Broadening the continuum of care: CAMH Annual Report 2005

CAMH Annual Report

When most people think about psychosis- -- a severe break from accepted reality, characterized by symptoms such as hallucinations or delusions -- -they commonly, if not always, associate it with schizophrenia.

However, psychosis can be caused by other disorders, including mood disorders such as severe bipolar disorder or depression. While a holistic, multidisciplinary approach has been in place for years for people with schizophrenia, no parallel system has yet existed for people with psychosis related to mood disorders. Traditionally, people with mood-related psychosis have been treated within schizophrenia programs. The Early Mood-Psychosis Case Management System, the first of its kind in Canada, is setting out to change that.

Recently, the Canadian Mental Health Association - Toronto (CMHA) received funding from the Ontario Ministry of Health and Long-Term Care to address the need for a new approach for helping people with mood disorders. Now, the CMHA and CAMH's Schizophrenia, Mood and Anxiety, and First Episode Psychosis programs are partnering to develop a comprehensive system of care.

While treatments, outcomes and support systems for people with mood disorders are different from those of people with schizophrenia, CAMH's Schizophrenia Program's extensive experience with setting up and running a multidisciplinary system is invaluable.

"We all agree that this is a difficult-to-treat population, and only a collaborative system-wide approach can be successful," says Dr. Arun Ravindran, Clinical Director, Mood and Anxiety Program, CAMH. "We know early intervention and support makes a very significant difference to the course and outcome of these illnesses."

Currently, CMHA has begun to assemble a case management team, which will include nursing staff, an occupational therapist, an addiction specialist, a social worker and a part-time psychiatrist. With their experience in community case management and extensive links to community agencies, CMHA is the perfect partner to handle ongoing arrangements for client care.

They will address the broad needs of clients: housing, employment or income support, family support, education, and social and peer support. They will also facilitate the transfer of care to community treatment providers.

CAMH's Mood Disorders Program will provide psychiatric support; beds for urgent admissions, diagnostic evaluations and medical stabilization; and day treatment resources for clients in the transition period. As the system evolves, CAMH will work with the CMHA to provide follow-up care and support, particularly for those clients with more severe illness.

Karen O'Connor, Director of Specialized Services, Canadian Mental Health Association: Without a co-ordinated approach, we can't provide proper treatment. The beauty of bringing together partners is that it is one system. Together, we are building a network of early intervention services for clients with mood disorders.

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