ADDICTION & MENTAL HEALTH YEAR END SERVICE SUMMARY

Transcription

1 ADDICTION & MENTAL HEALTH YEAR END SERVICE SUMMARY April 1, 2008 March 31, 2009 Prepared by: Information Management, Evaluation and Research,,

2 ADDICTION & MENTAL HEALTH - YEAR END SERVICE SUMMARY FY Table of Contents Note: Note: The Service Area Descriptions included in the Year End Summary have been provided from the Mental Health Website. In 2009, the - Calgary Health Region changed its name to -. Also during the fiscal year Mental Health & Addictions Services changed its name to Addiction and Mental Health. Lastly, Information & Evaluation Unit is now known as Information Management, Evaluation & Research. * Service Area Descriptions (where available) precede the page number listed. Page* Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - all Mental Health 5 ACCESS MENTAL HEALTH Access Mental Health - Adult 7 Access Mental Health - Child and Adolescent 8 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - Addictions Services 9 ADDICTION SERVICES AND CLARESHOLM CARE CENTRE Addiction Centre - Adolescent 12 Addiction Centre - Adult 14 Addiction Consultation Service - FMC 16 Addiction Services Network - PLC 18 Addiction Services Network - RGH 20 Claresholm Care Centre for MH & Addic-Community Support Serv 25 Claresholm Care Centre for MH & Addiction - Inpatient 26 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICTS - Adult Services 28 ADULT MENTAL HEALTH SERVICES Active Treatment Team 30 Adult Aboriginal Mental Health - Therapist 33 Adult Aboriginal Mental Health - Wellness 35 Adult Mental Health Service - SCHC 38 Assertive Community Treatment 41 Bipolar Clinic - Regional 44 Carnat Centre 47 Community Based Mental Health 50 Community Extention Team 53 Community Mental Health Rehabilitation Team 56 Consultation Liaison - FMC 59 Consultation Liaison - PLC 62 Consultation Liaison - Psychiatry Outpatient 65 Dialectical Behavioural Therapy Program 69 Early Psychosis Treatment Service 72 Early Psychosis Treatment Service - Prime Clinic 74 FMC - Mental Health Day Treatment 77 Inpatient Adult Psychiatric Units 83 Report prepared by: IMER, -

3 ADDICTION & MENTAL HEALTH - YEAR END SERVICE SUMMARY FY Table of Contents Page Inpatient Adult Psychiatric Units - Diagnoses 85 Joint Services - Persons with DD Service Description 87 Mental Health Act of Alberta 88 Mental Health Outreach - Sheldon Chumir 90 Mobile Response Team 93 Mobile Response Team - South 95 Mobile Response Team - North 97 Northwest Community Mental Health Centre 100 Outpatient Mental Health 103 Outpatient Schizophrenia Service 106 Primary Mental Health Care 109 Psychiatric Assessment Service 112 Psychiatric Consultation Clinic - RGH 115 Psychiatric Emergency Services & MH Urgent Care Services 120 Psychiatric Emergency Outreach Team - FMC 122 Psychiatric Emergency Outreach Team - PLC 124 Psychiatric Emergency Outreach Team - RGH 126 Psychiatric Emergency Outreach Team - SCHC 128 Regional Capacity Assessment Team 131 Regional Mental Health Housing 134 Regional Psychological Assessment Service 136 RGH - Mental Health Day Treatment Service 140 Shared Mental Health Care 143 Short Stay Unit Follow-up 145 Urgent Therapy Services 148 Walk-In Service - SCHC 151 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - Child & Adolescent 153 CHILD AND ADOLESCENT Adolescent Day Treatment Program 155 Calgary Eating Disorders Program 158 CAMHUS -Urgent Services 161 Child and Adolescent - Shared Mental Health Care 163 Collaborative Mental Health Care 165 Complex Kids 167 Family, Adolescent & Child Services 169 Healthy Minds, Healthy Children 173 Mental Health Inpatient Care Unit 175 Mental Health Inpatient Care Unit - Day Patient 178 Multidisciplinary Consultation Services 180 Pediatric Behavioural Development Clinic 182 Student Health Partnership - Mental Health 185 Unit 26 - Young Adult Program 187 Young Adult Services - Outpatient 190 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - Forensic 192 FORENSIC Calgary Diversion Service 194 Report prepared by: IMER, -

4 ADDICTION & MENTAL HEALTH - YEAR END SERVICE SUMMARY FY Table of Contents Page Community Georgraphic Team Resources 198 Forensic Adolescent Program 200 Forensic Assessment & Outpatient Service 203 Southern Alberta Forensic Psychiatric Centre 206 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - Geriatric 208 GERIATRIC Carewest - Geriatric Mental Health Recovery & Rehabiliation Unit 210 Community Geriatric Mental Health Services 213 Community Geriatric Mental Health Service - SCHC 216 Community Geriatric Mental Health Service - Sunridge 219 Geriatric Mental Health Consulting Services 222 Geriatric Mental Health Day Treatment 225 Geriatric Mental Health Outreach Team 228 Geriatric Mental Health - Unit 48 RGH 231 Map: MENTAL HEALTH CLIENTS BY SOCIAL DISTRICT - Rural 233 RURAL Airdrie Mental Health Clinic 235 Black Diamond Mental Health Clinic 238 Bow Valley Mental Health Clinic - Banff/Lake Louise 241 Bow Valley Mental Health Clinic - Canmore 243 Chestermere Mental Health Clinic 246 Claresholm Mental Health Clinic 249 Cochrane Mental Health Clinic 252 Didsbury Mental Health Clinic 255 High River Mental Health Clinic 258 Nanton/Vulcan Mental Health Clinic 261 Okotoks Mental Health Clinic 263 Strathmore Mental Health Clinic 266 CONTRACTED SERVICES Contracts 268 Grants 269 GLOSSARY Glossary 270 Report prepared by: IMER, -

5 AHS-Calgary Mental Health Client Summary Includes 28,715 Clients with 41,461 Enrollments in Fiscal Year Calgary Urban Social Districts: Number of Clients with Dx Number of clients ,864 Most Common Diagnoses 5,115 4,833 4,784 4,557 Male Female 3,275 2,151 2,184 Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Dementia Personality Eating Disorder Age and Gender 522 <= >=65 Age group Non-Urban Clients: North Rural South Rural East Rural West Rural Area Outside Calgary Region Homeless (Documented) Missing Postal Code Number of Clients 2,585 1, ,802 1, ,265 These results describe clients registered in more than 90 mental health programs, clinics, and nursing units, using data extracted from the ARMHIS, CARA, RAIS, GMHIS, CHR Inpatient, Triage, ADTP, CMHC, and Clinibase data systems, and so represent a large majority (~97%) of the individuals who accessed CHR Mental Health Services. Clients not included were from programs such as Adult Aboriginal and contracted mental health agencies. Some of these data sources may be added to the I&E Unit Data Repository in the near future, so the numbers reported above may change slightly in subsequent reports.

6 ACCESS MENTAL HEALTH Access Mental Health is a non-emergent access and intake point for Mental Health Services. It also acts as a centralized mental health information source for the Calgary Zone. Anyone can call, fax or and receive assistance. Access Mental Health will: Assist new clients attempting to gain entry to, Child and Adolescent Mental Health Services Screen and complete referral packages for a number of identified programs within Adult Mental Health Services Facilitate equitable and transparent access to service Represent one face to Mental Health Services to increase clarity and decrease confusion around available resources. Streamline the process of accessing mental health services in the Provide accurate information about mental health services to external and internal services including wait times. Matches callers to the right service, right place and the right time Advocate for consumers by ensuring that Mental Health Services follow through and provide the assistance that they say they will

7 Access Mental Health Services ACCESS MENTAL HEALTH - ADULT Mental Health Indicators Number of Calls 21,416 Number of Calls by Contact Type Other Professional 14% (3084) Self 46% (9798) Family Physician 22% (4672) Family Member 7% (1556) Friend 1% (220) Psychiatrist 2% (448) Social Worker 3% (561) Other 4% (847) Unknown 1% (230) TOTAL 100.0% (21416) Number of Calls by Reason for Call Information 82% (17614) Referral Package 16% (3434) Out of Scope 1% (183) Intake 1% (173) Crisis Intervention 0% (10) Other 0% (2) number of calls TOTAL 100.0% (21416) Persons of Concern Number of persons of concern 18,151 Persons of Concern by Gender Male 59% (10651) Female 34% (6186) Unknown 7% (1314) TOTAL 100.0% (18151) Persons of Concern by Age 0-17 years 1% (240) % (15072) % (449) Unknown 13% (2390) TOTAL 100.0% (18151) source: MHIOS source: MHIOS source: MHIOS source: MHIOS source: MHIOS source: MHIOS 7,

8 Access Mental Health Services ACCESS MENTAL HEALTH - Child and Adolescent Mental Health Indicators Number of Calls 7,248 Number of Calls answered =< 2 minutes (4652) Number of Calls abandoned (904) Number of Referral Faxes (965) source: symposium source: symposium source: symposium 8,

9 AHS-Calgary Addictions Services Summary Includes 1,319 Clients with 1,518 Enrollments/Admissions in Fiscal Year Calgary Urban Social Districts: Number of Clients with Dx Most Common Diagnoses 60 1, Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Childhood Dx Personality Somatoform Dis. 29 Number of clients Male Female Age and Gender North Rural South Rural East Rural West Rural Non-Urban Clients Area Outside Calgary Region Number of Clients <= >=65 Age group Homeless (Documented) Missing Postal Code 53 0 These results describe clients registered in 5 MH Services (the Adult and Adolescent Addiction Centre programs, the FMC Addiction Consultation Service, and the Addiction Services Network at RGH and PLC) using data extracted from the CARA data system. Clients in addictions programs at the Claresholm Care Centre were not included.

10 ADDICTION CENTRE PROGRAM NETWORK Addiction Program The Addiction Program incorporates treatment, education and research of concurrent disorders across the health care continuum. It operates under the Services within the. Concurrent disorders Concurrent disorders are described as two or more disorders in a single individual interacting in the presenting clinical picture. The Addiction Program promotes the Progressive and Integrated Recovery (PaIR) Model. Progressive: Based on assessment results and motivation, patient care starts with lowest level of treatment intensity required/desired followed by higher levels as needed. Integrated: Combines treatment elements from mental health, medicine and addiction to create a unified and comprehensive program. Recovery: Recovery management provides an alternative to the traditional provision of unrelated, serial episodes of acute care. Addiction Centre The Addiction Centre specializes in the comprehensive assessment, diagnosis and treatment of adults/adolescents with substance/behavioural addiction concurrent with a mental health and/or chronic physical health condition. The Addiction Centre aims to: Bridge the gap between addiction and physical/ psychiatric treatment services. Provide a bio-psycho-social assessment. Provide a treatment and referral service that encourages patients to be active participants in their treatment and take responsibility for their overall well-being. Provide a multi-dimensional model of care to meet the needs of our patients. Teach and train health care professionals about concurrent disorders. Evaluate assessments and interventions using standardized evaluation tools. A referral from a physician is required for treatment at the Addiction Centre, and the patient's physician is expected to be actively involved. There is both an adult service and an adolescent service.

11 Addiction Network The Addiction Network includes acute care and community based satellites. Each Addiction Network satellite provides enhanced consultation services to individuals presenting with a history of substance abuse/behavioural addiction concurrent with a significant psychiatric and/or medical diagnosis. Services are supported by a registered nurse, psychologist, and consulting family physician and/or psychiatrist. Claresholm Centre The Concurrent Disorders Residential Program at Claresholm is intended for individuals with concurrent disorders 18 and older who would benefit from residential treatment.

