Understanding Concurrent Disorders

2. Understanding Concurrent Disorders

3. History • A proposal, Strengthening Community Supports for Concurrent Disorders • Reduce ED visits • SIGMHA – Data Analysis Findings • Quality Task Team identified 10 strategies • Including: • Intensive Case Management (Concurrent Disorders) • Bridging Program from ED to Community Services • Home based Withdrawal Management Program

4. One Program – 3 Services Crisis Management Support (St. Elizabeth’s Healthcare, COAST (CMHA-HRB) Concurrent Disorders Case Management (Trillium Healthcare, CMHA-HRB) Community Withdrawal Management Services (PAARC, ADAPT)

5. Our Mission CCDP is dedicated to strengthening community supports for individuals with substance use concerns or a combination of mental health and substance use concerns (i.e. Concurrent Disorders) through the provision of an integrated continuum of services. Reducing ED visits by 10% and return visits by 80%

6. Crisis Management Support • Immediate 24/7 Telephone Response to provide support and arrange follow-up • Crisis support in the client’s home or in the Community • Provides support while being linked to addiction, mental health or community services

7. Case Management • Assessment of client’s current situation • Provides support to identify and develop goals around substance use and mental health needs • Facilitates referrals and linkages to community supports and services

8. Community Withdrawal Management Services (CWMS) • Offers an alternative to residential withdrawal management for individuals who can safely withdraw from substances in a supportive community environment • Works with the client to develop a safe plan for withdrawal • Provides monitoring and support during all stages of withdrawal

9. 17 Staff Positions Crisis Management Support (CMHA- HRB COAST – 1 FTE Concurrent Crisis Worker) (Mobile Crisis or Peel – 2FTE Concurrent Crisis Worker) Concurrent Case Management (CMHA-HRB 5 FTE Intensive Concurrent Case Managers) (Trillium Health Care – 2FTE Intensive Concurrent Case Managers) Community Withdrawal Management Services &Transitional Case Management (ADAPT – 3 FTE Withdrawal Management Counsellors / Transitional Case Managers, 1 FTE RN, 1 FTE RPN, 1 FTE Program Manager/Counsellor) (PAARC – 2 FTE Transitional Case Managers)

10. Transitional Case Management • Offers support during transition from CWMS to additional Mental Health or Addiction or Concurrent Disorders Services • May include pre and post withdrawal support

11. Steering Committee Purpose: to oversee the development and implementation for the initiative and to uphold obligations to the LHIN. • In addition, Promote inter-organizational collaboration • A framework for decision making • Key representatives from other organizations • Chaired by the CEO CMHA-HRB

12. Key Roles and Working Groups • Implementation Co-ordinator – Nora McAuliffe • Program Evaluator – Peter Mueller • HR & IT Working Group • Communication & Education Working Group • Process Working Group

13. HR & IT Working Group Purpose: To look at the potential for joint recruitment and hiring processes. (need to add in IT purpose) • Common Data Base (CRMS) • Laptops from Lead Agency • Common Training

14. Communication & Education Work Group The group’s primary task was the design and implementation of a joint orientation package for new team members. • Common language • Knowledge transfer • Promote common practices • Team building

15. Process Working Group Purpose: To develop protocols and processes for each component of the program and make recommendations to the Steering Committee on policies and structures. • Comprised of Team Leads, Clinical Managers/ Directors from participating agencies • Development and implementation of integrated practices • Development of collaborative processes

16. Process Working Group - 2 • Referral Processes for Hospital Crisis Services • Community Referrals • Common Intake Service • No wrong door • Eligibility Criteria • Consent to service • Common Referral, Admission Criteria, Screening & Assessment Processes • Client & Community Brochure

17. Guiding Principles Through the provision of integrated, continuum of services to reduce the usage of Emergency Departments, CCDP is dedicated to the following principles: • Client centered, empathic, respectful, hopeful, individualized, holistic, flexible, supportive, non-judgemental and comprehensive services • Philosophy of care (individualized and harm reduction) • Concurrent Disorders is the expectations not the exception • Welcoming and Accessible • Continuity of Care • Integrated services and processes

18. Info & Referral No Wrong Door Approach Through any participating organization.

19. Lessons Learned

20. Moving Forward

21. Program Evaluation • Peter Mueller – Program Evaluator • Evaluation Framework (Matrix) • Focus Group • Client Surveys

22. Presented by: Carrie Woodcock Program Manager ADAPT CWMS Jason Barr Manager CMHA-HRB Coast Program Thank You!

23. Funding for CCDP has been provided by the Mississauga Halton Local Health Integration Network (MHLHIN)

24. Q & A