Presentation to Residence Life Staff Mental Health Crisis Center Mobile Crisis Response Team

Transcription

1 Presentation to Residence Life Staff Mental Health Crisis Center Mobile Crisis Response Team Waterford Hospital Waterford Bridge Road St. John's NL A1E 4J8 Bus: Fax Sept 30, 2011

2 INTRODUCTIONS

3 What is Mental Health Crisis? The onset of an emotional disturbance or situation distress (which may be cumulative) involving a sudden breakdown of an individual s ability to cope (Ontario Ministry of Health and Long Term Care, 1999) 3

4 Why would your community need us????? this group you will be presenting to probably has one of the highest potentials of utilizing your services. Each year we have approximately 1400 residents living on campus with the majority of them being between the ages of that are away from home and their usual support system. Statistically this large interconnected group is at a higher risk of suicide, and the onset of other mental health issues than other demographics. An information session with your department will be extremely helpful.

5 Who said that?????? Dwayne Taverner Supervisor Residence Life Office Housing, Food & Conference Services

6 What is a mental health crisis continued It can include feelings of being overwhelmed, stressed, frustrated Crisis can happen at any time; for anyone. We all experience crisis! 6

7 Are you in need of Mental Health Emergency Services? Our mental health can be affected by: Relationships with family or friends Addiction Issues Financial Difficulties School or work stress Grief or Loss Abuse or Traumatic Events Illness 7

8 What are Mental Health Emergency Services? Psychiatric Assessment Unit Short Stay Unit Mental Health Crisis Center Gambling Addiction Helpline Mobile Crisis Response Team 8

9 Program Evolution The Mental Health Crisis Centre was opened in 1996 on St. Clare Avenue Psychiatric Assessment Unit and Short Stay Unit opened 2004 at Waterford Hospital MHCC integrated into Mental Health Emergency Department 2008 Mobile Crisis Response launched in March

10 Psychiatric Assessment Unit Mental Health Emergency Room; operational 24 hours a day year round 3 holding beds used for further observation (maximum 23 hours) All clients are seen by Psychiatric Nurse and Physician No referral needed Serves St. John s, Rural Avalon, and Labrador 10

11 Short Stay Unit Inpatient unit for brief crisis stabilization 7 private rooms Average length of stay 3.5 days Team includes LPN s, RN s, Nurse Practitioner, Social Worker, GP, and Psychiatrist. Intensive intervention; each client sees each team member, everyday 11

12 Mental Health Crisis Phone Line or hours a day Province wide Voluntary Confidential No referral required 12

13 Gambling Addiction Helpline HELP (4357) 24 hours a day Province wide Voluntary Confidential No referral required 13

14 The Crisis Center and Gambling Helpline are phone based services providing support; information; the ability to explore options and solutions; and connect you to other hospital or community supports Priority is given to individuals with serious mental illness and those who may be at risk of causing harm to themselves or others. 14

15 INTEGRATED HEALTH SERVICE CALL US ( ) VISIT US ( PAU) WE WILL COME TO YOU (MOBILE TEAM)

16 Time for some laughter.. What does a clock do when it is hungry?????? I used to be a kleptomaniac..???????

17 Some Relevant History On MCR 17

18 Tragedies That Sparked Change In the summer of 2000, Norman Reid, 43, was fatally shot by the Royal Canadian Mounted Police outside of his home in Little Catalina. On Oct. 17, 2000, Darryl Power, 23, was fatally shot by the Royal Newfoundland Constabulary outside his mother s house in Corner Brook. 18

19 Luther Inquiry 19

20 Luther Inquiry Recommendation 14 IT IS HEREBY RECOMMENDED that the Mental Health Crisis Centre operated by the St. John's Regional Health and Community Services Board be continued and that their services, walk-in and telephone, be promoted throughout the entire Province. IT IS FURTHER RECOMMENDED that the service be expanded to assist police in dealing with crisis situations pertaining to mentally ill persons. 20

21 Luther Inquiry Recommendation 15 IT IS FURTHER RECOMMENDED that the Regional Health Boards establish mobile health units to respond to mentally ill persons in crisis where no criminal offence is alleged. Each unit would be developed locally and based on local needs. In the greater St. John's area, a model along the lines of Vancouver's Car 87 or Hamilton's Coast Programme should be developed. In other areas, the models would vary. Intervention would be by experienced mental health workers. Police officers would only be called to assist where the workers determine there is a concern for personal safety. 21

