Mental Health & Addictions Program

1. Mental Health & Addictions Program March 30th, 2011 Brad Hunt, MSW, RSW Karen Brown, BSW,RSW

2. Presentation Overview • Description of Community Liaison Social Worker Role • Brief Descriptions of high demand services Community - Adult Mental Health & Addictions Program • Brief Descriptions of units at Waterford Hospital • Step by step process of an admission to acute care • Questions

3. Community Liaison SW Position Description • Position Origin • Came about as a result of Navigators and Networks: • Harnessing resources and meeting the needs of • individuals with complex needs (2008) • It is recommended that each of the government organizations • (HRLE, EH, HCS, Justice, and NLHC) designate positions/individuals as liaisons/ • navigators for their system. This will be the "go to" person with the knowledge contacts, authority to respond to requests, and ability to direct people to programs or services within their organizations which address the particular concern or issue. • Start date August 2008 • Other liaison positions in social service / government departments such as HRLE and NLHC

4. Position Description • Responsible for community linkages, consultation and systems navigation for persons with complex mental health needs • Organize and oversee development and implementation of service plans in collaboration with community systems (ie. HRLE, CSP, EH). • Involvement in the development and implementation of an Intersystem Collaborative Network (NavNet). • Act as provincial resource consultant to services providers re: mental health services. • Member of Clinical Efficiency Program – MH & A • Located at Waterford Hospital

5. Scope of Work • Based upon the needs of the mental health program • Case conferencing large portion of work • Consultation on complex cases on psychiatric acute care units and other units of the Waterford (ie. W2A, N4B) • Consultation on complex cases in the community (i.e.. ACT Team, Community Support / Case Management, CSP, Housing,etc) • Resource for health professionals and families, consumers • Committees: ie. Complex Discharge Committees, Ethics Committees, Intergovernmental Liaison Committees, various community based committees • No caseload – Important component of position

8. Complex Needs -What’s Working? • Continual client engagement is key • Collaboration works well but needs to be co-ordinated • Challenging policies that create barriers is crucial • If it makes sense – Do it!

9. Referral / Contact • Who Can Refer? • Anyone • No paper work required • Call or e-mail: • Brad Hunt • 777-3710 • brad.hunt@easternhealth.ca

10. Mental Health and Addictions Program • Offers promotion, prevention, urgent/emergent, acute rehabilitative and continuing care services to children and youth, adults and seniors with mental health and substance use/gambling problems; addictions and mental illnesses both in our hospitals and in the community. • Services range from assessment, counseling, detoxification, treatment and follow up to vocational rehabilitation, housing services, case management and leisure programming. These services range from prevention and early intervention to long-term therapy, from crisis response to support services.

11. High Demand Community Services All Services listed below are for Adults • All are assessment based • Adult central intake is in the planning process, as well the EH website will be set-up to assist with areas of need, rather than services descriptions. • All Services listed below are for those 18 years and older • Mental Health and Addictions Services for Youth (Outpatient) all go through Child and Adolescent (Youth) Central Intake – 777-2200

12. High Demand Community Services • Case Management Services • Provides counseling, help with crisis situations, managing symptoms of illness, teaching skills -ie. medications and health, assist with housing and day to day routines, advocacy and education for individuals and families. • Referral process – anyone can refer • Intake 777-3438 • Location: Waterford Bridge Rd. • Assertive Community Treatment Team (ACTT) • Provides comprehensive community based treatment to individuals with severe and persistent mental illness. Similar in scope to Case Management services regarding services offered. Criteria differs in that individuals must have an DSM IV: Axis I diagnosis. Priority is given to individuals with a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder because of the long-term impairments these conditions cause. 24 hour service. Shared caseload. • Referral Process – anyone can refer; 30 day assessment procedure • Intake: 752-3511 • Location: Major’s Path

13. High Demand Community Services • Traumatic Stress Program • Provides counseling services to individuals exposed to traumatic life events such as single accident traumas, chronic traumatic experiences like abuse, neglect and traumatic loss. Individual and group formats are offered with a focus on client stability during trauma recovery. • Referral Process – anyone can refer • Intake: 752-4393 • Location: Ropewalk Lane • Concurrent Disorders Services • Provides treatment to individuals who have a substance use / gambling problem and coexisting psychiatric illness of severe and persistent nature. Individual and group formats offered with a client centered, harm reduction approach. • Referral Process – anyone can refer • Intake: 777-3603 • Location: Waterford Hospital

