at least two officers to see the inmate and hear their communications. Notwithstanding the above, for privileged communications between an inmate and a lawyer or a medical practitioner, only constant sight is required. As well, it is recognized that for brief periods (e.g. for staff and/or inmate use of washroom facilities or purchase of food), the sight and sound requirements may be maintained by one officer. During these types of situations, the inmate may be restrained to a secure object (e.g., a hospital bed). During an inmate’s use of the washroom, officers will position themselves to maintain safe and secure custody, while ensuring the appropriate dignity of the inmate.

Structured Intervention Unit: provides an alternative institutional living environment in circumstances where an inmate cannot be maintained in a mainstream inmate population for institutional security or safety reasons pursuant to subsection 34(1) of the CCRA.

Structured Living Environment: accommodation in the mainstream population at women’s institutions for inmates classified as minimum or medium security. The Structured Living Environment provides intermediate mental health care as well as an accommodation option that is more structured with a higher level of staff presence.

Support and outreach services: supportive interventions for inmates with mental health needs who do not require the specialized accommodations offered by the Structured Living Environment and who reside in residential living accommodations. These services provide a continuum of specialized interventions.

Therapeutic quiet room: a space for inmates located in the Structured Living Environment that may be used on a voluntary basis as part of an overall management strategy to assist inmates in preventing emotional dysregulation by removing themselves from anxiety-provoking situations. This provides them with the opportunity to engage in self-soothing skills, thereby enhancing their emotional ability to cope. Inmates participating in support and outreach services are also authorized to utilize the therapeutic quiet room.

Annex B: Reintegration Movement Plan off the Secure Unit