12 Addictions Network and Claresholm Centre ADDICTION CENTRE - ADOLESCENT Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 127 No Shows 4 Average Wait Time (dys) 78 Direct Procedures 1672 Indirect Time (hours) 2695 Referral Source Family Physician/Pediatrician 16% (20) Mental Health (Outpt/Inpt) Services 9% (11) Psychiatrist 2% (2) Addiction Centre 74% (94) Other 0% (0) referrals TOTAL 100.0% (127) source: Triage source: Triage Residence - Urban 82% (113) - Rural 9% (12) Other Alberta 9% (12) BC 1% (1) Other 0% (0) existing enrollments TOTAL 100.0% (138) Age and Gender Female Male Total <12 years 0 0 (0) (7) (17) (26) (46) (32) => (10) existing enrollments TOTAL (138) 38% 62% source: Triage 12

13 Addictions Network and Claresholm Centre ADDICTION CENTRE - ADOLESCENT Diagnoses by DSM-IV-TR N = 355 Diagnoses, 138 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III Diagnoses counted. Axis I Additional Codes 0.7% (1) Adjustment Disorders 0.7% (1) Anxiety Disorders 34.1% (47) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 60.9% (84) Dissociative Disorders Eating Disorders 1.4% (2) Factitious Disorders Impulse Control Disorders 0.7% (1) Mental Disorders due to General Medical Mood Disorders 30.4% (42) Other Conditions That May be a Focus 21.7% (30) Schizophrenia and Other Psychotic Disorders 2.9% (4) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 97.1% (134) Axis II Axis II 2.2% (3) Axis III Axis III 1.7% (6) 13

14 Addictions Network and Claresholm Centre ADDICTION CENTRE - ADULT Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 549 No Shows 38 Average Wait Time (dys) 93 Direct Procedures 9793 Indirect Time (hours) 1463 Referral Source Family Physician 20% (111) Inpatient (all sites) 1% (7) Psychiatrist 2% (9) Mental Health Outpatient Services 75% (411) Emergency Department 1% (5) MH Agencies/Other Outpt/Other 1% (6) referrals TOTAL 100.0% (549) source: Triage source: Triage Residence - Urban 85% (363) - Rural 9% (37) Other Alberta 6% (25) BC 0% (1) Other 0% (0) existing enrollments TOTAL 100.0% (426) source:cara Age and Gender Female Male Total 0-17 years 0 1 (1) (35) (97) (124) (115) (46) >= (8) existing enrollments TOTAL (426) 50% 50% source:cara 14

15 Addictions Network and Claresholm Centre ADDICTION CENTRE - ADULT Diagnoses by DSM-IV-TR N = 1072 Diagnoses, 426 Existing Enrollments Axis I and II Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 17.8% (76) Adjustment Disorders 4.2% (18) Anxiety Disorders 13.6% (58) Delirium, Dementia, and Amnestic 0.5% (2) Disorders Usually First Dx'd in Infancy 1.2% (5) Dissociative Disorders Eating Disorders 2.1% (9) Factitious Disorders Impulse Control Disorders 4.5% (19) Mental Disorders due to General Medical Mood Disorders 30.3% (129) Other Conditions That May be a Focus 11.7% (50) Schizophrenia and Other Psychotic Disorders 6.1% (26) Sexual and Gender Identity Disorders 0.7% (3) Sleep Disorders 0.2% (1) Somatoform Disorders 9.2% (39) Substance Related Disorders 95.8% (408) Axis II Axis II 19.5% (83) Axis III Axis III 13.6% (146) 15

16 Addictions Network and Claresholm Mental Health & Addictions Centre ADDICTION CONSULTATION SERVICE - FMC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 448 Indirect Time (hours) 0 FY source: Triage Referral Source Not available Residence - Urban 74% (224) - Rural 19% (58) Other Alberta 4% (12) BC 2% (5) Other/Rest of Canada 1% (2) existing enrollments TOTAL 100.0% (301) Age and Gender Female Male Total 0-17 years 1 1 (2) (20) (44) (63) (90) (52) >= (30) existing enrollments TOTAL (301) 37% 63% 16

17 Addictions Network and Claresholm Mental Health & Addictions Centre ADDICTION CONSULTATION SERVICE - FMC FY Diagnoses by DSM-IV-TR N = 335Diagnoses, 301 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes Adjustment Disorders Anxiety Disorders 1.0% (3) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 1.3% (4) Mental Disorders due to General Medical Mood Disorders 1.7% (5) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 91.0% (274) Axis II Axis II 3.7% (11) Axis III Axis III 11.3% (38) 17

18 Addictions Network and Claresholm Centre ADDICTION SERVICES NETWORK - PLC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 808 Indirect Time (hours) 0 source: Triage Referral Source Not available Residence - Urban 72% (320) - Rural 21% (95) Other Alberta 5% (22) BC 0% (1) Other 1% (4) existing enrollments TOTAL 100.0% (442) Age and Gender Female Male Total 0-17 years 0 1 (1) (27) (65) (115) (137) (60) >= (37) existing enrollments TOTAL (442) 29% 71% 18

19 Addictions Network and Claresholm Centre ADDICTION SERVICES NETWORK - PLC Diagnoses by DSM-IV-TR N =493 Diagnoses, 442 Existing Enrollments Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Asis III counted. Additional Codes Adjustment Disorders Anxiety Disorders 1.6% (7) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 1.6% (7) Mental Disorders due to General Medical Mood Disorders 8.1% (36) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 2.0% (9) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 92.3% (408) Axis II Axis II 2.7% (12) Axis III Axis III 2.8% (14) 19

20 Addictions Network and Claresholm Centre ADDICTION SERVICES NETWORK - RGH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 351 Indirect Time (hours) 0 Referral Source Not available Residence - Urban 75% (166) - Rural 20% (43) Other Alberta 4% (9) BC 0% (0) Other 1% (2) existing enrollments TOTAL 100.0% (220) Age and Gender Female Male Total 0-17 years 2 2 (4) (24) (32) (47) (62) (36) >= (15) existing enrollments TOTAL (220) 32% 68% 20 Services

21 Addictions Network and Claresholm Centre ADDICTION SERVICES NETWORK - RGH Diagnoses by DSM-IV-TR N =294 Diagnoses, 220 Existing Enrollments Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes Adjustment Disorders 3.2% (7) Anxiety Disorders 0.5% (1) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 0.5% (1) Factitious Disorders Impulse Control Disorders 1.4% (3) Mental Disorders due to General Medical Mood Disorders 0.9% (2) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 4.1% (9) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 97.3% (214) Axis II Axis II 1.8% (4) Axis III Axis III 18.0% (53) 21 Services

22 CLARESHOLM CENTRE for MENTAL HEALTH & ADDICTIONS What We Do The focus of the Claresholm Centre for MH & Addictions is to provide treatment and education for adults who are coping with a mental illness and who may also have chronic pain and addiction and benzodiazepine dependence with anxiety in order to reach and maintain their overall mental health and well-being. Our programs aim to assist clients in managing their illness, increasing independence, and returning to their own community environment. The Centre has assisted individuals with bipolar disorder, mood and anxiety disorders, schizophrenia, substance abuse, and other disorders. Professionals at the Centre believe in each individual s potential for development and success. Our team includes nurses, social workers, psychologists, psychiatrists, recreational and occupational therapists, dieticians, pharmacists and other mental health providers. Who We Serve Our Centre is unique in the as well as in Canada. Serving Southern Alberta, the 100 bed inpatient, 40 outpatient, community focused psychiatric rehabilitation centre is located one hour south of Calgary in the welcoming rural community of Claresholm, Alberta. Individuals are placed in one of three program areas for their stay: Active Rehabilitation Program The Active Rehabilitation Program Unit is designated for individuals over age 18, who are considered able to participate in rehabilitation and reintegration. A comprehensive model with varying levels of care and gradual transition to independent living. Concurrent Disorders Program In partnership with the Addiction Centre FMC the Residential Concurrent Disorders Program at Claresholm specializes in the treatment of adults with chronic pain and addiction and benzodiazepine dependence with anxiety. The Residential Program is intended for medically stable individuals 18 and older who would benefit from residential treatment while undergoing a supervised drug tapering program. L.O.S weeks in 3 week blocks. Individuals will be assessed and admitted through the Addiction Centre at the Foothills Medical Centre. Please refer to for further information regarding the Addiction Centre's services. Extended Treatment Program Extended Treatment Program Unit is designed for individuals over age 18, experiencing difficulties in functioning due to mental health concerns. Individuals are provided with rehabilitation support and/or maintenance and a mental health care plan. Individuals will eventually be transitioned into supportive housing or a long-term care centre, as appropriate. Once a client is ready for transition and re-entry into community living, follow-up support, outpatient programs, and outreach services are coordinated for clients. These form a comprehensive treatment model with various service options for clients.

23 Services Provided Medication management and Pharmacy Rehabilitation and addictions programs Education for clients and families One-to-one sessions Group therapy Occupational therapy Leisure, education & employment pursuits Client advocacy Discharge planning Resource support and referral Transitional satellite housing Community support services (outpatient support and outreach) How to Make a Referral There are 3 processes available to refer patients for admissions to the Claresholm Centre for Mental Health & Addictions including: Active Rehabilitation and Extended Treatment Unit Referrals 1. Referral Assessment Team Application - for Referrals may be made by: 1. Physician s Orders (accompanied by referral letter) 2. Verbal Request 3. Independent Case Review *Independent Case Review refers to those individuals that Claresholm Referral Assessment Team identifies as potential rehabilitative patients when conducting rounds and/or visits to Inpatient units In order for Claresholm Centre for Mental Health and Addictions to process a referral, please fax the Referral Application attention: Admissions Coordinator or contact the Admissions Coordinator. On-site assessments are scheduled based on referral and at the earliest availability of the Claresholm Referral Assessment Team. 2. Referral Application Out-of-region health teams, family physicians, and staff can complete the Referral Application and fax to the Admissions Coordinator. *Please Note: Referring providers from health zones outside of the should contact the Centre s Admissions Coordinator at for clients being referred to rehabilitation programs.

24 Concurrent Disorders Unit Referrals 3. Admissions Process/Application Please contact the Addiction Centre in Calgary for any referrals to the Concurrent Disorders Program. Referrals will be processed centrally at the Addiction Centre in Calgary and are available on the website: Please note on the referral form that the patient is to be considered for residential treatment. The minimum length of a Concurrent Disorders Residential Program stay will be 3 weeks, with a maximum stay of 6 months. Admissions Criteria Active Rehabilitation and Extended Treatment Programs Primary Axis I diagnosis Adults ages 18 and over Ability to function in an open, integrated community setting Potential for skill development supporting increased independence Demonstrate a willingness to participate and engage in programming Concurrent Disorders Program Opiate Dependence and Chronic Pain The criteria for admission includes: Adults with chronic pain and addiction Willingness to change - amenable to progressive withdrawal/tapering and appropriate use of medication Medically stable as indicated by a physical examination within the previous 3 month period Not acutely psychiatrically unstable at time of admission Able to operate in an open, integrated community setting Need for stable recovery environment Referral source is willing to follow up after discharge Benzodiazepine Dependence and Anxiety Disorder The criteria for admission includes: Adults with chronic benzodiazepine dependence with an anxiety disorder Willingness to change amenable to progressive withdrawal/tapering and appropriate use of medication Medically stable as indicated by a physical examination within the previous 3 month period Not acutely psychiatrically unstable at time of admission Able to operate in an open, integrated community setting Need for stable recovery environment Referral source is willing to follow up after discharge

25 Addictions Network and Claresholm Centre CLARESHOLM CENTRE for MH & ADDICTIONS - Community Support Services Mental Health Indicators Capacity 40 + New Admissions 5 Discharges 5 source: Pgm Stats source: Pgm Stats 25 Services

26 Addictions Network and Claresholm Centre CLARESHOLM CENTRE for MH & ADDICTIONS - INPATIENT Mental Health Indicators Number of Beds 100 Occupancy 83.2% Average Length of Stay (days) 177 New Admissions 161 Discharges 178 Against Medical Advice 35 Rererral Source Acute Care Hospitals (all RHA's) 63% (101) MH Outpatient Services 11% (17) CCC - Community Support Services 5% (8) AHE/AHP 1% (2) Physicians 11% (18) AADAC 9% (15) admissions TOTAL 100.0% (161) Discharge Disposition Planned 68% Transfer 10% Against Medical Advice 20% From Leave of Absence 1% Death 1% discharges TOTAL 100.0% source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats Age 0-17 years 0% % % % % >= 65 4% admissions 100% source: Pgm Stats Diagnoses by DSM-IV N = 178 Discharges Primary Diagnoses are counted once per DSM-IV category per discharge. Axis I Schizophrenia and Other Psychotic Disorders 38% Mood Disorders 11% Anxiety Disorders 3% Adjustment Disorder 1% Substance Abuse/Dependency 44% Other Conditions 3% continued source: Pgm Stats 26

27 Addictions Network and Claresholm Centre Axis II Axis III CLARESHOLM CENTRE for MH & ADDICTIONS - INPATIENT Axis II 3% None reported source: Pgm Stats source: Pgm Stats Mental Health Act of Alberta N=161 Admissions 24 Hour hold 4.3% 7 Formal Patients Admitted 9.9% 16 Formal Certificates Issued (post admission) 5.6% 9 source: Pgm Stats 27

28 AHS-Calgary Adult MH Services Summary Includes 15,719 Adult Mental Health Clients with 23,642 Enrollments/Admissions in Fiscal Year Calgary Urban Social Districts: Most Common Diagnoses ,991 Number of Clients with Dx Number of clients ,038 3,277 2,834 2,953 2,305 Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Dementia Male Female 1,615 1,161 Age and Gender Personality Childhood Dx 489 North Rural South Rural East Rural West Rural Non-Urban Clients Area Outside Calgary Region Homeless (Documented) Number of Clients <= >=65 Missing Postal Code 24 Age group These results describe clients registered in almost 50 urban adult MH Services (including urgent care programs such as the Psychiatric Emergency services at 4 sites) using data extracted from the CARA, ARMHIS, and inpatient ADT data systems.

