Mental Health Cindy Dawson CYC (Cert.)

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Mental Health Centralized Intake for CHEO/ROMHC Youth

Program• Any referrals for services at CHEO

or the Royal Ottawa Mental Health Centre are filtered through a Centralized Team

• This team consists of 3.2 Intake Workers

• In the last quarter of 2012 (Oct to Dec) 884 referrals were processed through Centralized Intake

Mental Health Centralized Intake for

CHEO/ROMHC

• All external referrals require a referral package completed by the referring physician

• Family physician is included in the process for continuity of care

• Families are encouraged to communicate with their primary care provider until seen at CHEO/ROMHC

Mental Health Centralized Intake for

CHEO/ROMHC

• The child/youth is seen at CHEO/ROMHC or redirected to a more appropriate community mental health resource or both

• Centralized Intake will also assess the urgency and prioritize the referral if necessary

Criteria for Acceptance CHEO/ROMHC Youth Program

• Patients have accessed community mental health agencies

• Patients are experiencing moderate to severe impairment in daily functioning (this would be in more than one area, such as moderate in school and social functioning)

Specialty Outpatient Teams

• Mood and Anxiety: offers individual, group and family interventions for children and youth up to 16 presenting with mood disorders and anxiety. Including DBT group programming. (Wait time approx. 10 months)

• ADHD and Disruptive Behaviour: children

and youth presenting with moderate to severe symptoms of ADHD/ADD; parent groups offered (with children 6 to 12 years of age). (Wait time approx. 3 to 4 months)

Specialty Outpatient Teams

• Consultation Team: children and youth presenting with diagnostic clarification; med consults; symptoms of psychosis. Short term follow up (3-4 sessions). Wait time approx. 3 to 4 months

Specialty Outpatient Teams

• Abuse and Trauma: children and youth up to 18 who have been victims of sexual and/or physical abuse, victims of trauma (PTSD) and perpetrators of abuse; support groups offered for adolescent girls who have been victims of sexual abuse; interventions for parents and/or families around abuse and trauma. (Wait time approx. 4 months)

Specialty Outpatient Teams

Eating Disorders:• Children and youth up to 18 yrs with

symptoms of anorexia and bulimia nervosa.

• Require a height, weight, growth curve, EEG and bloodwork to assess urgency

• See Community Resources

Currently closed to new referrals – Aug, 2012

Specialty Outpatient Teams

Behavioural Neurosciences Consultation: (wait times vary) • Children and youth up to 18 yrs with interacting medical condition

and mental health problems: 4 services1. Medical/surgical: this service is for inpatient and outpatient

consults requiring mental health/psychiatric intervention2. Neuropsychological/cognitive assessment: for all patients

who are suffering from a cognitive impairment due to their medical problem (ie seizure disorder)

3. Tourette Syndrome: for all patients who are experiencing tic symptoms associated with a mental health problem

4. Dual Diagnosis: children and youth up to the age of 18 with a cognitive impairment and/or a pervasive developmental disorder and a mental health problem. Below 2nd percentile in functioning

Approx Wait time is 6 to 9 months, 12 months for Neuropsychology

Specialty Outpatient Teams (Contd.):

Royal Ottawa Mental Health Centre: • specialized out-patient services for

youth 16 to 18 yrs of age presenting with major psychiatric problems. (Wait time approx. 12 months)

• Youth partial hospitalization unit for youth 16 to 18 yrs of age for those not attending school (Wait time approx. 3 months)

CHEO/ROMHC Outreach

• Patients that live outside the Ottawa region will receive consultations via OTN

• This service allows family to access services without having to drive a long distance for services

• Short term follow up is offered through OTN

• Current wait times are 12 months

CHEO Telepsychiatry Program

• Referrals are received from designated mental health providers outside of the Ottawa Region

• Families receive a one time psychiatric assessment via Ontario Telehealth Network for children up to 18 years of age

• Wait times vary, currently very little

Urgent Care

What does Urgent Care do?

• Provide prompt mental health assessments on an outpatient basis for children and youth who are in crisis but not at immediate risk

• Provide recommendations– referral to a community mental health

agency– additional short term intervention by a

member of the team– referral to other internal services if

necessary

Who and Where is Urgent Care?

• Located in the Mental Health Patient Service Unit (MHPSU) ambulatory area at CHEO

• Services are provided by– Psychiatry– Psychology

• Covered by Centralized Intake during the day, Crisis Intervention evenings

Urgent Care

Who Accesses?

Urgent Care

YSB

Other ER

FamilyDoctors

School Boards CHEO

ER Doctors

Crisis Worker

A protocol is set up within the school board as to how to access urgent care

Social Worker or Psychologist within the school is contacted prior to accessing urgent care

Working together in Urgent Care

Is this Urgent Care?

Urgent Care Emergency Criteria Urgent Care Criteria

• Patient on a Form 1• Sudden/recent onset of

psychotic symptoms• Inability to contract for

safety• Specific

suicide/homicide plan (date, time, means)

• Inability to care for self

Send to CHEO Emergency 613-737-2328

• Current suicidal/homicidal ideation without a specific plan• Current/recent suicide attempt/gesture (medically stable)• Previous hx of suicide attempts• Acute change in mental status (e.g. depression, anxiety)• Acute emotional crisis from trauma or psychosocial stressors• Ability to contract for safety

Mon – Fri 0800-2300 hrs call 1-877-251-2273 (long distance) or613-737-2273

Exclusion Criteria for Urgent Care Clinic

• Involved in any current /on going treatment

• Evidence of substance abuse as primary problem

• Chronic behavior/conduct disturbance• Chronic conflicts; family / school

related• Legal assessments and/or placement

issues

Centralized IntakeUrgent Care

• Any student that is considered at imminent risk is advised to present to the CHEO emergency department

• Crisis Intervention Workers are available from 0730 hrs to 2330 hrs for the purpose of risk assessment – Call CHEO ER when sending any student 613-737-2328

PLEO – Parent lifelines of Eastern Ontario 613-321-3211

Ementalhealth.ca

Important Resources

Crisis Line 613-260-23601-877-377-7775

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