Hamilton Psychiatric Hospital - Programs and Departments

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CONCLUSION

STRATEGIC DIRECTIONS
In January, 1999, the Minister of Health approved the Health Services Restructuring Commission's (HSRC) recommendations for HPH and instructed HPH to proceed with implementation of:

Transfer of governance and management of HPH to St. Joseph's Hospital.

The districts of Haldimand-Norfolk to be serviced by HPH. (this adds 14 beds to the HSRC's recommended number of 118 specialized tertiary mental health beds for a total of 132 to be transferred to St. Joseph's plus 10 beds to ABI Chedoke; and 53 beds recommended for transfer to Niagara-still to be approved by the Minister)

In addition, the HSRC recommended the transfer of 18 minimum secure forensic beds and agreed to wait until the government had determined further numbers of forensic beds required to serve each region across the province. The Ministry has made that decision and has determined that Central South Region (previously referred to as Central West) requires a total of 70 forensic mental health beds.

The HSRC also recommended that St. Joseph's hospital build a new mental health pavilion (site to be determined).

TEACHING/EDUCATION AND RESEARCH
Clinical Teaching/Education
The HPH is an accredited teaching hospital, which means it is closely affiliated with universities and community colleges in the education and training of health care professionals across several disciplines. HPH's major affiliation is with McMaster University as a clinical teaching unit specializing in training psychiatry, psychology, nursing, occupational and physical therapy, and social work. Teaching facilities like Mohawk College and other community colleges and universities in Central South Ontario also have affiliation agreements with HPH for training of health professionals in disciplines such as recreation therapy, pastoral care, pharmacy, vocational counseling and music therapy. Other placements include clerical staff, computer technicians, and trades occupations. All students are oriented to mental illness information and mental health care networks.

During the fiscal year 1998/99 the hospital provided training opportunities for 165 individuals. We had nine individuals complete their psychiatric residency (each for a six-month term) and 31 clinical clerks (each for a term of 136 days for a total of 4,216 teaching days). In addition to these medical students, 134 individuals from secondary and post-secondary institutions participated in educational placements at HPH. As an accredited teaching hospital with a World Health Organization (WHO) affiliation, HPH also facilitates placements for students from across Canada and around the world.

The continuing changes as a result of mental health reform and health services restructuring offer the opportunity to reshape and advance mental health service delivery. The role of the mental health care practitioner continues to evolve with these changes. Active student participation and the learning processes associated with clinical teaching placements are a welcome and necessary asset to ensure current and future workforces are able to provide the highest quality of care for those with a serious mental illness.

Staff Education and Training Initiatives
In order to ensure a professionally satisfying work environment, which fosters learning, the hospital continues to provide limited resources for staff to receive continuing education both in and out of hospital.

Human resource information systems changes and issues related to the Year 2000 millennium bug will be major components of the training resources used in the Information Systems area. These efforts and other programs such as Health & Safety training initiatives will complement the training supports offered in the key area of Mental Health Services. Components such as mental health reform/community psychiatry skills will ensure that staff keep informed with the skills and knowledge needed to provide "state of the art" care for our clients.

As was the case in our past operating plan, additional training resources are being offered to ensure employees have the skills, information and supports needed to address the additional challenges of managing change and stress during the restructuring process.

Providing Community Education
The launch of this public Internet website provides another effective vehicle to share our information and expertise with community partners. The website will become an important part of the continuing education programs and services used to provide information and knowledge to community stakeholders.

The hospital uses a variety of methods to further develop an understanding of the disorders we treat and tries to de-stigmatize mental illness. These include:

Brochures on HPH programs, services and information regarding the symptoms and treatment of common mental illnesses;

Sponsoring or co-sponsoring of workshops, seminars and conferences, such as Best Practice Models, Dealing with the Forensic Patient & the Mentally Disordered Offender and the McMaster Muskoka Seminars;

Facility tours targeted for secondary and post-secondary students in non-mental health course-streams. The tours include a general information session and discussion around mental illness and stigma issues;

In addition to the routine case-related education sessions, mental illness information & treatment information sessions are provided by request to local shopping mall security staff, church staff and volunteers, drop-in centres, community services (both mental health and non-mental health related), and providers of supportive housing. In support of furthering sensitivity to the special needs and issues of the seriously mentally ill, information sessions for agencies such as the new recruits of the Hamilton-Wentworth Regional Police and Hamilton-Wentworth Correctional Services are provided on a regular basis.

Material from the extensive collection of videos and reading materials covering a wide range of general and specific issues affecting the seriously mentally ill are also accessed by many of our community agencies from our medical library.

The Clinical programs also carry out educational services for community providers specific to the needs of their special populations.

Research
The hospital is intricately involved in all levels of research from patient recruitment to publication of findings, and approaches research as a multidisciplinary endeavour. All research is approved by the Regional Research Ethics Committee or by the Psychiatrist-in-Chief. Individual clinical programs support outcome-focused research based on clinical diagnosis.

Research activities currently being conducted or recently completed at HPH include:
Drug studies, particularly in the Mood Disorders Program
Building a cognitive and behavioural intervention into ward and outpatient environments
Bridging the Discharge Process - evaluation of enhanced discharge/transition process
Smoking and Schizophrenia - Phases 1 and 2
The Nurse-Client Experience - explorations with an interpersonal method
Case Management
The Experience of Clients and Caregivers Preceding an Aggressive Incident
Service initiative with Family Physicians on the Internet
Evaluation of health care services, and clinical research (geriatric psychiatry) in areas of mood, psychotic disorders and dementia
Evaluation of education and development strategies with community partners.
Rapid Transcranial Magnetic Stimulation (a possible alternative to electro-shock therapy-ECT)
Molecular Investigation of the Pathology of Mood Disorders and novel interventions i.e. cognitive behaviour therapy for unipolar and bipolar patients.
Psychosocial Rehabilitation using a variety of interventions i.e. Cognitive Behaviour Therapy (CBT), Interpersonal Psychotherapy Training (IPT).
First Break Collaborative Research Project: MDP to study first episodes of a mood disorder, as they appear in those under the age of 18 years (partnership with Chedoke).