14. High Demand Community Services • Housing Division • Provides community based housing services to individuals who require supportive living arrangements to improve their quality of life and maintain psychiatric stability. There are 4 major services: • Community Care • Provides high level residential support (Level 1) services. 24 support services within each home, case management and therapeutic recreation. There are 14 private owned / subsidized homes with total of 178 placements. Homes range in size from 3 to 22 residents. • Referral Process: anyone can refer • Intake: 834-0807 • Location: CBS ( 1 home in Goulds)

15. High Demand Community Services • Family Care • Provides medium level residential support services and supervision in a family environment. Homes can accommodate 1 to 3 residents with a maximum of 45 placements. Case management services are provided and referrals are made to other services as needed. Home operators do not provide 24 hour supervision. • Referral Process: anyone can refer • Intake: 777-3340 • Location: Office – Waterford Bridge Rd. - Homes – St. John’s • Access House • Provides 24 hour supportive transitional housing. Maximum of 11 beds. Counseling, goal setting and life skill development are key program elements. Individual and group formats. • Referral Process: anyone can refer • Intake: 752- 4145 • Location: Empire Ave.

16. High Demand Community Services • Supportive Board and Lodging Subsidy • Non Relative • Financial subsidy provided in supportive board and lodging situation whereby clients lives with a boarding home operator, has a private bedroom and provided with 3 meals a day and other support such as housekeeping, supervision of medications and liaising with client's support network. Amount of subsidy varies depending individual need. • Referral: Typically by case manager or other health professional. Requirement to receive subsidy. • Intake: 777-3342 • Location: Waterford Bridge Rd. • Relative • Financial subsidy provided in supportive board and lodging situation whereby client lives with a relative (as defined by Dept. of Health). Maximum subsidy is $362.00 per month. Screening and assessment determines amount given.

17. High Demand Community Services • Referral Process: Typically by case manager or other health professional. Requirement to receive subsidy. • Intake: 777-3341 • Location: Waterford Bridge Rd. • START Clinic • Provides short term assessment, referral and treatment. The clinic provides rapid access to mental Health service to individuals who require urgent but not crisis intervention. Referrals are seen within 72 hours for initial assessment. Clients cannot be currently followed by another service of the MH & A program. • Referral Process – Physicians, ER departments or hospital based consultation liaison services • Intake: 777-5390 • Location: St. Clare’s Hospital

18. High Demand Community Services • Emergency Services • Crisis Line • Provides confidential 24 hour service province wide. Offers support through exploring options and solutions as well as connecting individuals with other hospital and community supports. • (1-888)-737-4668 • Gambling Help Line 1-888-899-4357 • Location: Waterford Site • Mobile Crisis Response Team • Similar services provision as Crisis Line except interveners visit people in their homes or community. It is accessed through the Crisis Line and is available Wednesday through Saturday between 4:00pm and 12:00 midnight. Still in pilot phase. Age 16 years and up • Contact number is Same as Crisis Line

19. High Demand Community Services • 24 Hour Walk-In Crisis Service • Psychiatric Assessment Unit (PAU) – Waterford Site • Primary ER for assessment of mental health needs. • Psychiatric Emergency Service – Health science Complex (HSC) • Psychiatric Triage Nurse will complete screening. If further action required individual cases are consulted to Waterford Site.

20. Waterford Hospital Inpatient Units • All Units listed are Adult • Acute Care - W3A Max 20 beds • - E3A Max 20 beds • (HSC Psyc Unit Max 18 beds) • Short Stay and Assessment Unit – Max 7 beds + 3 holding beds PAU • Geriatric - E2A Assessment Unit – Max 18 beds • - N2A Transitional / Residential - Max 25 beds • - N3A Residential - Max 25 beds • Forensics Unit – N4B Max 17 beds (unable to refuse admission) • Psychiatric Rehabilitation Unit - W2A Max 20 beds • Developmental Disability Unit – N2B 12 Beds occupied