29 ACTIVE TREATMENT TEAM What We Do To provide community-based treatment for individuals who have a severe and/or persistent mental illness by (1) reintegrating clients into their communities through the development of skills necessary to increase their levels of functioning and increase independence and quality of life, and (2) fostering and facilitating a therapeutic alliance between hospital and community in order to promote continuity of care. Services Provided Active Treatment team is comprised of an inter-disciplinary team, which utilizes a clinical case management model of service delivery. Services include: Intake assessments Psychiatric consultations Individual and/or group therapy Medication Management Transition Services i.e. Independent Living Support Who We Serve Adults years of age with an Axis I diagnosis including disorders of mood, psychosis, anxiety, post traumatic stress. High risk clients. Referral Process How to Make a Referral All referrals to this program must be screen by Access Mental Health - Adult & Senior Services. Prospective clients can be self-referred, or referred by physicians, significant others or other agencies. Admission Criteria Between the ages of years Axis I diagnosis Experience pervasive impairments across different areas of functioning, including social relationships, work, leisure, and self-care. Admission is strictly voluntary. Individuals must be willing to address their mental health concerns. Exclusion Criteria Absence of Axis I diagnosis. Predominant diagnosis of substance abuse. Developmental disorders e.g. IQ <70.

30 Adult Mental Health ACTIVE TREATMENT TEAM at Sheldon Chumir Centre Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 587 No Shows - Average Wait Time (dys) 122 Direct Procedures 7460 Indirect Time (hours) 180 Referral Source Family Physician 74% (435) Psychiatrist 6% (36) Self 7% (44) Mental Health Services 6% (33) Acute - Inpatient 2% (10) Other 5% (29) referrals TOTAL 100.0% (587) source: Triage source: Triage Residence - Urban 109% (506) - Rural 4% (18) Other Alberta 2% (11) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (535) Age and Gender Female Male Total 0-17 years 3 0 (3) (38) (88) (123) (169) (102) >= (12) unknown 0 0 (0) existing enrollments TOTAL (535) 56% 44% 30

31 Adult Mental Health ACTIVE TREATMENT TEAM at Sheldon Chumir Centre Diagnoses by DSM-IV-TR N = 705 Diagnoses, 535 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV category per existing enrollment. Axis I Additional Codes 1.3% (7) Adjustment Disorders 1.1% (6) Anxiety Disorders 13.1% (70) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy, Childhood.. 1.5% (8) Dissociative Disorders 0.7% (4) Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 49.0% (262) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 40.4% (216) Sleep Disorders Somatoform Disorders 0.4% (2) Substance Related Disorders 6.0% (32) Axis II Axis II 11.2% (60) Axis III Axis III 5.4% (38) 31

32 ADULT ABORIGINAL MENTAL HEALTH What We Do Accessible and integrated mental health services provided in a milieu that supports and encourages connection to traditional Aboriginal healing. Cross cultural education and information (workshops, presentations, consultations) regarding the unique cultural identities, histories and socio political contexts of the lives of Aboriginal peoples and their relationship to mental health concerns. Services Provided Therapists and Aboriginal Mental Wellness Workers provide culturally relevant and safe mental health interventions including assessment, treatment, information, referral and outreach support to access health resources including access to traditional healing resources. The education facilitator and community coordinator provide cultural awareness education and consultation. Who We Serve We provide service to First Nations, Metis and Inuit (Aboriginal) people within the context of their families and their communities. Referral Process How to Make a Referral Call Admission Criteria Aboriginal individuals and their families experiencing mental health concerns. Exclusion Criteria Children and non-voluntary clients.

33 Adult Mental Health ADULT ABORIGINAL MENTAL HEALTH - THERAPISTS Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 84 No Shows - Average Wait Time (dys) - Direct Procedures 338 Indirect Time (procedures) 100 Referral Source General Practice Physician 10% (8) Mental Health Clinics (Outpt/Community) 4% (3) 43% (36) Self 37% (31) Other 7% (6) referrals TOTAL 100.0% (84) Residence Calgary 79% (66) Siksika/Morley/Eden Valley 4% (3) Other 1% (1) NFA/Unknown 17% (14) referrals TOTAL 100.0% (84) source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats First Nations Status First Nations - Non Status 13% (11) First Nations - Status 70% (57) Metis 13% (11) Inuit 0% (0) Bill C-31 1% (1) Unknown 5% (4) referrals TOTAL 100.0% (84) source: manual stats Gender Female 81% (68) Male 15% (13) Unknown 4% (3) referrals TOTAL 100.0% (84) source: manual stats 33

34 Adult Mental Health ADULT ABORIGINAL MENTAL HEALTH - THERAPISTS Diagnoses by DSM-IV-TR N = 87 Diagnoses, 84 Referrals Primary Diagnoses counted once per DSM-IV-TR category. Axis I Additional Codes/Unknown 79.8% (67) Adjustment Disorders 2.4% (2) Anxiety Disorders 4.8% (4) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical 1.2% (1) Mood Disorders 2.4% (2) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 3.6% (3) Sexual and Gender Identity Disorders 1.2% (1) Sleep Disorders Somatoform Disorders Substance Related Disorders Axis II Axis II 4.8% (4) Axis III None Reported source: manual stats source: manual stats source: manual stats 34

35 Adult Mental Health ADULT ABORIGINAL MENTAL HEALTH - WELLNESS Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 93 No Shows - Average Wait Time (dys) - Direct Procedures 764 Indirect Time (procedures) 185 Referral Source 8th&8th Clinic 2% (2) Mental Health Clinics (Outpt/Community) 16% (15) Acute Care Inpatient 39% (36) Other 25% (23) Unknown 18% (17) referrals TOTAL 100.0% (93) Residence Calgary 30% (28) Siksika/Morley 39% (36) Other 6% (6) NFA/Unknown 25% (23) referrals TOTAL 100.0% (93) source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats Residence First Nations - Non Status 6% (6) First Nations - Status 69% (64) Metis 5% (5) Inuit 0% (0) Bill C-31 1% (1) Unknown 18% (17) referrals TOTAL 100.0% (93) source: manual stats Gender Female 35% (33) Male 48% (45) unknown 16% (15) referrals TOTAL 100.0% (93) source: manual stats 35

36 Adult Mental Health ADULT ABORIGINAL MENTAL HEALTH - WELLNESS Diagnoses by DSM-IV-TR N = 93 Diagnoses, 93 Referrals Primary Diagnoses counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes/Other/Unknown 45.2% (42) Adjustment Disorders 6.5% (6) Anxiety Disorders 8.6% (8) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 19.4% (18) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 7.5% (7) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 12.9% (12) Axis II None Reported Axis III None Reported source: manual stats source: manual stats source: manual stats 36

37 ADULT MENTAL HEALTH - South Calgary Health Centre What We Do The mental health services of the South Calgary Health Centre (SCHC) are designed to provide enhanced access to psychosocial intervention and brief psychotherapy for individuals and families with psychosocial and/or mental health concerns. While the location of the health centre is most suitable for those families residing in the south part of Calgary and nearby rural areas, all residents within the broader are able to utilize the services at South Calgary Health Centre. Services Provided Change-oriented brief psychotherapy is offered in individual, couple or family format. Selfreferrals can be made or referrals can be provided by family physicians, psychiatrists and other health/mental health providers through Access Mental Health. Hours of operation for Adult Mental Health are Monday - Thursday and on Friday Phone: To send referrals phone Use North entrance. Located on the 2nd Floor in the Mental Health area

38 Adult Mental Health ADULT MENTAL HEALTH SERVICE - South Calgary Health Centre Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 583 No Shows 21 Average Wait Time (dys) 59 Direct Procedures 2858 Indirect Time (hours) 11 Referral Source SCHC MH Urgent Care 15% (88) Access Mental Health (MD & Self) 75% (440) SCHC Walk-in/FACS/MRT/Other 4% (23) Outpatient MH Clinics 1% (4) Self 0% (0) Other 5% (28) referrals TOTAL 100.0% (583) source:cara source:triage source:cara source: Triage Residence - Urban 83% (462) - Rural 4% (20) Other Alberta 14% (77) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (559) Age and Gender Female Male Total 0-17 years 0 0 (0) (68) (162) (155) (127) (41) >= (6) existing enrollments TOTAL (559) 70% 30% 38

39 Adult Mental Health ADULT MENTAL HEALTH SERVICE - South Calgary Health Centre Diagnoses by DSM-IV-TR N = 665 Diagnoses, 559 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 4.3% (24) Adjustment Disorders 26.3% (147) Anxiety Disorders 19.0% (106) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 0.4% (2) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 34.5% (193) Other Conditions That May be a Focus 30.1% (168) Schizophrenia and Other Psychotic Disorders Sexual and Gender Identity Disorders 0.4% (2) Sleep Disorders Somatoform Disorders 0.4% (2) Substance Related Disorders 1.8% (10) Axis II Axis II 1.6% (9) Axis III Axis III 0.3% (2) 39

40 ASSERTIVE COMMUNITY TREATMENT SERVICE What We Do The Assertive Community Treatment Team provides services to adults 18 and over with severe or persistent mental illness who are ordinarily unable to engage in traditional mental or community services. Services Provided Services are provided to individuals who have difficulties with daily living tasks, accessing medical, legal, housing and financial services and support. Services provided are case management, administration and monitoring of medications, providing services in the client's own environment, assistance to access medical, dental, legal and housing resources; facilitation of family and community involvement; advocacy accessing income support and substance abuse interventions. Who We Serve 18 years and older. Axis I diagnosis of mental illness i.e. schizophrenia, severe psychotic disorders, mood disorders; severe or persistent mental illness, inability to access traditional mental health resources and treatment. Referral Process How to Make a Referral Self, GP, Family Member All referrals to this program can be initiated by contacting Access Mental Health - Adult Services. Please call (403) Ext 2 to initiate a referral.

