Community mental health refers to the delivery of mental health care in community settings. This may mean working with clients in their own home or bringing mental health services directly to individuals in shelters or who are living on the streets. Unfortunately, people living in shelters or on the streets are marginalized and have a high rate of mental illness. They often face barriers to receiving services. Community mental health services seek to address these issues.
The assessment and treatment services provided by The Royal’s community mental health workers (often in partnership with community service providers) allow people with serious and persistent mental illness to live in the community rather than a hospital. Eight teams provide a range of levels of support, depending on the needs of the individual. We also offer education to care providers to help increase their understanding and ability to cope with mental illness. The work of community mental health workers can:
- Prevent unnecessary admissions to hospital (or reduce the length of time in hospital if required).
- Assist patients to improve their quality of life in the community.
- Help patients reach their optimum level of independent functioning.
The Teams
Psychiatric Outreach Services: This is team of mental health professionals that work in the community with adults who are homeless (or near homeless) and seriously and persistently mentally ill. The team provides assessment, short term intervention and links to service. This team serves the City of Ottawa and Renfrew County.
Dual Diagnosis Consultation Outreach Team: This specialized outreach team provides clinical assessments, education and treatment recommendations for the care of dually diagnosed individuals who are over age 16. The team is based in Ottawa and serves the Champlain Local Health Integration Network (LHIN).
ACT Teams: An Assertive Community Treatment (ACT) team is an interdisciplinary team of mental health professionals working in partnership with clients living with serious and persistent mental illness. Each team includes psychiatrists, nurses, social workers, occupational therapists, recreation therapists, addiction specialists, community mental health workers and peer support workers.
- Treatment, including medications and medication monitoring
- Regular support in the environment of the client, including ongoing assessment and modification of treatment plans.
- Collaboration with families and agencies
- Links to other community resources
- Life skills teaching
- Assistance with housing
- Assistance when dealing with legal system
- Active vocational support
- Continuity of care with no time limit
- Inter-agency liaison
- Active recreational support
- Vocational counseling and support
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Day, evening and weekend access with emergency after-hours service (for active clients only)
The Royal has ACT teams serving the Ottawa, Stormont, Dundas, Glengarry, Leeds, Grenville, Lanark, Prescott and Russell.
Ottawa Step Down: The Ottawa Step Down Program has a team made up of case managers from a variety of disciplines and a team psychiatrist. The team provides support to clients who are managing at a stable level in the community. Step Down receives referrals from all five ACT teams in the City of Ottawa.
Dual Diagnosis ACT Team: This specialized team provides service to individuals with both a severe and persistent mental illness as well as a developmental disability in the mild or greater range, plus clients with a pervasive developmental disability. The team is based at the Brockville Mental Health Centre and serves the South East LHIN.
Community Treatment Order Coordination: A Community Treatment Order (CTO) is a doctor’s order for a person to receive treatment or care and supervision in the community. People who have difficulty following treatment may be considered for a CTO. The CTO Coordinator works with physicians, patients, families and care providers to set-up community treatment plans and coordinates CTOs. The Royal’s CTO Coordinator works in partnership with The Ottawa Hospital and The Montfort Hospital to provide regional CTO services to the Champlain LHIN.
Homes for Special Care: The Homes for Special Care program provides residential care to individuals with a mental illness who no longer require hospitalization. Administered by the Brockville Mental Health Centre, the program is funded and residences are licensed by the Ontario Ministry of Health and Long Term Care. Each home is privately owned and operated.
Referrals to the ACT program are accepted from the patient themselves, mental health-care facilities, family, community providers and family physicians.
The ACT Teams does not accept emergency admissions to the program. Patients who have not been admitted to the ACT program must access emergency care through their local hospital or psychiatric facility.
Emergency services are provided after hours, on weekends and on holidays to registered patients of ACT. Emergency services for patients not already part of the ACT caseload must access the psychiatric facility in their community. The ACT team does not accept emergency admissions to the program.
- Canadian Mental Health Association Ottawa Branch
- Cornerstone Women’s Shelter – provides emergency shelter and supportive housing for homeless women in Ottawa.
- Mental health crisis line
- Ottawa Salus – offers rehabilitation services, community support services, recreology and housing to men and women, 16 years of age or older, with mental health problems.
- Ottawa Inner City Health – aims to improve the health and access to health care for people who are chronically homeless.
- The Ottawa Mission – non-profit, faith-based ministry, meeting the needs of the homeless and those at risk of being homeless in the Ottawa region.
- The Salvation Army Ottawa Booth Centre
- Shepherds of Good Hope – services include an emergency men’s shelter, women’s outreach, recovery, managed alcohol harm reduction program and the street community outreach team. There are also housing options and support services like a soup kitchen, grocery and clothing programs and Christmas hamper program.
- Youth Services Bureau – services are organized around four key areas: community, employment, mental health and youth justice. There is also a crisis support line: 613.260.2360 or 1.877.377.7775 (toll free for Eastern Ontario)