Understanding Concurrent Disorders

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

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)

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% Our Mission

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

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

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

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)

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

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

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

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

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

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

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

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

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

Lessons Learned

Moving Forward

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

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

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

Q & A