41 Adult Mental Health ASSERTIVE COMMUNITY TREATMENT SERVICE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 18 Average Wait Time (days) 139 Direct Procedures - Indirect Time (hours) - - Calgary 93% (99) - Rural 7% (8) Other Alberta 0% (0) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (107) Reason for Closure Referred for Further Services 46% (6) Client Withdrew from Service 8% (1) Declined Services 23% (3) Deceased 15% (2) Mutual Agreement 8% (1) discharges TOTAL 100.0% (13) Gender Female Male Total 0-17 years 0 0 (0) (5) (18) (26) (32) (23) =>65 yrs 2 1 (3) (107) 30% 70% 41

42 Adult Mental Health ASSERTIVE COMMUNITY TREATMENT SERVICE Diagnoses by DSM-IV-TR N = 90 Diagnoses, 107 Existing Enrollments (17 Primary Diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders Anxiety Disorders 0.9% (1) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 3.7% (4) Other Conditions That May be Focus Schizophrenia and Other Psychotic Disorders 79.4% (85) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 4.7% (5) None reported None reported 42

43 BIPOLAR CLINIC - REGIONAL What We Do Comprehensive outpatient assessment, consultation and treatment to individuals diagnosed with a mood disorder and their families. Services Provided Assessment, treatment, monitoring Education for patients and family Support for patients and family Therapy for patients and family Referral to other agencies Who We Serve Serves Referral Process Physician or psychiatrist only

44 Adult Mental Health BIPOLAR CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 1835 Indirect Time (hours) 70 Referral Source Not available source:pgm stats Residence - Urban 81% (235) - Rural 12% (36) Other Alberta 6% (16) BC 0% (1) Unknown/Rest of Canada 0% (1) existing enrollments TOTAL 100.0% (289) Age and Gender Female Male Total 0-17 years 0 0 (0) (12) (52) (52) (89) (55) >= (25) unknown 0 0 (4) existing enrollments TOTAL (289) 69% 31% 44

45 Adult Mental Health BIPOLAR CLINIC Diagnoses by DSM-IV-TR N = 339 Diagnoses, 289 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 10.0% (29) Adjustment Disorders Anxiety Disorders 0.7% (2) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.3% (1) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 93.8% (271) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 4.8% (14) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 0.7% (2) Axis II Axis II 5.2% (15) Axis III Axis III 1.5% (5) source:cara source:cara source:cara 45

46 CARNAT CENTRE Sunridge Mall What We Do Assessment, stabilization, active rehabilitation, relapse prevention and health promotion for individuals with schizophrenia. Assessment and consultation of other primary psychotic disorders. Services Provided Consultation, assessment, Neuropsychological evaluation, Rehab/Psychoeducational and Social groups, Clinical follow-up, Clozapine clinics. Family therapy and caregiver support. Who We Serve Persons 18+ with a diagnosis of Schizophrenia. Consideration and assessment of individuals presenting with other primary psychotic disorders. Referral Process How to Make a Referral All referrals to this program can be initiated by contacting Access Mental Health - Adult Services. Please call (403) Ext 2 to initiate a referral. Admission Criteria Persons 18+ with a diagnosis of Schizophrenia. Consideration and assessment of individuals presenting with other primary psychotic disorders. Exclusion Guidelines Individuals with limited capacity for rehab may be directed to the alternate services Primary presentation of current alcohol/substance dependence - Individual will be encouraged to seek initial/concurrent treatment as appropriate

47 Adult Mental Health CARNAT CENTRE - at Sunridge Mall Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 33,983 Indirect Time (hours) 484 Referral Source Not available Residence - Urban 91% (406) - Rural 5% (20) Other Alberta 4% (18) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (444) Age and Gender Female Male Total 0-17 years 0 0 (0) (25) (76) (117) (153) (54) >= (19) existing enrollments TOTAL (444) 35% 65% 47 CalgaryZone

48 Adult Mental Health CARNAT CENTRE - at Sunridge Mall Diagnoses by DSM-IV-TR N = 565 Diagnoses, 444 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 2.0% (9) Adjustment Disorders Anxiety Disorders 2.0% (9) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 2.3% (10) Dissociative Disorders Eating Disorders 0.2% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 9.5% (42) Other Conditions That May be a Focus 2.5% (11) Schizophrenia and Other Psychotic Disorders 87.4% (388) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 5.2% (23) Axis II Axis II 8.1% (36) Axis III Axis III 6.4% (36) 48 CalgaryZone

49 COMMUNITY BASED MENTAL HEALTH Sunridge Mall What We Do Provides service to adults 18 to 64 with a chronic or severe persistent mental illness. Services Provided Program provides psychiatric consultation, assessment, and treatment for individuals presenting with symptoms associated with depressive and bipolar disorders, anxiety, schizophrenia, and other psychotic disorders. Treatments include a variety of individual and group therapy modalities, medication management, case management, therapeutic home visits, independent living supports, and satellite services. Target population is individuals presenting with chronic and persistent mental illness. Referral Process How to Make a Referral All referrals to this program must be screened by Access Mental Health - Adult & Senior Services. Please call to initiate a referral

50 Adult Mental Health COMMUNITY BASED MENTAL HEALTH - Sunridge Mall Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 346 No Shows 39 Average Wait Time (dys) 108 Direct Procedures 5003 Indirect Time (hours) 146 Referral Source Psychiatry Inpatient 12% (43) Mental Health Outpatient Service 11% (39) Self 14% (48) Other 52% (179) Unknown 11% (37) existing enrollments TOTAL 100.0% (346) source:cara source:triage source:cara Residence - Calgary 95% (436) - Rural 2% (7) Other Alberta 3% (14) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (457) Age and Gender Female Male Total 0-17 years 0 0 (0) (31) (85) (126) (124) (84) >= (7) existing enrollments TOTAL (457) 58% 42% 50

51 Adult Mental Health COMMUNITY BASED MENTAL HEALTH - Sunridge Mall Diagnoses by DSM-IV-TR N = 644 Diagnoses, 457 Existing Enrollments Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 4.4% (20) Adjustment Disorders 5.0% (23) Anxiety Disorders 14.0% (64) Delirium, Dementia, and Amnestic Disorders First Dx'd in Infancy 2.2% (10) Dissociative Disorders 0.4% (2) Eating Disorders 0.2% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 48.6% (222) Other Conditions That May be a Focus 0.0% (0) Schizophrenia and Other Psychotic Disorders 42.7% (195) Sleep Disorders Somatoform Disorders Substance Related Disorders 3.3% (15) Axis II Axis II 9.6% (44) Axis III Axis III 7.5% (48) 51

52 COMMUNITY EXTENSION TEAM The Community Extension Team (CET) is a team of Mental Health Clinicians (nurses and social workers) and Outreach Workers who provide short term intensive mental health outreach services to clients with a psychiatric diagnosis in the. Referral Criteria Who we serve The clients best serviced by CET are mental health clients who are at a transition point in their mental health care, primarily from hospital to community services. CET promptly initiates referrals received from Access Mental Health. In order to maintain a quick turn around time, referrals should be made for clients who can be transitioned within 6 months. Clients best served also have: A history of poor connections and difficulties with independently maintaining a community follow-up plan A connection to psychiatrist/md or clinical treatment team An identified treatment plan outlining short and long-term goals to allow the client to live as independently and self-sufficiently in the community as their care needs permit Service Description What we do This outreach service provides direct mental health services to clients within their own immediate environment. We provide a service bridge to ongoing mental health services for individuals who are at risk for deterioration during critical treatment transitions. We provide assistance in the areas of: Medication access, routine and planning (due to nature of the work, CET does not give injections) Basic needs (e.g. housing, income applications) Negotiating required services Transportation training Life Skills Development (e.g. budgeting) Developing social and recreational supports Ensuring continuity of care (information transfer and advocacy)

53 Adult Mental Health COMMUNITY EXTENSION TEAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 133 No Shows - Average Wait Time (dys) 5 Direct Procedures 5208 Indirect Time (hours) 685 Referral Source FMC/PLC/RGH Inpatient 71% (94) Mental Health Outpatient Service 11% (14) AHP 1% (1) Other 18% (24) referrals TOTAL 100.0% (133) Reason for Discharge Client withdrew 25% (31) Client Deceased 1% (1) Inclusion Criteria not Met 8% (10) Problem Goal Met 62% (78) Other 4% (5) discharges TOTAL 100.0% (125) Age and Gender Female Male Total 0-17 years 1 1 (2) (26) (45) (41) (29) (27) >= (14) unknown 0 0 (19) existing enrollments TOTAL (203) 56% 44% source:pgm stats source:pgm stats source:pgm stats source:pgm stats source:pgm stats source: pgm stats 53

54 Adult Mental Health COMMUNITY EXTENSION TEAM Diagnoses by DSM-IV-TR N = 203 Diagnoses, 203 Existing Enrollments Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 4.4% (9) Adjustment Disorders 3.0% (6) Anxiety Disorders 7.4% (15) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders 0.5% (1) Eating Disorders 1.0% (2) Factitious Disorders Impulse Control Disorders 0.5% (1) Mental Disorders due to General Medical 0.5% (1) Mood Disorders 23.6% (48) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 57.6% (117) Sexual Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 1.5% (3) Axis II None reported Axis III None reported source: pgm stats source: pgm stats source: pgm stats 54

55 COMMUNITY MENTAL HEALTH REHABILITATION SERVICES at Sunridge Mall What We Do The Community Mental Health Rehabilitation team is committed to the delivery of rehabilitation services, with outreach in the community, focused on promoting healthy lifestyle choices in productivity, self care and leisure. Services Provided Implementing best practices in a client centered, goal oriented approach, and we will support the clients in adopting a philosophy of wellness in their lives. Services offered include: Functional Assessment Leisure education Health Promotion Life Skills Vocational Education Physical Activity Groups Who We Serve Primary Axis 1 diagnosis Adults Identified rehab needs/goals Identified end point Physician of record who has agreed to service Referral Process How to Make a Referral All referrals to the Community Mental Health Rehabilitation team are made via telephone through Access Mental Health (403) Client is aware that they will receive a phone call in 48hrs from the CMHR triage cocoordinator If a professional makes the referral, Access Mental Health sends a disposition letter to the referring source stating that Access will provide the name and number of the Triage Coordinator Triage coordinator notifies the referral source, via fax or note, informing the source that the triage date will be within the next 48 business hours Three phone calls will be attempted to connect with the client. Following the triage date the triage Coordinator will notify the service of the intent of the CMHRT team and identify the therapist assigned or other resources if referral is inappropriate. This information is communicated by telephone or by written letter. Admission Criteria Adults Identified rehabilitation goals Clients must have an identified end point Clients must have a physician of record

56 Adult Mental Health Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 1051 Indirect Time (hours) 191 Referral Source Not available Residence COMMUNITY MENTAL HEALTH REHABILITATION SERVICES - Sunridge Mall - Urban 92% (119) - Rural 2% (2) Other Alberta 6% (8) BC 0% (0) Rest of Canada 0% (0) Other/Outside Canada 0% (0) existing enrollments TOTAL 100.0% (129) Age and Gender Female Male Total 0-17 years 0 1 (1) (19) (12) (31) (41) (24) >= (1) existing enrollments TOTAL (129) 67% 33% source:cara source:cara source:cara 56

57 Adult Mental Health COMMUNITY MENTAL HEALTH REHABILITATION SERVICES - Sunridge Mall Diagnoses by DSM-IV-TR N = 236 Diagnoses, 129 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 2.3% (3) Adjustment Disorders 10.1% (13) Anxiety Disorders 7.0% (9) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 4.7% (6) Dissociative Disorders 1.6% (2) Eating Disorders 0.8% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 55.8% (72) Other Conditions That May be a Focus 0.8% (1) Schizophrenia and Other Psychotic Disorders 17.8% (23) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 1.6% (2) Substance Related Disorders 2.3% (3) Axis II Axis III Axis II 10.1% (13) Axis III 28.5% (59) Note: Intervention and Enrollment activity decreased with Service Area move to Sunridge location in Service offered services to SSU Unit clients when located in PLC. 57

58 CONSULTATION LIAISON - FMC What We Do Consultation Liaison is a sub-specialty within psychiatry that provides assessment and treatment of patients who are experiencing an overlap of physical and mental health issues. Our mandate is to provide timely psychiatric consultations and treatment recommendations to patients and families who are on in-patient medical/surgical units. We work collaboratively with the medical/surgical staff to provide, education and resources to facilitate comprehensive care. Services Provided The Consultation Liaison service utilizes a multi-disciplinary team approach for assessment and treatment. Upon receiving a consult, a Clinician, Medical Resident, or Medical Student will initiate the assessment process and review each patient with an attending Psychiatrist. Patients are followed as needed while in hospital for supportive therapy, behavioural management, or making community resource referrals for discharge follow-up. Consultation also offered to unit staff re: behavioural and psychiatric interventions while patients are on the unit. Who We Serve Patients on medical/surgical in-patient units with a primary medical condition, who have co-existing psychological and psychiatric concerns that are impacting implementation of the treatment plan in hospital and/or potential or actual difficulty with the illness experience. Health care teams caring for medical/surgical in-patients. Families of medical/surgical in-patients. Referral Process Referrals are accepted from any team member, or after request by the patient or family. Electroncially enter physician's order for consultation through the SCM referral system. Requests can be made for patients to be seen: "Today"; in "24 hours"; or in "48 hours". We strive to see all patients within a 48 hour period.

