Providing mental health care when and where it’s needed most.
The Royal’s Community Mental Health Program (CMHP) brings care directly to where patients live, allowing them to remain part of their community as they work towards recovery. CMHP provides assessment, consultation and treatment for people with serious and persistent mental illness.
The program offers services to people in supportive housing, assisted living, shelters, and to unhoused populations. The Royal also supports and educates our community providers and partners as part of CMHP.
The referral process is different across services and teams.
Services offered
CMHP’s specialized community-based teams operate out of multiple sites, with a main office in Carlingwood Shopping Centre.
The teams provide varying levels of specialized support depending on the needs of the individual. They also educate care providers to increase their understanding and ability to cope with and help treat mental illness.
CMHP teams can:
- Prevent unnecessary admissions to hospital
- Reduce the length of time patients spend in hospital
- Help patients recover from mental illness and re-integrate into their community
- Provide support and education to staff of community partner agencies
- Help patients regain independent functioning
- Conduct research and evaluation on models of community mental illness treatment and care
Teams and referrals
The referral process varies by team; however, all programs require referral. Find details on each team and their referral information in the dropdowns below.
An Ottawa-based team of mental health professionals that works in the community with homeless or vulnerably housed adults experiencing serious and persistent mental illness. The team provides assessment, short-term intervention and connections to other services. They also serve patients of Renfrew Mental Health located in Arnprior, Renfrew and Pembroke.
The Psychiatric Outreach Team works with community partners, including shelters, encampments, drop-ins and supportive housing, to provide treatment to mutual clients. The team supports and educates staff of community partner agencies on mental illness and intervention.
Referrals are made on behalf of clients directly from community partner agencies, such as but not limited to CMHA, Ottawa Inner City Health, and the City of Ottawa.
This specialized team provides clinical assessments, education and treatment recommendations for the care of dually diagnosed (intellectual disability + mental illness) individuals who are over age 18. The team is based in Ottawa and serves the Ontario Health East Region.
Referrals
Family physicians can refer an individual to this team by completing the Central Intake Referral Form and Violence/Aggression Assessment Checklist. Please fax the completed referral form and checklist to the Central Intake Team at (613) 798-2976.
Referral forms can also be completed and submitted through the Ocean eReferral platform. For more information about Ocean eReferral, please visit our Referrals page.
If you have any questions, contact the team at (613) 722-6521 ext. 7141.
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 engaging in treatment and meet the appropriate criteria may be considered for a CTO.
The CTO Coordinator works with physicians, patients, families and care providers to build community treatment plans. The Royal’s CTO Coordinator is partnered with The Ottawa Hospital and The Montfort Hospital and provides regional CTO services to the Champlain LHIN.
Referrals
Referrals are made through healthcare providers, usually a family physician.
For CTO referrals in the Ontario Health East area, contact Montfort Hospital’s CTO Coordinator at (613) 746-4621 ext. 3959.
The Royal’s Ottawa-based Flexible Assertive Community Treatment (FACT) teams are comprised of interdisciplinary mental health professionals. The teams work with patients to develop recovery goals and help patients with housing, school or jobs, life skills, relationships and integration into their communities. The team also provides treatment, medication monitoring and ongoing assessment of mental illness concerns.
FACT teams work closely with other care providers, including family physicians, drop-ins, staff from supportive housing and inpatient teams, to provide the best possible care to their patients.
FACT teams are available days, evenings and weekends through an emergency after-hours on-call system for their active clients. FACT teams do not accept emergency admissions.
Referrals
Healthcare providers can refer an individual using the FACT Central Intake Referral Form. Please fax completed referral forms to FACT Central Intake at (613) 739-8400.
If you have questions about referrals to FACT services, please contact (613) 722-6521 ext. 7325.
This specialized team provides service to individuals with both a severe and persistent mental illness and an intellectual disability. The team provides multi-disciplinary services for patients and works with their care providers to establish effective treatment and behavioural plans.
FACT-DD is for people with an intellectual disability over the age of 18 with symptoms of mental illness and who may experience the following:
- Significant behavioural challenges;
- Extended hospital stays and frequent use of emergency services; and
- Involvement in the criminal justice system.
This team is based at the Ottawa campus and serves the Ottawa region.
Referrals
Healthcare providers can refer an individual to this team by completing the Central Intake Referral Form and Violence/Aggression Assessment Checklist. Please fax the completed referral form and checklist to the Central Intake Team at (613) 798-2976.
Referral forms can also be completed and submitted through the Ocean eReferral platform. For more information about Ocean eReferral, please visit our Referrals page.
If you have any questions, contact the team at (613) 722-6521 ext. 7141.
This specialized team provides service to individuals with both a severe and persistent mental illness and an intellectual disability. The team provides multi-disciplinary services for patients and works with their care providers to establish effective treatment and behavioural plans.
FACT-DD is for people with an intellectual disability over the age of 18 with symptoms of mental illness and who may experience the following:
- Significant behavioural challenges;
- Extended hospital stays and frequent use of emergency services; and
- Involvement in the criminal justice system.
This team is based at the Brockville campus and serves South, East and North Lanark, Leeds and Grenville.
Referrals
Healthcare providers can refer an individual to this team by completing The Regional Client Access Form and Violence/Aggression Assessment Checklist. Please fax the completed referral form and checklist to the number on the form.
Referral forms can also be completed and submitted through the Ocean eReferral platform. For more information about Ocean eReferral, please visit our Referrals page.
If you have questions, contact the team at (613) 345-1461 ext. 1500.
Step Down provides case management services to patients who no longer require the intensive level of service that FACT & ACT programs provide. This service works collaboratively with patients on recovery goals.
The Ottawa Step Down Program is made up of six interdisciplinary staff. Step Down receives referrals from the five Ottawa-based FACT & ACT teams.
Referrals
Ottawa area FACT & ACT Teams can refer to this service.
ACTT Services in the Champlain Ontario Health East
In Prescott and Russell, referrals can be made by calling the Hawkesbury General Hospital’s ECTI/ACT team at (613) 764-5464.
In Stormont, Dundas and Glengarry, referrals can be made by calling the Cornwall Community Hospital’s ACT team at (613) 933-7184.
In Leeds, Grenville and Lanark, referrals can be made by calling the Brockville General Hospital’s ACT team at (866) 499-8445.
Additional Support
Gain support and knowledge on mental illness through a group or session
The Royal offers a range of groups and sessions to support patients and families through the process of mental illness treatment. You do not need a doctor’s referral to access these events, but registration may be required.
Access MHA
AccessMHA is a web-based service that provides a single point of entry to eastern Ontario’s system of mental illness and addiction treatment.
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Share your suggestions and feedback
CMHP is always working to improve patient-centred care, safety, timeliness, efficiency, effectiveness, and/or equity of its programs. This suggestion box is open to CMHP patients, patients’ family members and staff.
This suggestion box does not replace our established formal complaint process or safety concerns reporting process. Urgent or life-threatening concerns should be brought to the attention of a staff member directly and/or emergency services (911).
Regional Psychosis Clinic
The Regional Psychosis Clinic is for adults experiencing persistent psychosis related to schizophrenia spectrum disorders. It provides long-term therapies and treatment, including recovery and rehabilitation services.
Client & Family Resource Hub
The Hub is a space for patients and families to find information and resources on programs at The Royal and from our community partners. The Hub is staffed by knowledgeable volunteers and provides free access to computers and Wi-Fi.
