Hamilton Psychiatric Hospital - Programs and Departments

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COMMUNITY OUTREACH
The funding for HPH community outreach activities in 1998/99 was $10,140,188 or 25.2% of the base budget. For a number of years HPH has worked with other mental health service providers to develop these supports in the community. HPH has a three-pronged approach for developing these initiatives:

Partnership with other community mental health service providers

Sponsor community service programs at a location off site in the community.

Community-based outreach directly from HPH inpatient services

COMMUNITY PARTNERSHIPS

St. Joseph's Hospital

Emergency Psychiatric Services (EPT)

Community Psychiatry Services (CPS)

St. Joseph's Community Health Centre

East Region Mental Health Services

St. Joseph's Community Health Centre

Geriatric Program-Mood Disorders partner

COAST Program of Hamilton-Wentworth (Community Outreach and Support Team)

Adult Mental Health Services of Haldimand-Norfolk

Hamilton-Wentworth Regional Public Health Unit

Homeless Program

Bridge to Discharge

Hamilton Health Sciences Corp.

McMaster University Medical Centre

Hamilton Program for Schizophrenia (HPS)

Niagara Region Public Health Unit

Mood Disorders Satellite Clinic

Wellington Psychiatric Outreach Program (WPOP)

Canadian Mental Health Association/Brant

Intensive Case Management Team

Grimsby/West Lincoln Initiative

HPH SPONSORED COMMUNITY INITIATIVES

Community Schizophrenia Service

Mental Health Services for Adults with Developmental Handicaps

Homes for Special Care (St. Giles (Hamilton) and the St. Catharines (Niagara) programs)

Geriatric Psychiatry Program

Brant Geriatric Outreach Program

Niagara Geriatric Outreach Program

Halton Geriatric Outreach Program (ACT Team)

ACT Team-Haldimand-Norfolk

Rainbow Ceramics and Crafts

NOTE: Each of the inpatient programs previously discussed in this section has an associated outpatient component with its inpatient service. (see specific program for details)
Statistics, on community-based services are kept separately, and where the host agency is one other than HPH (or a partner in service delivery), the statistics are collected by that agency.

Our statistics, financial and human resources data include patient activity in "Other Community-based" services. "Other Community-based" services on the following chart includes: Homes for Special Care (St. Giles, St. Catharines); Hamilton Health Sciences Corp. (McMaster University Medical Centre MUMC); St. Joseph's Hospital (East Region Mental Health Services, Emergency Psychiatric Services EPT, Community Psychiatry Services CPS, Community Health Centre CHC); Wellington Psychiatric Outreach Program WPOP; Rainbow Ceramics and Crafts; Hamilton-Wentworth Region Public Health Unit (Bridge to Discharge Program, Homeless Program); Crisis Outreach and Support Team COAST; Grimsby West Lincoln initiative; Canadian Mental Health Association/Brant (Case Management) and the Exit Team; Adult Mental Health Services of Haldimand-Norfolk.

Table #25 "Other Community Based" Services

1997/98 (actual)

1998/99 (actual)

1999/2000 (forecast)

Salaries
2,539,056

2,951,970

2,981,400

Benefits
733,537

723,626

529,200

ODOE
1,169,174

1,344,385

1,112,400

TOTAL
4,441,767

5,019,981

4,623,000

FTEs
56.0

64.8

65.3

Registered Outpatients

325

376

380

Outpatient Days
2,446

2,348

2,903

Outpatient Contacts (includes non-registered patients)
16,303

15,652

19,350

*1998/99 and 1999/2000 statistics/dollars include Adult Mental Health Services of Haldimand-Norfolk -previously shown with Community Liaison Program.
*Outpatient contacts for some programs/services are understated due to failure to report statistics.

THE COMMUNITY SCHIZOPHRENIA SERVICE
The Community Schizophrenia Service (CSS) opened its doors in downtown Hamilton in 1997, at First Place and currently serves over 370 clients. The Service is designed to provide clinical support and treatment to outpatients of HPH who have a diagnosis of schizophrenia. Initially the program only served the Hamilton-Wentworth area with the plan to expand throughout the region. CSS is in discussions with Adult Mental Health Services of Haldimand-Norfolk and the Haldimand-Norfolk ACT Team to see how these services can work together. The program has also developed service agreements with COAST and the Homeless Program of the Public Health Department. (both in Hamilton-Wentworth)

The next phase of implementation includes plans to transfer other services, currently being provided to outpatients of the three Schizophrenia Programs onsite at HPH, to the new community site. This phase will not be completed until the consolidation of the inpatient Schizophrenia Services.

The CSS provides services to patients residing in Homes for Special Care HSC-(homes owned and operated privately, but licensed by the Ministry of Health to specifically provide housing to the seriously mentally ill moving from a provincial psychiatric hospital to the community). Residents of these homes receive their clinical treatment and services from the CSS as opposed to onsite at the hospital. Staff also provide education for HSC home owners and operators, specifically, in the proper handling of medication. The program now has vocational, recreational and occupational therapy services through HPH.

The CSS continues to generate a lot of interest from other mental health centres wishing to pursue similar community endeavours and provided consults with Vancouver, Kemptville, London and Toronto's Addictions and Mental Health Services Corporation.

ASSERTIVE COMMUNITY TREATMENT TEAMS (ACTT)
Haldimand-Norfolk
Earlier this year, an Assertive Community Treatment Team that supports people with serious and persistent mental illness in Haldimand-Norfolk was established. The home base for this ACT Team is Adult Mental Health Services of Haldimand-Norfolk in Hagersville. The ACT Team consists of 4.9 FTE clinical staff and a .5 FTE clerical support. MOH has added $400,000 to HPH's base budget for this team.

This team provides community-based tertiary services, which includes assessment, monitoring and consultation services, which are enhanced by the use of a telepsychiatry connection between HPH and the Hagersville and Simcoe offices of Adult Mental Health Services.

It is expected that 98% of patient contacts will occur in the community with very few seen at headquarters.

Halton Geriatric Mental Health Outreach Program
This program is the newest addition to the Geriatric Outreach Programs. It is a partnership between HPH, Joseph Brant Memorial Hospital, Halton Healthcare Services Corporation, Community Care Access Centre of Halton and North Halton Mental Health Clinic. MOH has added $300,300 to HPH's base budget for this ACT Team.

The service consists of a multi-disciplinary team with clinical training in geriatric psychiatry. This team provides community-based tertiary services, which includes specialized assessment, consultation, treatment and short-term specialty case management. Criteria to enter the program require age-related illnesses with mental health problems and/or behavioural disturbance. Emphasis is on those that "cannot or will not" seek psychiatric care through traditional services.

Staffing includes 11 FTEs including 1.7 clerical support. With HPH as the lead organization, these positions are a combination of committed program resources by HPH (2FTEs) and the four partners.

To meet geographical needs, headquarters is in Milton with a satellite office in Burlington. The program is beginning to take clients in September 1999 and the expected number of registered patients at each location is:

Milton Office: 120 - 150

Burlington Office: 200

Given the nature of the program 98% of patient contacts will occur in the community with very few seen at headquarters.

The program is standardizing the intake and assessment procedures throughout the region to ensure continuity of care. As with the other outreach programs, emphasis will continue to be on education and community development.