Addiction services partnership increases access to treatment, decreases stigma

Scarborough residents receiving enhanced support closer to home

The addition of new addiction and mental health specialists at both Rouge Valley Health System and The Scarborough Hospital is just one of many changes implemented under an integrated addictions partnership, launched about a year ago between Lakeridge Health’s Pinewood Centre and Mental Health Program, the Rouge Valley Health System (RVHS), and The Scarborough Hospital (TSH). Together, the three hospitals, with funding from the Central East Local Health Integration Network (LHIN), have partnered to grow addiction services and capacity in the Scarborough community and to establish a community withdrawal treatment program for substance users.

The new addictions and mental health specialist working at the Centenary site of RVHS is opening up many eyes and minds to change.

Patients who had previously hesitated to seek the type of treatment they need are becoming much more open about it after talking with the addiction counsellors, says RVHS’s mental health manager, Julie Kish.

“Just from the volumes and numbers of people that the counsellor has been meeting, you know she’s going to be touching a lot of lives in a positive way,” Kish says.

Then there are hospital staff members whose beliefs are shifting as they work and train with Pinewood Centre staff, and begin considering new ways of treating concurrent disorders.

“It’s interesting to see how some people who have some very traditional ideas are definitely open to change when new information and best practices are introduced,” Kish says.

Jai Mills, the Central East LHIN’s mental health and addictions lead, says a key objective was to increase access by sharing the expertise of Lakeridge Health’s Pinewood Centre, with offices across Durham Region, and a newly established location in Scarborough so that clients didn’t have to travel to downtown Toronto, which is a barrier to seeking and receiving treatment. Pinewood Centre specializes in addiction services and deepening its reach into Scarborough carries the potential to help more people.

“Pinewood’s a hidden gem in some ways,” Mills says. “It’s nationally recognized as having very high care standards and great treatment outcomes, and this integration has allowed people to have more access to that service.”

Paul McGary, Lakeridge Health’s Director of Mental Health and Pinewood Centre, says accessibility to addiction and concurrent disorders treatment in the Scarborough community has been enhanced considerably through the partnership.

More than 210 people have been served by the newly-created community outpatient program to safely withdraw from the use of a range of substances. The holistic program includes such elements as acupuncture treatment, nutrition and lifestyle guidance and relapse prevention skills. It starts with two weeks of daily program attendance and participation, followed by an opportunity to engage in two to six more weeks of continued supportive programming.

Developed with input from clients, family members and service providers, the withdrawal program is garnering very positive feedback, McGary says.

“Engaging clients and service providers helped us to identify the population’s needs and what they’d like to see in a community withdrawal program,” he says.

“That’s perhaps been the greatest learning; having the voice of lived experience in designing and then improving the services we offer,” McGary says.

“We’re also listening to our colleagues in the hospital system and others in the LHIN and what their needs are for their clients.”

Referrals to the withdrawal program come from various sources, including primary care providers, community agencies, culturally-based programs, and RVHS and TSH.

It’s also part of the work of the addictions and mental health counsellors embedded at each hospital, as they help to grow capacity for service.

The counsellors are working with hospital staff to enhance their understanding and recognition of substance use and concurrent disorder issues. This training is “a big step” in quashing the stigma surrounding addiction and mental health, Kish says.

“People (with addiction and mental health issues) are often using the emergency department as their source of health care services when they don’t know where else to turn,” McGary says. “And often they have co-morbid conditions such as diabetes, congestive heart failure, or slips, trips and falls. They come to the emergency department and the physical symptoms are addressed, so our purpose for working in the hospitals is not only to work with staff to increase capacity, but also to improve clinical services to people with addiction issues.”

At TSH, the additional expertise of Pinewood has enabled a more comprehensive and integrative approach to mental health and substance use conditions,” said Susan Engels, Patient Care Director, Mental Health & Addictions and Emergency & Urgent Care at TSH.

“The new on site substance use and addictions Counsellor has provided direct care to patients in the Emergency Department (ED) with a focus on strong transitions to the community so that patients may be successful without an unnecessary repeat visit to the ED. Each assessment provides an opportunity for the ED staff and the crisis workers to actually experience the application of the substance use learning module provided by our Pinewood partner.  There is also a great opportunity to work with clinicians in acute care areas beyond mental health and the ED to build greater capacity on the medical and surgical units, given that patients with addictions are often admitted for an acute medical condition and the substance use component may not be fully understood or addressed during the hospital stay.”

This whole effort has “taken off like a rocket,” McGary says, with nearly 640 individuals supported in the past year through the hospitals in Scarborough, for a total of almost 2,400 visits.

Having Pinewood’s expertise on site is invaluable, Kish says. “We always had to refer people out to Pinewood to get their expertise and now it’s like Pinewood is right here and so patients will get the expertise quicker, easier and with no referrals or waits.”

The Central East LHIN is currently implementing its third Integrated Health Service Plan (IHSP), setting out a shared goal for the local health care system to help Central East LHIN residents spend more time in their homes and their communities.

Mental health and/or substance abuse issues can be very disruptive to individual and family lives.

Together with Lakeridge Health’s Pinewood Centre and Mental Health Program, the Rouge Valley Health System, The Scarborough Hospital and many other dedicated and innovative health service providers, clinicians and people with lived experience from across Scarborough, Durham Region and the North East, the LHIN is actively working on the “Community First – Mental Health and Addictions Aim”.

For more information on these and other mental health programs, please visit the Central East Health Line at www.centraleasthealthline.ca, Rouge Valley http://www.rougevalley.ca/mental-health, The Scarborough Hospital http://www.tsh.to/areas-of-care/mental-health/ or Lakeridge Health http://www.lakeridgehealth.on.ca/en/ourservices/Mental-Health---Pinewood-Centre.asp

Submitted by Natalie Hamilton, Axiom News.  To contact Natalie, please email natalie@axiomnews.ca.