Transcript Urgent Care

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Mental Health
Cindy Dawson CYC (Cert.)
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 services
1. Medical/surgical: this service is for inpatient and outpatient consults
requiring mental health/psychiatric intervention
2. 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?
Family
Doctors
Crisis
Worker
YSB
Urgent
Care
School
Boards
CHEO
ER
Doctors
Other
ER
Working together in Urgent Care
 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
Is this Urgent Care?
Urgent Care
Emergency 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
Urgent Care Criteria
• 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) or
613-737-2273
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 Intake
Urgent 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
Important Resources
PLEO – Parent lifelines
of Eastern Ontario
613-321-3211
Crisis Line
613-260-2360
1-877-377-7775
Ementalhealth.ca