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 PositionsCrisis 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 CommitteePurpose: 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 GroupPurpose: 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 GroupPurpose: 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 PrinciplesThrough 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 WoodcockProgram Manager ADAPT CWMS

Jason BarrManager CMHA-HRB Coast Program

Funding for CCDP has been provided by the Mississauga Halton Local Health Integration

Network (MHLHIN)

Q & A