Increased access to mental health care made possible by $500,000 in Central East LHIN funding
Sadness. Hopelessness. Anxiety. These are just some of the symptoms that may prompt someone to call Scarborough and Rouge Hospital’s (SRH) Regional Community Crisis Program, a telephone crisis support line and crisis support team.
Now, thanks to half a million dollars from the Central East Local Health Integration Network (Central East LHIN), individuals who call the crisis line (at 416-495-2891) will be able to immediately speak with a dedicated professional crisis worker, 24 hours a day, seven days a week. Many other crisis services provide supportive counselling and crisis de-escalation over the phone, however, SRH’s newly expanded program offers much more: evidence-based psychotherapy sessions by phone and the inclusion of brief e-therapies to augment these telephone sessions.
“This funding support is enabling us to not only increase access to mental health care for patients in distress, but to provide a unique service that incorporates the most current and evidence-based interventions,” said Faiza Khalid-Khan, patient care director, Mental Health, Birchmount and General sites.
“A round-the-clock telephone crisis service with enhanced features is a meaningful gain for members of the Scarborough and East York communities who may need immediate crisis assistance outside of regular business hours. We also invested in a robust staff education program to refresh and build upon skills required to provide these additional interventions.”
Led by Khalid-Khan and Shawnna Balasingham, patient care manager, Mental Health, Birchmount and General sites, the Community Crisis Program was designed with quality improvement and patient-centred care in mind, and incorporates input from patient advisors and the hospital’s Innovation and Performance Improvement office.
The team worked diligently to design standard work that would ensure the level of care matched the patient’s level of need. One of the ways this is accomplished is through the use of a standardized crisis triage rating scale (CTRS), which helps to ensure consistency and reduces clinical variation. Through the CTRS, which is used during the patient’s initial call to the crisis line, the crisis worker can determine if the patient requires:
- An e-module that reviews de-escalation techniques and provides links to breathing exercises, as well as a crisis plan;
- Further telephone support (one to two evidence-based psychotherapy sessions that use concepts of cognitive behavioural therapy, mindfulness-based stress reduction, and dialectical behavioural therapy);
- A home visit (reserved for those patients whose burden of illness is so high that their functioning has greatly deteriorated and they are unable to leave their homes); and/or
- Immediate psychiatric care and medication due to a great decline in functioning.
Most callers to a typical crisis line receive supportive counselling to de-escalate their situational crisis, but due to access barriers, it is difficult for them to get connected to follow-up care where they learn to develop the coping skills needed to reduce distress. Many don’t even meet the eligibility criteria to access outpatient mental health care – concerns that have been voiced by family practitioners in the community. SRH’s Community Crisis Program is unique in that it uses short-term psychological interventions to equip callers who don’t meet the requirements for outpatient follow-up with the tools to work through their feelings of distress moving forward.
“We’re expecting that these strategies will help to keep patients well in the community, and reduce visits to the Emergency department,” said Balasingham. “We also expect this expanded service to support family practitioners who carry a caseload of patients experiencing higher levels of distress.”
The Mental Health team will continue to monitor patient outcomes and data to ensure the program is delivering high-quality, patient-centred care.
For more information on crisis support available at SRH’s Birchmount and General sites, please visit www.tsh.to/areas-of-care/mental-health/regional-crisis-programs/.