59 Adult Mental Health CONSULTATION LIAISON - FMC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 2036 Indirect Time (hours) 649 source:cara source:pgm stats source:cara Referral Source Not available Residence - Urban 75% (766) - Rural 17% (177) Other Alberta 5% (47) BC 2% (22) Other /Rest of Canada 1% (8) Unknown/Outside Canada 0% (0) existing enrollments TOTAL 100.0% (1020) Age and Gender Female Male Total 0-17 years 6 6 (12) (84) (118) (110) (174) (174) >= (348) existing enrollments TOTAL (1020) 47% 53% 59

60 Adult Mental Health CONSULTATION LIAISON - FMC Diagnoses by DSM-IV-TR N = 1903 Diagnoses, 1020 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 10.5% (107) Adjustment Disorders 19.7% (201) Anxiety Disorders 6.7% (68) Delirium, Dementia, and Amnestic 27.7% (283) Disorders Usually First Dx'd in Infancy 1.0% (10) Dissociative Disorders 0.1% (1) Eating Disorders 0.9% (9) Factitious Disorders 0.1% (1) Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 17.7% (181) Other Conditions That May be Focus 4.5% (46) Schizophrenia and Other Psychotic Disorders 6.7% (68) Sexual and Gender Identity Disorders 0.1% (1) Sleep Disorders Somatoform Disorders 0.8% (8) Substance Related Disorders 20.0% (204) Axis II Axis II 16.2% (165) Axis III Axis III 28.9% (550) 60

61 CONSULTATION LIAISON PLC What We Do Consultation Liaison offers bio-psychosocial assessment and consultation to medical/surgical inpatient units for patients with a primary medical condition and a co-existing psychological and/or psychiatric concern that impacts implementation of their treatment plan or adjustment to hospital. Services Provided Upon receiving a referral the CL team initiates an assessment process. A suggested management plan is developed and proposed to the referral source. This plan may include providing supportive therapy to patients and/or families, offering recommendations to staff regarding behavioral management during hospitalization, or making referrals to community resources for post discharge follow up. Who We Serve Patients on medical surgical inpatient units with a primary medical condition, who have co-existing psychological and/or psychiatric concerns that are impacting implementation of the treatment plan in hospital and/or their experience of the hospital stay. Outpatients referred from the Multiple Sclerosis Clinic at FMC. Referral Process How to Make a Referral Enter physician s order for consultation/psychiatry referral and reason for request through SCM electronic referral system. Admission Criteria Patients are seen in consultation, responsibility for care remains with the referring physician and staff. Exclusion Criteria Medical condition incompatible with psychiatric assessment (i.e.coma). Patients without indication of a psychiatric condition (i.e. housing or financial problems).

62 Adult Mental Health CONSULTATION LIAISON - PLC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 1316 Indirect Time (hours) 462 Referral Source Not available Residence - Urban 76% (777) - Rural 17% (177) Other Alberta 5% (48) BC 1% (8) Other/Unknown 1% (7) existing enrollments TOTAL 100.0% (1017) Age and Gender Female Male Total 0-17 years 15 3 (18) (42) (110) (123) (190) (162) >= (372) existing enrollments TOTAL (1017) 55% 45% source:cara source:pgm stats source:cara 62

63 Adult Mental Health CONSULTATION LIAISON - PLC Diagnoses by DSM-IV-TR N =1188 Diagnoses, 1017 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 0.7% (7) Adjustment Disorders 21.0% (214) Anxiety Disorders 0.6% (6) Delirium, Dementia, and Amnestic 21.6% (220) Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 40.3% (410) Other Conditions That May be Focus Schizophrenia and Other Psychotic Disorders 1.8% (18) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.8% (8) Substance Related Disorders 8.7% (88) Axis II Axis II 0.1% (1) Axis III Axis III 18.2% (216) Note: CL-PLC enrollment increases reflected through increase in the recording of Intake Assessments. Most enrollments are a brief one-time visit. 63

64 CONSULTATION LIAISON Psychiatry Outpatient Service Not available

65 Adult Mental Health CONSULTATION LIAISON - Psychiatry Outpatient Mental Health Indicators FY0708 FY0809* New Enrollments *new 08/ Existing Enrollments 277 Unique Active Enrollmts 276 Carryovers 265 Discharges 2 Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 1749 Indirect Time (hours) 0 Referral Source Not available Residence - Urban 78% (215) - Rural 13% (35) Other Alberta 8% (23) BC 1% (4) Other/Unknown 0% (0) existing enrollments TOTAL 100.0% (277) Age and Gender Female Male Total 0-17 years 4 0 (4) (25) (66) (58) (79) (36) >= (9) existing enrollments TOTAL (277) 64% 36% source:cara source:pgm stats source:cara 65

66 Adult Mental Health CONSULTATION LIAISON - Psychiatry Outpatient Diagnoses by DSM-IV-TR N =361 Diagnoses, 277 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 2.2% (6) Adjustment Disorders 13.0% (36) Anxiety Disorders 30.3% (84) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 1.8% (5) Dissociative Disorders Eating Disorders 0.4% (1) Factitious Disorders Impulse Control Disorders 0.4% (1) Mental Disorders due to General Medical 0.4% (1) Mood Disorders 66.1% (183) Other Conditions That May be Focus 3.6% (10) Schizophrenia and Other Psychotic Disorders 3.6% (10) Sexual and Gender Identity Disorders Sleep Disorders 1.1% (3) Somatoform Disorders 0.4% (1) Substance Related Disorders 7.2% (20) Axis II None Reported Axis III None Reported 66

67 DIALECTICAL BEHAVIOURAL THERAPY What We Do To provide community-based treatment for individuals who are diagnosed with Borderline Personality Disorder Specifically the DBT service is designed to address Stage 1 issues, those being: Suicidal behaviours Therapy interfering behaviours, including those issues that make it difficult to engage in treatment Quality of life interfering behaviours (i.e. Behaviours that generate immediate crisis and inappropriate reliance on hospitalization) Services Provided The Dialectical Behavioural Therapy Program is comprised of an inter-disciplinary team, which utilizes a clinical case management model of service delivery. The treatment modalities utilized are individual and group therapy the focus of which is acquisition, strengthening and generalization of effective coping skills. Who We Serve Individuals are between the ages of 18 and 65 years Possess a severe and persistent psychiatric disorder, that being BPD Individuals with a psychiatric disorder that is characterized by pervasive impairments across different areas of functioning, including social relationships, work, leisure, and self-care. Referral Process How to Make a Referral All referrals to this program must be screened by Access Mental Health - Adult & Senior Services. Physician referral only Completion of Referral History form (NB: Please ensure that all information is current e.g. telephone number, Health Care #) DBT Program utilizes designated physicians therefore any referrals that are accepted into the program will have one of the clinic's designated physicians during the client's tenure in the program. It is the expectation that the referring physician will continue to follow the client once they have been discharged from this program. Admission Criteria Exhibits a psychiatric disorder that is characterized by pervasive impairments across different areas of functioning, including social relationships, work, leisure, and self-care. Is willing to make a commitment to work on self harm behaviors i.e. suicidal, parasuicidal, substance abuse, recklessness/impulsivity.

68 Exclusion Criteria Severe developmental delay Mild retardation Primary diagnosis of substance abuse Anti-social personality disorder Receiving treatment from other Mental Health Services that would conflict with the services and expectations of the program and/or be a duplication of service

69 Adult Mental Health DIALECTICAL BEHAVIOURAL THERAPY PROGRAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 93 No Shows - Average Wait Time (dys) 457 Direct Procedures 5477 Indirect Time (hours) 277 Referral Source Family Physician 52% (48) Psychiatrist 41% (38) Self 0% (0) Mental Health Clinics 4% (4) Acute - Inpatient 1% (1) Other 2% (2) referrals TOTAL 100.0% (93) Residence - Urban 89% (120) - Rural 6% (8) Other Alberta 5% (7) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (135) Age and Gender Female Male Total 0-17 years 0 0 (0) (27) (45) (37) (24) (2) >= (0) existing enrollments TOTAL (135) 93% 7% source:cara source:triage source:cara source: Triage 69

70 Adult Mental Health DIALECTICAL BEHAVIOURAL THERAPY PROGRAM Diagnoses by DSM-IV-TR N = 172 Diagnoses, 135 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV category per existing enrollment. Each Axis III counted. Axis I Additional Codes Adjustment Disorders 0.7% (1) Anxiety Disorders 6.7% (9) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy, Childhood.. Dissociative Disorders Eating Disorders 0.7% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 9.6% (13) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 3.0% (4) Axis II Axis II 98.5% (133) Axis III Axis III 6.4% (11) 70

71 EARLY PSYCHOSIS TREATMENT SERVICE (EPTS) Who We Are The Early Psychosis Treatment Service (EPTS) currently operates in Calgary, Alberta. The program began in December 1996 and was designed to meet the needs of young people diagnosed with a first episode of psychosis. Represented on the team are the disciplines of Psychiatry, Psychology, Nursing, and Social Work. Our Goals Early identification Reduce delays in initial treatment Treat primary symptoms of psychosis Reduce secondary morbidity Reduce frequency and severity of relapse Promote normal psychosocial development Reduce stress for families and caregivers Our Three-Year Program The Calgary Early Psychosis Treatment Service is a three-year outpatient program. This means that patients and their families can utilize our services for up to three years. At the end of three years, patients will be referred to other agencies or to the care of their family physician. Referral Process Individuals can be referred to EPTS by their physician, psychiatrist, mental health worker, or counsellor. First contact with the program will be for a comprehensive assessment. The role of the assessment is to work out what has been going on and whether this is the best program to meet the needs of the individual. If the referral is appropriate, the individual will be admitted to the program under the care of a psychiatrist and case managers who will work with them for the duration of the program. Referral Criteria Experiencing a first episode of psychosis Hospitalized for a first episode of psychosis In first three months of treatment for psychosis Schizophrenia spectrum disorders Where We Are Foothills Medical Centre Street NW Calgary, Alberta T2N 2T9 Tel.: Fax:

72 Adult Mental Health EARLY PSYCHOSIS TREATMENT SERVICE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 4305 Indirect Time (hours) 82 Referral Source Not available Residence - Urban 85% (401) - Rural 10% (49) Other Alberta 4% (21) BC 0% (0) Other/Rest of Canada 0% (1) existing enrollments TOTAL 100.0% (472) Age and Gender Female Male Total 0-17 years (33) (177) (132) (75) (47) (8) >= (0) existing enrollments TOTAL (472) 33% 67% source:cara source:pgm stats source:cara 72

73 Adult Mental Health EARLY PSYCHOSIS TREATMENT SERVICE Diagnoses by DSM-IV-TR N = 627 Diagnoses, 472 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 0.4% (2) Adjustment Disorders Anxiety Disorders 1.9% (9) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 1.1% (5) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 8.7% (41) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 96.6% (456) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 21.0% (99) Axis II Axis II 1.7% (8) Axis III Axis III 1.1% (7) 73

74 Adult Mental Health EARLY PSYCHOSIS TREATMENT SERVICE - PRIME CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 115 Indirect Time (hours) 3 Referral Source Not available Residence - Urban 90% (19) - Rural 5% (1) Other Alberta 5% (1) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (21) Age and Gender Female Male Total 0-17 years 5 3 (8) (10) (2) (0) (1) (0) >= (0) existing enrollments TOTAL (21) 48% 52% source:cara source:pgm stats source:cara 74

75 Adult Mental Health EARLY PSYCHOSIS TREATMENT SERVICE - PRIME CLINIC Diagnoses by DSM-IV-TR N = 27 Diagnoses, 21 Existing Enrollments Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes Adjustment Disorders Anxiety Disorders Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 23.8% (5) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 95.2% (20) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 9.5% (2) Axis II None reported Axis III None reported 75

76 FMC MENTAL HEALTH DAY TREATMENT SERVICE What We Do A day program offering a variety of groups and individual therapy to assist clients in gaining coping skills and functioning independently. Services Provided Designed to meet individual needs. Must be stable enough to attend groups. For clients with mood disorders, post-traumatic stress disorder, grief issues, adjustment disorders, depression. Who We Serve Serves and Beyond Referral Process Physician Psychiatrist Community Services How to Make a Referral All referrals to this program must be screened by Access Mental Health & Adult Senior Services. Must have a Foothills Medical Centre Psychiatrist/Psychologist who is responsible for their care while they are attending the Day Treatment Program. Referral from Family Physician - accompanied by a recent history and reason for referral.

