Care: CAMH Annual Report 2003

CAMH Annual Report

CAMH provides comprehensive, accessible care for people with addiction and mental health problems. We recognize the client as a whole person who has social, physical, emotional, spiritual and psychological needs. Care must reflect the client's preferences, needs and cultural beliefs.

Interdisciplinary plan for client care

CAMH has developed the Interdisciplinary Plan for Client Care -- a tool for assessing client needs and planning treatment in a comprehensive client-focused manner. Worked out by the client and staff together, each care plan sets out the client's medical/therapeutic goals related to his or her illness or substance use, as well as goals for housing, income, work, education, spirituality and connections with family, friends and support groups. The plan outlines the client's preferences regarding meals, sleeping times, visitors, types of treatment and the need for interpretation or culturally specific services.

"The plan is about the whole person, their real-life issues, and the kind of treatment and supports they need," says CAMH Social Worker Jane Paterson, one of the leaders on the project. "It is an approach that reflects CAMH's strategic directions -- to support the strengths of the client, both in managing their illness and in building their capacities to work, learn, form relationships, live independently and to recover."

Innovative home-like facilities provide new hope for recovery

After two years of planning, our new Integrated Rehabilitation Unit has opened at the Queen Street site. This unit is a pilot project to test and refine a new approach to client care in an enriched environment for clients and staff.

Designed for people receiving long-term care for severe mental illness, the new unit offers specialized services in a comfortable, more home-like setting, to help clients achieve the highest possible level of recovery and rebuild skills needed to live independently in the community. Some of the 60 clients in the new unit have been in hospital for many years. They receive intensive rehabilitation from a multidisciplinary care team and learn how to look after their own needs, such as preparing meals, making beds and joining groups.

"The hope is that, with a more supportive and personalized care approach, these clients will enjoy a more meaningful quality of life, be able to rebuild lost skill sets and move on to become more successful in the community," says Karen Martin, the manager of the unit.

Clients helped plan the renovated unit; they recommended more respect and more control over personal space, security and privacy. The new facilities include more private spaces, more home-like living areas, key-pad locks on each room, private client washrooms and individual client rooms decorated in colours

they chose. Some of the recommended design changes could not be made, because of the constraints of the current facilities at Queen Street. However, when the Queen Street site is redeveloped, the recommendations will be part of new "alternate milieu" inpatient facilities.

Full consolidation of Emergency Services at the College Street site

A six-bed Emergency Assessment Unit (EAU) opened in October to enhance CAMH's Emergency Services. The EAU, located at the College Street site, was built specifically for holding clients who need admission, short-term crisis intervention or further assessment and observation. The EAU provides a more comfortable environment for clients, enhances our staff's ability to provide quality care and has reduced the pressure on inpatient admissions for short-term stays. This enhanced service led to a significant drop in activity at the Queen Street emergency facility, resulting in its closure and the full consolidation of CAMH's emergency services at the College Street site in late March.

Reshaping clinical programs to meet client needs

CAMH has made significant changes in clinical programs this year to better meet the needs of clients. These changes include:

Neuro/Geriatrics: The Neuropsychiatry Program, Geriatric Psychiatry Program and OPUS 55 were combined in a single Neuro/ Geriatric Program. This combined program will better serve older adults who often have a combination of needs, including mental illness, cognitive impairment, substance use problems, medication conditions, as well as declining physical health, housing problems, financial concerns and social stigma. The new program is providing holistic care in both inpatient and outpatient programs.
Mood and Anxiety Program: With a new clinical director in place, the Mood and Anxiety Program is being expanded to better address the needs of clients. Changing from a completely outpatient-based program, it has opened a 13-bed inpatient unit to meet the specialized needs of people with mood and anxiety problems.
Child, Youth and Family Program: The integration of Youth Addictions, Child Psychiatry and SAPACCY (Substance Abuse Program for African Canadian and Caribbean Youth) created a new program to better serve the needs of children and youth who often need care for mental health and substance use problems.

These changes are part of the long-range plan for programs and services, which is outlined in CAMH's Functional Program for the proposed redevelopment of the Queen Street site. Many of the proposed program changes and enhancements depend on the development of new facilities and a new environment of care.

LEARN assists young people get back on track

Early detection and treatment of psychosis increase the opportunity for long-term recovery.

"Helping young people get back to school, back to work, back with friends and back into life is the goal of CAMH's new LEARN centre," says Dr. Robert Zipursky, Clinical Director of the Schizophrenia Program.

LEARN stands for Learning, Employment, Advocacy and Recreation Network. This unique facility, in Toronto's west end, opened in September 2002. The new facility, offering services that were often unavailable before, addresses the complex needs of youth recovering from a first episode of psychosis. These needs include education, social skills, emotional support, family education and support and management of problem substance use.

Snowboarding therapy

Young adults in the REACH (Recovery and Education for Adolescents Choosing Health) program learned to snowboard this winter, as a result of a partnership between CAMH and Chill. Chill is an organization that helps young people, who would not otherwise have the opportunity, to try snowboarding. Once a week for six weeks, clients in the day treatment addiction program spent the day at a snowboarding centre, where they were taught the fundamentals of the popular sport.

Like other outdoor adventure activities that are part of our youth addiction programs, the snowboarding experience gave the young adults a chance to challenge themselves, learn a new skill and build self-esteem in an alcohol- and drug-free environment.

"It was an incredible experience for everyone," said Youth Addictions Counsellor, Lori Morgan. "The youth saw that they could snowboard for a day without using [drugs or alcohol], which was a huge accomplishment. It made them realize it was possible to do other things without using [drugs or alcohol] too."