Mental Health Cindy Dawson CYC (Cert.) r

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 2 nd 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 Family Doctors 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 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 hrs call (long distance) or

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

PLEO – Parent lifelines of Eastern Ontario Ementalhealth.ca Important Resources Crisis Line