77 Adult Mental Health FMC - MENTAL HEALTH DAY TREATMENT SERVICE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 3058 Indirect Time (hours) 180 Referral Source Not available Residence - Urban 87% (116) - Rural 7% (10) Other Alberta 6% (8) BC 0% (0) Other 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (134) Age and Gender Female Male Total 0-17 years 0 0 (0) (10) (14) (35) (51) (23) >= (1) existing enrollments TOTAL (134) 68% 32% source:cara source:pgm stats source:cara 77

78 Adult Mental Health FMC - MENTAL HEALTH DAY TREATMENT SERVICE Diagnoses by DSM-IV-TR N = 158 Diagnoses, 134 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes 3.0% (4) Adjustment Disorders 3.0% (4) Anxiety Disorders 19.4% (26) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 83.6% (112) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 0.7% (1) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 0.7% (1) Axis II Axis II 6.0% (8) Axis III Axis III 1.3% (2) 78

79 INPATIENT ADULT PSYCHIATRY UNITS 21, 22, 23 - FMC What We Do We provide comprehensive interdisciplinary care to adult psychiatric inpatients suffering from a major psychiatric disorder. Services Provided The client has access to a variety of care provider expertise from a variety of professions that include: nursing staff, medical staff, psychologists, social workers, occupational therapists, and recreational therapists. Who We Serve Adult inpatients suffering from an acute phase of a psychiatric disorder who required admission to an inpatient facility. We have admitted individuals between the ages of 14 to 18 who would be better served if hospitalized on the adult inpatient units. Referral Process How to Make a Referral The majority of admissions to the unit arrive from one of the three Emergency Departments in the city or as a transfer from a rural emergency department. The unit also accepts the transfer of individuals who have been assessed by Consultation Liaison personnel who have determined that the client would benefit from further mental health intervention. Admission Criteria Individuals suffering from an acute phase of a psychiatric disorder. Exclusion Criteria Under 14 yrs of age unless with Admin consent. For placement only.

80 INPATIENT ADULT PSYCHIATRY UNITS 25, 27 - PLC What We Do The Mental Health Services provide comprehensive multidisciplinary programs and specialized services to the acutely ill psychiatric population through nursing, medical staff, psychology, social work, pharmacy, occupational therapy and recreational therapy. Services Provided Comprehensive Psychiatric assessment, interventions and treatment Neuro-psych assessments Social Work, individual and family assessment therapy, community liaison Assessment of daily functioning in all aspects of life Rehabilitation community services Discharge planning and transition services Teaching units for nurses, medical students and psychiatric residents Who We Serve Adults 18 years+ suffering from an acute psychiatric disorder and require admission to an acute care facility. Patients have a primary Axis I psychiatric diagnosis. Referral Process Emergency Department of Peter Lougheed Hospital. Patients are assessed by the Emergency Psychiatric assessment team. Consultation Liaison Team Mobile Response Team Direct admissions can be arranged Admission Criteria Primary psychiatric diagnosis Psychiatrist with admitting privileges Family physicians with admitting privileges Exclusion Criteria Patients under the age of 18 are admitted if their needs can best be served on the unit.

81 INPATIENT ADULT PSYCHIATRY UNITS 45, 49 - RGH What We Do Unit 45 is a 20 bed and Unit 49 a 30 bed acute care adult unit providing comprehensive interdisciplinary care through nursing, medical staff, psychology, social work, occupational therapy and recreational therapy to adult patients suffering from major psychiatric disorders and mental health problems. Services Provided Mental Health needs are assessed through a variety of individual and group activities by various disciplines. For example: Occ. Therapy looks at daily functioning in all aspects of life. Rec Therapy looks at social functioning and community reintegration. Changeways, a psychoeducational program, is one vehicle to help patients look at coping styles and strategies. This is a multidisciplinary program. We are heavily invested in community resources such as the climbing wall at U of C. Nursing and medical staff provide individual counseling as well taking care of health issues that require consultation or medication. A nursing highlight is the Family Systems approach. Psychology provides necessary information to plan care and Social Work assist in planning discharge and community liaison. Who We Serve Primary focus is adults between 18 and 65 years of age with a primary psychiatric disorder. Referral Process How to Make a Referral Admissions are normally through the Emergency department having been assessed by the Psychiatric Crisis Assessment Team. Direct admissions may be accepted from a physician with admission privileges. Admission Criteria Primary psychiatric disorder and admitting physician approval. Exclusion Criteria Must fit inclusion criteria.

82 INPATIENT - SHORT STAY UNIT 37 (formerly U38) What We Do For those patients who have the potential to be cared for at a lower level of care within 72 hours. Short-term stabilization and reconnection with community resources. Services Provided Intensive psychiatric and psychosocial intervention combined with active mobilization of community and family resources. This may safely permit a return to the community within 72 hours. Who We Serve Adults between the ages of Adolescents may be admitted to the unit but only for a brief period while resources are put in place. There are no defined inclusion/exclusion criteria. We determine the need for admission based on the individual needs of the patient. There is the expectation that this person would be able to return to the community within 72 hours. Referral Process How to Make a Referral Contact the Clinical Medical Director for SSU to verbally refer the patient between the hours of 0800 and 1600 Monday to Friday. After hours admissions occur through the on-call psychiatrist at the PLC site. Case is discussed and decision made regarding admission to SSU. Referral must be accompanied by a psychiatric assessment and other relevant documentation. Medical clearance is necessary. Admission Criteria Patients for whom optimum management is a brief stabilization and intensive needs assessment with the establishment of appropriate supports to continue management in the community. Exclusion Criteria None identified

83 Adult Mental Health Utilization Indicators INPATIENT ADULT PSYCHIATRIC PCU'S - FMC, PLC, RGH Available Beds # of Discharges Average LOS Occupancy Rates RGH PCU % PCU % RGH Total 801 PLC PCU % PCU % SSU % PLC Total FMC PCU % PCU % PCU % FMC Total TOTAL ACUTE CARE Note: Occupancy rates for units are calculated using bed census days. source: HIR source: HIR source: HIR Residence SSU Adult Inpt - Urban Rural Other Alberta BC 9 11 Outside AB Out of Country/Unknown 2 2 discharges TOTAL source: HIR Age and Gender (excludes SSU) Female Male Total 0-17 years discharges TOTAL % 48% source: HIR 83

84 Adult Mental Health Electroconvulsive Therapy INPATIENT ADULT PSYCHIATRIC PCU'S - FMC, PLC, RGH Treatments Receiving ECT RGH Inpatient Outpatient RGH TOTAL PLC Inpatient Outpatient PLC TOTAL FMC Inpatient Outpatient FMC TOTAL ACUTE CARE TOTAL source:hir Mental Health Act of Alberta # Patients Formal # Patients 24 Hr Hold # PCU Discharges RGH PCU PCU RGH Total PLC PCU PCU SSU PLC Total FMC PCU PCU PCU FMC Total TOTAL % 21% Formal 24 Hr Hold source: HIR source: HIR source: HIR 84

85 Adult Mental Health INPATIENT ADULT PSYCHIATRIC PCU's BY DIAGNOSTIC CATEGORY Axis I, II, III Diagnoses are counted once per DSM-IV-TR category per discharge DSM-IV-TR Diagnostic Categories 5055 Diagnoses; 2251 Discharges Acute Care Total % per dx category # per dx category % per dx category # per dx category %per dx category # per dx category % per dx category Axis I Schizophrenia and Other Psychotic Disorders 41.9% (944) 43.4% (262) 41.5% (351) 41.3% (331) Mood Disorders 37.2% (837) 41.1% (248) 34.5% (292) 37.1% (297) Substance Related Disorders 27.8% (625) 27.8% (168) 31.4% (266) 23.8% (191) Other Conditions That May Be a Focus 16.2% (364) 17.9% (108) 13.8% (117) 17.4% (139) Adjustment Disorders 13.0% (293) 10.3% (62) 10.0% (85) 18.2% (146) Anxiety Disorders 10.6% (238) 7.5% (45) 12.3% (104) 11.1% (89) Disorders Usually First Dx'd in Infancy, Childhood 4.8% (108) 5.8% (35) 5.1% (43) 3.7% (30) Delirium, Dementia and Amnestic 1.9% (42) 3.8% (23) 1.8% (15) 0.5% (4) Mental Disorders Due to General Medical Condition 2.2% (50) 1.5% (9) 2.5% (21) 2.5% (20) Eating Disorders 1.3% (30) 0.5% (3) 2.6% (22) 0.6% (5) Impulse Control Disorders 0.8% (18) 0.5% (3) 1.3% (11) 0.5% (4) Sleep Disorders 0.4% (8) 0.2% (1) 0.5% (4) 0.4% (3) Dissociative Disorders 0.3% (6) 0.2% (1) 0.6% (5) 0.0% (0) Somatoform Disorders 0.5% (11) 0.2% (1) 0.8% (7) 0.4% (3) Factitious Disorders 0.1% (3) 0.0% (0) 0.4% (3) 0.0% (0) Additional Codes 0.0% (1) 0.2% (1) 0.0% (0) 0.0% (0) Sexual and Gender Identity Disorders 0.2% (4) 0.3% (2) 0.2% (2) 0.0% (0) Axis II Axis II Codes 13.6% (307) 13.4% (81) 14.9% (126) 12.5% (100) Axis III Axis III Codes 51.8% (1166) 54.3% (328) 53.7% (454) 47.9% (384) Note: Total Diagnosis count from MR through to 5th Diagnosis Diagnoses; 604 Discharges PLC (25, 27) 1928 Diagnoses; 846 Discharges 1746 Diagnoses; 801 Discharges FMC (21, 22, 23) RGH (45, 49) # per dx category 85

86 Adult Mental Health INPATIENT ADULT PSYCHIATRIC PCU's BY DIAGNOSTIC CATEGORY SSU comparison to Overall Adult Acute Care notable as SSU has unique adult admission criteria. Axis I, II Diagnoses are counted once per diagnosis within the DSM-IV-TR category. DSM-IV-TR Diagnostic Categories 5055 Diagnoses; 2251 Discharges Acute Care Total % per dx # per dx category category 2830 Diagnoses; 1408 Discharges PLC - SSU % per dx category # per dx category Axis I Schizophrenia and Other Psychotic Disorders 41.9% (944) 6.1% (86) Mood Disorders 37.2% (837) 18.5% (261) Substance Related Disorders 27.8% (625) 48.4% (682) Other Conditions That May Be a Focus 16.2% (364) 13.0% (183) Adjustment Disorders 13.0% (293) 42.6% (600) Anxiety Disorders 10.6% (238) 8.6% (121) Disorders Usually First Dx'd in Infancy, Childhood 4.8% (108) 7.2% (101) Delirium, Dementia and Amnestic 1.9% (42) 0.4% (5) Mental Disorders Due to General Medical Condition 2.2% (50) 0.6% (8) Eating Disorders 1.3% (30) 0.9% (12) Impulse Control Disorders 0.8% (18) 1.1% (16) Somatoform Disorders 0.4% (8) 0.2% (3) Dissociative Disorders 0.3% (6) 0.2% (3) Sleep Disorders 0.5% (11) 0.0% (0) Factitious Disorders 0.1% (3) 0.8% (11) Additional Codes 0.0% (1) 0.9% (13) Sexual and Gender Identity Disorders 0.2% (4) 0.0% (0) Axis II Axis II Codes 13.6% (307) 27.4% (386) Axis III Axis III Codes 51.8% (1166) 42.6% (600) Note: Total Diagnosis count from MR through to 5th Diagnosis. 86

