January 14, 2016 - CAMH’s former Dual Diagnosis Toronto Service is responding to a new wave of clients with big changes to its model of care and new names for the entire service and its Toronto operations.
“Our traditional population was clients who had an intellectual disability combined with mental health challenges, primarily in the age range of 30 to 50,” says Christina Bartha, Executive Director, Underserved Populations Program at CAMH.
“Several years ago we began to see a new wave of young adult clients, many with autism spectrum disorders and complex issues.”
Developing a new model of care: Christina Bartha
After a comprehensive program review, a new care model has been launched: Adult Neurodevelopmental Services (ANS). This includes the Toronto Adult Neurodevelopmental Clinics and Brief Intervention Inpatient Unit. In Peel, a smaller consultation service will continue and will retain the existing name of the Peel Dual Diagnosis Consultation Clinic.
The new Toronto service retains a small inpatient unit with a shorter length of stay (a target 8 to 12 weeks), and expands the outpatient services through five care pathways that span consultation and short-term intervention to more intensive treatments.
In addition to serving clients with intellectual disabilities, the service will provide assessments and treatment of anxiety disorders for the high-functioning autism client population.
“Our vision is that the Toronto Clinics and new care pathways will deliver great inter-professional care, support excellence in teaching, learning and research -- and advocate for the needs of these very complex and vulnerable clients,” says Christina.
The Toronto model encompasses a total of six new clinics/pathways, four of which are already up and running. The goal is to respond early and intensively to prevent hospitalization and support the client to to live in the community during and after treatment. The new name reflects the variety of neurodevelopmental challenges faced by the evolving client population.
Inpatient: The Brief Intervention Inpatient Unit is now a five-bed unit. In the past, active treatment of clients was conducted over many months or even years. Under the new model, so far the new inpatient team has successfully treated and discharged clients in a much shorter length of time -- in some cases within eight weeks. The goal is to treat 30 clients per year, a four-fold increase from the previous model.
Joe Persaud is Regional Executive Director, Kerry's Place Autism Services,Toronto Region. He says the new model of care at CAMH will assist families with referral options and to access much-needed early intervention services. “The outpatient services will allow families and individuals with autism spectrum disorder to receive services where they are most comfortable – in their home.”
Joe recalls a recent client who had repeated admissions to hospital emergency departments for self-injury. “The admission to CAMH’s program and the special care he received there may have saved his life. We continue to work with CAMH for a successful discharge for this individual.”
Looking ahead to the next phase of site redevelopment at CAMH’s Queen Street West site, the team is playing close attention to space design. The new brief intervention inpatient unit will be a state-of-the art unit designed to address the complex sensory, behavioural and environmental needs of clients, who often have extreme sensitivities to sights and sounds, for example.
Addressing the housing challenge
“Going forward, one of the biggest challenges we face is finding appropriate supportive housing in the community,” says Christina. “There’s an acute shortage for clients with intellectual disabilities in general and more so for people with more complex mental health needs and autism. We are committed to working with our community partners to address the housing challenge and build a better continuum of care for these vulnerable clients.”
Do you know a person who could benefit from the new care model at CAMH? To learn more please contact Access CAMH at 416-535-8501 (select option 2).
Expanded treatment services and capacity: The Adult Neurodevelopmental Services (Toronto) Leadership Team.