Toronto, ON (June 16, 2025) - Individuals with criminal justice involvement have significantly higher rates of healthcare visits, including ambulatory care visits, emergency department visits, and hospitalizations, compared to the general population.
Researchers at ICES, St. Michael’s Hospital’s MAP Centre for Urban Health Solutions, and the Centre for Addiction and Mental Health (CAMH) conducted one of the first Canadian studies to examine how correctional populations in Ontario are using healthcare services overall and for substance-use related issues using population-level administrative health data.
They matched a total of 208,188 adults (60% male) with and without criminal justice involvement (CJI) who had a healthcare visit between 2015 and 2020 by age, sex, and neighbourhood marginalization. Most individuals were younger (between 18-30 years old) and lived in urban areas. Matching allowed the researchers to assess the impact of CJI on healthcare use, beyond what these sociodemographic characteristics would show.
“We knew from previous research that individuals involved with the criminal justice system often have higher rates of substance use disorder, but there were very little data on how they actually use healthcare services in Ontario,” says lead author Cayley Russell, Research Manager with the Institute for Mental Health Policy Research at CAMH. “By looking at patterns of healthcare service use, we aimed to better understand their needs and identify where care systems are falling short.”
Key Findings
- Individuals with CJI (compared to non-CJI) had higher rates of emergency department visits (76% vs. 58%) medical/surgical hospitalizations (43% vs. 35%).
- Individuals with CJI also had higher rates of mental health conditions, such as depression, psychosis, and concurrent mental disorders, and were hospitalized for mental health issues at 14 times the rate of non-CJI individuals.
- Rates of healthcare visits related to alcohol use, drug use, and illicit drug-related overdoses were roughly 20 times higher among those with CJI.
- CJI females had more general healthcare visits, while CJI males had more visits related to mental health and substance use.
“The findings suggest that those with criminal-legal involvement have a set of complex needs that require targeted wraparound healthcare interventions both during incarceration and following community release,” says senior author Dr. Flora Matheson, scientist at St. Michael's Hospital's MAP Centre for Urban Health Solutions and ICES.
The authors provide several recommendations, including sex and gender-specific interventions, substance use prevention, and better linkage between correctional facilities and community-based health care.
This work aligns with a recent grant awarded to CAMH by the Canadian Institutes of Health Research (CIHR)’s National Women’s Health Research Initiative, which aims to advance mental health research and care for women involved in the forensic mental health and CJI system.
“There is an urgent need for integrated, trauma-informed healthcare services that begin within correctional settings and continue in the community,” says Russell. “Without meaningful reform, we risk missing critical opportunities to support one of the most underserved populations in our healthcare system.”
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For further information please contact:
ICES
Misty Pratt
Senior Communications Associate\
Media@ices.on.ca
343-961-6982
CAMH
media@camh.ca
About MAP
MAP is Canada’s largest research centre focused on health equity and the social determinants of health. Internationally recognized for ground-breaking science and innovation, MAP develops and implements real-world, evidence-driven program and policy solutions that disrupt cycles of socioeconomic exclusion and poor health. For more than 25 years, MAP has partnered with communities and policy makers across the country to take on complex issues such as homelessness, intimate partner violence, inequitable access to healthcare and the prevention of opioid-related harms. MAP’s impacts span from local to national and beyond. MAP’s vision is a healthier future for all. Learn more at maphealth.ca
About ICES
ICES is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on Bluesky and LinkedIn: @ICESOntario
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
About CAMH
The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines CJInical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca or follow @CAMHnews on Bluesky and LinkedIn.