87 JOINT SERVICES PDD & CHR What We Do Provide facilitation, support and the development of a common understanding between Addiction and Mental Health and the Persons With Developmental Disabilities to enhance service delivery for individuals with a developmental disability and a mental health diagnosis. Services Provided The following service is provided: consultation facilitation information support to address outstanding issues between the two organizations planning for the possible development of future specialized support services Who We Serve Adults with a developmental disability and a mental health diagnosis (dual diagnosis) Also, individuals who support or provide services to adults with a dual diagnosis Referral Process Contact: Manager, Joint Services PDD & CHR Admission Criteria Specialized service developed to support adults with a developmental disability and a mental health diagnosis (dual diagnosis) and the individuals who support them. Exclusion Criteria None identified

88 Adult Mental Health MENTAL HEALTH ACT of ALBERTA Designated Facilities within # Disch # 24 hr Hold # Formal % Formal FMC Unit % % % % PLC Unit % % % RGH Unit % % % SAFPC % Claresholm Centre for % source: HIR source: HIR source: HIR source: HIR source: CCC Note: A formal patient is defined as a person detained in a designated facility on the authority of 2 Admission Certificates or 2 Renewal Certificates. A 24 hour hold means a patient was conveyed and detained in a facility on the authority of either a Mental Health Warrant or Peace Officer's Power or 1 Admission Certificate. These patients never go on to become Formal during that stay. 88

89 MENTAL HEALTH OUTREACH Sheldon Chumir Centre Not available

90 Adult Mental Health MENTAL HEALTH OUTREACH - Sheldon Chumir Centre Formerly 8&8th Mental Health Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments * Unique Active Enrollmts Carryovers Discharges * A High volume 8&8th Mental Health Service discont. with move to Sheldon Chumir Referrals 241 No Shows - Average Wait Time (dys) - Direct Procedures (mode) 241 Indirect Time (hours) 140 Referral Source Alyth House 7.0% (16) CDIC 13.0% (32) SCC 1.0% (3) Self 39.0% (95) Sheriff King 5.0% (11) SOS 6.0% (15) YWCA-MDH 10.0% (23) Mustard Seed 7.0% (16) Other/Unknown 12.0% (30) referrals TOTAL 100.0% (241) source: manual stats source: manual stats source: manual stats source: manual stats Reason for Contact Medical & 9% (22) Mental Health and Addiction 9% (72) Mental Health and Medical 6% (47) Mental Health 4% (33) Medical 5% (44) Medical and Addiction 2% (15) Addiction 0% (2) Other/Blank 1% (6) referrals TOTAL 100.0% (241) Residence Gender Calgary 17% (41) No Fixed Address - Calgary 80% (193) Other 3% (7) referrals TOTAL 100.0% (241) source: manual stats source: manual stats Female 42% (101) Male 58% (139) unknown 0% (1) source: manual stats referrals TOTAL 100.0% (241) 90

91 Adult Mental Health MENTAL HEALTH OUTREACH - Sheldon Chumir Centre Diagnoses by DSM-IV-TR N = 224 Diagnoses, 241 Existing Enrollments (17 Diagnosis unknown) Primary Diagnoses counted to DSM-IV-TR category per existing enrollment. Axis I Axis II Axis III Axis IV Additional Codes Adjustment Disorders 4.6% (11) Anxiety Disorders 5.8% (14) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 0.4% (1) Factitious Disorders Impulse Control Disorders 0.4% (1) Mental Disorders due to General Medical Mood Disorders 10.4% (25) Other Conditions That May be a Focus 0.8% (2) Schizophrenia and Other Psychotic Disorders 15.4% (37) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 16.2% (39) Axis II 4.1% (10) Axis III 26.6% (64) Axis IV 8.3% (20) source: manual stats source: manual stats source: manual stats source: manual stats 91

92 MOBILE RESPONSE TEAM What We Do A multi-disciplinary team which offers outreach crisis intervention, prevention, urgent psychiatric assessments, critical incident stress management, respite beds and mental health educational presentations to individuals, groups and communities within the. Also available for professional consultations. Who We Serve Individuals and families currently experiencing a crisis or in distress whom may require professional assistance. Common issues include relationship problems, addictions, exposure to trauma and mental health concerns including but not limited to post partum depression, anxiety, psychosis, etc. Referral Process Professionals can call the direct lines o MRT South o MRT North o MRT Downtown Clients, families and friends call via Distress Centre Crisis Line

93 Adult Mental Health MOBILE RESPONSE TEAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) <1 Direct Procedures - Indirect Time (hours) - Referral Source Not available Residence - Urban 87% (445) - Rural 12% (63) Other Alberta 1% (5) BC 0% (0) Unknown/Rest of Canada 0% (1) existing enrollments TOTAL 100.0% (514) Reason for Closure Referred for Further Services 34% (175) Consultation Only 65% (332) Declined Services 1% (4) Mutual Agreement 0% (0) discharges TOTAL 100.0% (511) Age and Gender Female Male Total 0-17 years 8 9 (17) (69) (106) (101) (102) (52) >= (61) Unknown 2 4 (6) existing enrollments TOTAL (514) 60% 40% 93

94 Adult Mental Health MOBILE RESPONSE TEAM Diagnoses by DSM-IV N = 350 Diagnoses, 514 Existing Enrollments (164 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes 0.2% (1) Adjustment Disorders 6.8% (35) Anxiety Disorders 4.5% (23) Delirium, Dementia, and Amnestic 2.5% (13) Disorders Usually First Dx'd in Infancy Dissociative Disorders 0.2% (1) Eating Disorders 0.4% (2) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical 0.2% (1) Mood Disorders 18.5% (95) Other Conditions That May be a Focus 13.8% (71) Schizophrenia and Other Psychotic Disorders 8.2% (42) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 12.3% (63) Axis II 0.6% (3) None reported Note: MRT activity under-reported as client demographic information frequently unknown, therefore 'total' client enrollment volumes not able to be reported. The ARMHIS data collection system requires demographic data to enroll a client. 94

95 Adult Mental Health MOBILE RESPONSE TEAM - South Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) <1 Direct Procedures - Indirect Time (hours) - Referral Source Not available Residence - Urban 72% (104) - Rural 28% (40) Other Alberta 0% (0) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (144) Reason for Closure Referred for Further Services 23% (32) Consultation Only 77% (109) Declined Services 0% (0) Deceased 0% (0) discharges TOTAL 100.0% (141) Age and Gender Female Male Total 0-17 years 4 5 (9) (16) (38) (32) (24) (10) >= (14) Unknown 1 0 (1) existing enrollments TOTAL: (144) 64% 36% 95

96 Adult Mental Health MOBILE RESPONSE TEAM - South Diagnoses by DSM-IV-TR N = 107 Diagnoses, 144 Existing Enrollments (37 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes 0.7% (1) Adjustment Disorders 11.8% (17) Anxiety Disorders 6.3% (9) Delirium, Dementia, and Amnestic 1.4% (2) Disorders Usually First Dx'd in Infancy 1.4% (2) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.7% (1) Mental Disorders due to General Medical Mood Disorders 31.9% (46) Other Conditions That May be a Focus 6.9% (10) Schizophrenia and Other Psychotic Disorders 4.2% (6) Sexual Disorder Sleep Disorders Somatoform Disorders Substance Related Disorders 9.0% (13) None reported None reported Note: MRT activity under-reported as client demographic information frequently unknown, therefore 'total' client enrollment volumes not able to be reported. The ARMHIS data collection system requires demographic data to enroll a client. 96

97 Adult Mental Health MOBILE RESPONSE TEAM - North Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) <1 Direct Procedures - Indirect Time (hours) - Referral Source Not available Residence - Urban 90% (184) - Rural 9% (18) Other Alberta 0% (1) BC 0% (0) Unknown 0% (1) existing enrollments TOTAL 100.0% (204) Reason for Closure Referred for Further Services 56% (114) Consultation Only 44% (89) discharges TOTAL 100.0% (203) Age and Gender Female Male Total 0-17 years 4 7 (11) (29) (41) (41) (38) (20) >= (20) Unknown 2 2 (4) existing enrollments TOTAL: (204) 57% 43% 97

98 Adult Mental Health MOBILE RESPONSE TEAM - North Diagnoses by DSM-IV -TR N = 157 Diagnoses, 204 Existing Enrollments (47 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 25.5% (52) Anxiety Disorders 4.4% (9) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 2.0% (4) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 10.8% (22) Other Conditions That May be a Focus 10.3% (21) Schizophrenia and Other Psychotic Disorders 14.2% (29) Sleep Disorders Somatoform Disorders 1.0% (2) Substance Related Disorders 7.4% (15) None reported None reported Note: MRT activity under-reported as client demographic information frequently unknown, therefore 'total' client enrollment volumes not able to be reported. The ARMHIS data collection system requires demographic data to enroll a client. 98

99 NORTHWEST COMMUNITY MENTAL HEALTH CENTRE What We Do We provide assessment and treatment services to adults 18 and over with psychiatric problems. Services Provided Assessment and treatment services such as individual and group therapy as well as medication monitoring, outreach and home visiting are provided. Who We Serve Adults 18 and over with moderate to severe psychiatric problems that interfere with functioning. Referral Process How to Make a Referral All referrals to this program must be screened by Access Mental Health - Adult & Senior Services. Admission Criteria Adults 18 to 64 with a major psychiatric diagnoses Exclusion Criteria Developmental disabilities; substance abuse as a primary diagnosis; third party assessments

100 Adult Mental Health NORTHWEST COMMUNITY MENTAL HEALTH CENTRE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows 328* Average Wait Time (dys) 59 * any scheduled appt Direct Procedures 4426 Indirect Time (hours) 3327 Referral Source Not available Residence - Urban 97% (499) - Rural 3% (15) Other Alberta 0% (0) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (514) Reason for Closure Mutual Agreement 20% (49) Client Withdrew from Service 25% (60) Referred for Further Services 23% (55) Consultation Only 23% (57) Declined Services 9% (22) Deceased - suicide 0% (0) Deceased 0% (1) discharges TOTAL 100.0% (244) Age and Gender Female Male Total 0-17 years 0 0 (0) (42) (92) (129) (143) (91) >= (17) unknown 0 0 (0) existing enrollments TOTAL (514) 64% 36% 100

101 Adult Mental Health NORTHWEST COMMUNITY MENTAL HEALTH CENTRE Diagnoses by DSM-IV-TR N = 451 Diagnoses, 514 Existing Enrollments ( 59 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 2.9% (15) Anxiety Disorders 9.0% (46) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.2% (1) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 42.4% (216) Other Conditions That May be a Focus 0.8% (4) Schizophrenia and Other Psychotic Disorders 29.2% (149) Sleep Disorders Somatoform Disorders Substance Related Disorders 1.0% (5) Axis II 2.9% (15) None reported 101

102 OUTPATIENT MENTAL HEALTH What We Do The OPMH provides change-oriented psychotherapy to clients referred for treatment of mental disorders and interpersonal problems. Services Provided The program provides change oriented psychotherapy services. Specific approaches include individual and group therapy from Cognitive Behavioural and Psychodynamic orientations as well as individual, couple and family therapy from a Systems perspective. Who We Serve Clinical services are provided to clients between the ages of 16 and 64 with a DSM-IV disorder, with or without a physical component. Referral Process How to Make a Referral Referrals are accepted from psychiatrists and family physicians who practice within the Calgary Zone boundaries. All referrals to this program can be initiated by contacting Access Mental Health - Adult Services. Please call to initiate a referral. Admission Criteria Clients are admitted following a telephone intake and a review of the referral information by a Triage Committee as to the matching of the client s needs with the services offered and a congruence with the program s admission criteria. Exclusion Criteria Exclusion criteria include third party treatment requests, concurrent mental health treatment elsewhere and the presence of other readily available treatment options (e.g. employer EAP).