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23 Working Together for Mental Health In October 2005, this provincial policy document called for a range of emergency and crisis response services focused on providing timely, coordinated responses for people of all ages experiencing a mental health crisis that required immediate intervention. 23

24 Mobile Crisis Response Working Group In 2005, this group was formed. It included representatives from a range of stakeholders, including: consumers, family members, community groups, police and health care providers. 24

25 Contact was made with a number of Mobile Crisis services in Canada. The CMHA was an active participant. 25

26 Input was provided by CHANNAL (Consumers Health Awareness Network of Newfoundland and Labrador) SSNL (Schizophrenia Society of Newfoundland and Labrador) to ensure that the recommendations of consumers and families were at the forefront. 26

27 Mobile Crisis Response Team MCRT provides a rapid community based intervention with professional crisis interveners Psychiatric Nurse/Mental Health Social Worker, an LPN (in collaboration with other health professionals/community partners as needed) Provides support in an environment most comfortable for the client and is an alternative to ER visits or police response 27

28 Hours of Operation Mobile Crisis Wed to Sat 4:00 p.m. to 12 Midnight 28

29 Hours of Operation Planners arrived at the Mobile Crisis hours of operation by analyzing statistics and reports from the Crisis Centre, hospital, police and community agencies. The hours are based on usage patterns and peak times. The current hours may be expanded in the future depending on the demand. 29

30 Groups Targeted For Intervention People at risk of being detained under the Mental Health Care and Treatment Act. People who are acutely disturbed and are unable or unwilling to use alternate emergency services. People identified as the most frequent users of emergency mental health services 30

31 Functions of Mobile Crisis Assessment and Planning Crisis Support and Counselling Environmental Interventions and Crisis Stabilization 31

32 Functions of Mobile Crisis (cont.) Review/Follow-up/Referral Monitoring and Evaluation Information, Liaison, Advocacy and Consultation/Collaboration 32

33 Staff are knowledgeable in relevant legislation and reporting requirements: Mental Health Care and Treatment Act Child Youth and Family Services Act Neglected Adults Act 33

34 In addition to their educational background; staff have additional training in: Therapeutic Crisis Intervention Violence Threat Assessment Suicide Assessment Responding to Traumatic Events Conflict Resolution Deescalating Violence Critical Incident Stress Management Mental Health Status Exam 34

35 We have developed relationships with CYFS, RNC, RCMP, and HRLE to do joint training initiatives; each benefiting from the others expertise. Formalized agreements have been signed with Police and HRLE outlining the nature of our supportive relationship and giving MCR direct access to additional resources. 35

36 Mobile Crisis extends to: Holyrood Bay Bulls and Portugal Cove Torbay 36

37 Mobile Crisis Primary Referral Sources Mental Health Crisis Phone Line or RNC 911 or RCMP Dispatch 911 or (rcmp) Police will request the presence of MCRT if calls for service indicate a mental health crisis 37

38 UNMARKED VEHICLE 38

39 Whenever possible telephone based interventions will be the first line of response for crises. When MCRT is not available other emergency services (police, ambulance, MHCC, PAU, ER) will be used as per current standards and protocols. 39

40 Mobile Crisis will develop an intervention plan which takes into account the consumer s immediate strengths, needs and social support system. Mobile Crisis will establish face-toface contact as soon as possible. Services will be provided in the consumer's place of choice wherever possible. 40

41 Mobile Crisis will provide shortterm crisis support and counselling, risk assessment, de-escalation and safety planning. Where possible, attempts will be made to resolve crises within 1 visit. Linking people to other supports and health care may need to be done the day following the visit. 41

42 Expected Outcomes of Mobile Crisis Reduce inpatient admissions and hospital emergency visits for people in crisis. Rapid stabilization and return to pre-crisis functioning Establish linkages with necessary community supports Decrease police involvement in mental health emergencies 42

43 VIDEO

44 This year we are on pace for: visits to PAU ( at HCS) admissions to SSU calls to the MHCC - Last year there were 1700 work hours spent by police officers waiting in PAU with clients detained under MHCTA 44

45 Outcomes Approximately 59% of visits originated from the MHCC, 20% originated from the community and 22% originated from police. 70% of clients avoided hospital visit and remained in the community 30% were brought to HSC, St. Clares or PAU 45

46 Where from here? EXPANSION! *Briefing note submitted to government; seeking funding to expand to 7 days per week *Evaluation committee to lead formal review of Year 1 *Maximize community partnerships (increase opportunities for joint/reciprocal training, communication) 46

47 VIDEO. Puzzle pieces

48 Thank You 48