103 Adult Mental Health OUTPATIENT MENTAL HEALTH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 455 No Shows 5 Average Wait Time (dys) 208 Direct Procedures 8008 Indirect Time (hours) 878 Referral Source Access Mental Health 83% (378) RGH Day Program 7% (31) RGH Psych Assessm/Urgent Therapy 2% (11) MD Office 6% (29) Inpatient /Emerg/Other 1% (6) referrals TOTAL 100.0% (455) Residence - Urban 88% (557) - Rural 4% (24) Other Alberta 8% (48) BC 0% (1) Other 0% (0) existing enrollments TOTAL 100.0% (630) Age and Gender Female Male Total 0-17 years 1 0 (1) (47) (150) (136) (191) (102) >= (3) existing enrollments TOTAL (630) 72% 28% source: Triage source: Triage 103

104 Adult Mental Health OUTPATIENT MENTAL HEALTH Diagnoses by DSM-IV-TR N = 793 Diagnoses, 630 Existing Enrollments Axis I Axis II Axis III Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Additional Codes 31.6% (199) Adjustment Disorders 7.8% (49) Anxiety Disorders 25.2% (159) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.8% (5) Dissociative Disorders Eating Disorders 0.2% (1) Factitious Disorders Impulse Control Disorders 0.6% (4) Mental Disorders due to General Medical Mood Disorders 38.1% (240) Other Conditions That May be a Focus 15.6% (98) Schizophrenia and Other Psychotic Disorders 0.2% (1) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.3% (2) Substance Related Disorder 0.5% (3) Axis II 3.7% (23) Axis III 1.1% (9) 104

105 OUTPATIENT SCHIZOPHRENIA SERVICE - FMC What We Do Comprehensive outpatient assessment and treatment to individuals with schizophrenia and their families. Services Provided Continuous care to individuals with schizophrenia to support community integration. Who We Serve Diagnosed with Schizophrenia or Psychotic Disorder; Schizophrenia; Delusional Disorder; Psychotic Disorder; Schizophreniform Disorder; Schizoaffective Disorder. Referral Process Physician or Psychiatrist

106 Adult Mental Health OUTPATIENT SCHIZOPHRENIA SERVICE - FMC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 7029 Indirect Time (hours) 89 Referral Source Not available Residence - Urban 91% (667) - Rural 6% (41) Other Alberta 3% (25) BC 0% (1) Other 0% (2) existing enrollments TOTAL 100.0% (736) Age and Gender Female Male Total 0-17 years 3 7 (10) (82) (134) (120) (159) (115) >= (116) existing enrollments TOTAL (736) 45% 55% source: Triage 106

107 Adult Mental Health OUTPATIENT SCHIZOPHRENIA SERVICE - FMC Diagnoses by DSM-IV-TR N = 886 Diagnoses, 736 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 6.9% (51) Anxiety Disorders 3.8% (28) Delirium, Dementia, and Amnestic 0.8% (6) Disorders Usually First Dx'd in Infancy 2.7% (20) Dissociative Disorders 0.1% (1) Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 11.8% (87) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 82.1% (604) Sexual and Gender Identity Disorders Sleep Disorders 0.1% (1) Somatoform Disorders 0.1% (1) Substance Related Disorders 4.9% (36) Axis II Axis II 2.7% (20) Axis III Axis III 3.5% (31) 107

108 PRIMARY MENTAL HEALTH CARE - Sunridge Mall What We Do Primary Mental Health Care provides a broad range of mental health services including psychiatric consultation and various types of psychosocial treatment including individual, group and couple/family therapy. Specific types of therapy include cognitive behavioral, problemsolving, interpersonal, supportive, and systemic-narrative therapies. Who We Are The staff members of Primary Mental Health work together as a team. The professionals on the team include nurses, psychiatrists, clinical psychologists, social workers, occupational therapists and recreation therapists. In addition, the clinic offers training opportunities for advanced students in fields such as family medicine, psychiatry, and clinical psychology. Services Provided Multidisciplinary services include individual therapy, couple and family therapy, group therapy, and psychiatric consultation. A number of groups are available. Groups address specific concerns such as difficulties relating with others, depression, anxiety, panic disorder, and sexual abuse. There are also support groups that focus on maintaining or reintegrating individuals in the community and a stabilization/assessment group for individuals who are in crisis. In addition to addressing specific mental health and relationship issues, therapy also encourages healthy lifestyles and addresses return to work issues, as appropriate. Who We Serve Services are available to adults (16 to 64 years) in the community who have mental health and/or relationship concerns that would benefit from mental health intervention. Service is also provided to individuals referred from Psychiatric Emergency and Psychiatric Inpatient Units with the goals of preventing inpatient admission and/or facilitate timely discharge from hospital. Referral Process How to Make a Referral Referrals are accepted from physicians who practice within the. Referrals to Primary Mental Health can be initiated by contacting Access Mental Health - Adult Services. Admission Criteria Adults who are experiencing significant emotional and/or mental distress and who would benefit from mental health intervention. Exclusion Criteria Individuals with active psychosis, and/or whose primary problem includes addiction (alcohol, substance or gambling) are excluded from the clinic, as are individuals who are facing legal charges. Individuals who will be receiving ongoing mental health care elsewhere are also excluded from the clinic. The clinic does not accept third party requests for treatment.

109 Adult Mental Health PRIMARY MENTAL HEALTH CARE - Sunridge Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 625 No Shows 18 Average Wait Time (dys) 98 Direct Procedures 6763 Indirect Time (hours) 720 Referral Source MD Office 72% (450) Mental Health Outpatient Service 2% (15) Psychiatry (Inpt & Pgm) 13% (81) Psych ER 7% (41) Other 6% (38) referrals TOTAL 100.0% (625) Residence - Urban 88% (415) - Rural 7% (35) Other Alberta 5% (22) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (472) Age and Gender Female Male Total 0-17 years 0 0 (0) (50) (128) (113) (124) (46) >= (11) existing enrollments TOTAL (472) 76% 24% source: Triage source: Triage 109

110 Adult Mental Health PRIMARY MENTAL HEALTH CARE - Sunridge Diagnoses by DSM-IV-TR N = 735 Diagnoses, 472 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 9.1% (43) Adjustment Disorders 11.7% (55) Anxiety Disorders 35.8% (169) Delirium, Dementia and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 0.4% (2) Factitious Disorders Impulse Control Disorders 0.2% (1) Mental Disorders due to General Medical Mood Disorders 54.2% (256) Other Conditions That May be a Focus 17.8% (84) Schizophrenia and Other Psychotic Disorders 0.2% (1) Sexual and Gender Identity Disorders 0.4% (2) Sleep Disorders Somatoform Disorders 0.6% (3) Substance Related Disorders 3.4% (16) Axis II Axis II 12.1% (57) Axis III Axis III 6.3% (46) 110

111 PSYCHIATRIC ASSESSMENT SERVICE - FMC What We Do "PAS" is an outpatient program for individuals and their families experiencing acute emotional distress who are referred by a physician for psychiatric assessment, consultation and/or treatment. Services Provided Provide assessment, consultation, medication adjustment and monitoring, individual, couple, family or group therapy. Who We Serve Adults between the ages of 18 and 64. Referral Process Patients are referred: by a community physician. All community-based referrals are triaged through Access Mental Health. Phone: (403) Ext. 2, Fax: (403) Please contact Access Mental Health to help you initiate a referral or; directly to the program through the emergency department on an acute/crisis basis.

112 Adult Mental Health PSYCHIATRIC ASSESSMENT SERVICE - FMC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 670 No Shows 22 Average Wait Time (dys) 132 Direct Procedures 3914 Indirect Time (hours) 564 Referral Source Access Mental Health via GP 53% (352) Self 1% (8) Emergency 39% (262) Psych Emerg 4% (30) Psychiatrist 2% (16) Other 0% (2) referrals TOTAL 100.0% (670) Residence - Urban 88% (522) - Rural 5% (32) Other Alberta 6% (35) BC 0% (1) Other 0% (2) existing enrollments TOTAL 100.0% (592) Age and Gender Female Male Total 0-17 years 1 3 (4) (98) (146) (145) (135) (57) >= (7) existing enrollments TOTAL (592) 67% 33% source: Triage source: Triage 112

113 Adult Mental Health PSYCHIATRIC ASSESSMENT SERVICE - FMC Diagnoses by DSM-IV-TR N = 775 Diagnoses, 592 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 5.4% (32) Adjustment Disorders 8.1% (48) Anxiety Disorders 34.6% (205) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 1.0% (6) Dissociative Disorders Eating Disorders 2.4% (14) Factitious Disorders 0.2% (1) Impulse Control Disorders 0.7% (4) Mental Disorders due to General Medical Mood Disorders 58.6% (347) Other Conditions That May be a Focus 4.6% (27) Schizophrenia and Other Psychotic Disorders 1.0% (6) Sexual and Gender Identity Disorders Sleep Disorders 0.2% (1) Somatoform Disorders 2.4% (14) Substance Related Disorders 4.9% (29) Axis II Axis II 2.9% (17) Axis III Axis III 3.1% (24) 113

114 PSYCHIATRIC CONSULTATION CLINIC - RGH What We Do Psychiatric Consultation. Services Provided Psychiatric Assessment, one time consultation with patient and linkage with referring family physician. Who We Serve Adolescents (16 and over) and Adults Referral Process How to Make a Referral Family physicians must complete the Mental Health referral document. Admission Criteria Open Exclusion Criteria Third party requests Legal, insurance, AISH or Child Welfare involvement

115 Adult Mental Health PSYCHIATRIC CONSULTATION CLINIC - RGH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 455 No Shows 15 Average Wait Time (dys) 51 Direct Procedures 517 Indirect Time (hours) 637 Referral Source MD Office 100% (453) Mental Health Outpatient 0% (1) Inpatient 0% (0) Psych ER 0% (1) Other 0% (0) referrals TOTAL 100.0% (455) Residence - Urban 81% (252) - Rural 10% (30) Other Alberta 9% (28) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (310) Age and Gender Female Male Total 0-17 years 4 2 (6) (38) (54) (58) (70) (35) >= (49) existing enrollments TOTAL (310) 67% 33% source: Triage source: Triage 115

116 Adult Mental Health PSYCHIATRIC CONSULTATION CLINIC - RGH Diagnoses by DSM-IV-TR N = 520 Diagnoses, 310 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 20.3% (63) Adjustment Disorders 19.0% (59) Anxiety Disorders 31.6% (98) Delirium, Dementia, and Amnestic 5.2% (16) Disorders Usually First Dx'd in Infancy 0.6% (2) Dissociative Disorders Eating Disorders 1.3% (4) Factitious Disorders Impulse Control Disorders 0.3% (1) Mental Disorders due to General Medical 0.6% (2) Mood Disorders 52.6% (163) Other Conditions That May be a Focus 6.5% (20) Schizophrenia and Other Psychotic Disorders 3.2% (10) Sexual and Gender Identity Disorders 0.3% (1) Sleep Disorders 0.6% (2) Somatoform Disorders 1.9% (6) Substance Related Disorders 14.8% (46) Axis II Axis II 8.7% (27) Axis III Axis III 0.6% (3) 116

117 PSYCHIATRIC EMERGENCY SERVICES - FMC, PLC, RGH What We Do Crisis Intervention and Psychiatric Assessment for patients referred by Emergency Room Physician. The team functions in a consultant capacity. They will assess and make recommendations to the ER Physician or Psychiatrist. Services Provided Crisis Intervention Psychiatric Assessment Community support for discharged patients by Emergency Room Outreach Team Who We Serve All patients referred Referral Process How to Make a Referral Emergency Room Physician consults Psychiatric Emergency team and writes written order for consult. Admission Criteria Medically stable for assessment. Exclusion Criteria Medically unstable requiring treatment.

118 MENTAL HEALTH URGENT CARE - Sheldon Chumir Centre What We Do Urgent mental health assessment, crisis intervention and short term follow up. Services Provided Behavioural risk assessment, mental illness screening, psychosocial assessment, crisis intervention, access to urgent medical intervention, short term follow up and referral to appropriate services. Who We Serve Adults experiencing a mental health crisis related to abuse, violence, addictions, grief, stress, aging, relationships, anxiety and depression, suicidal thoughts and severe mental illness. Referral Process How to Make a Referral Clients should walk into Urgent Care, Sheldon Chumir Centre and ask to see a mental health clinician. Admission Criteria Individuals experiencing a mental health crisis. Exclusion Criteria Children, third party assessments and involuntary clients.

119 MENTAL HEALTH URGENT CARE South Calgary Health Centre What We Do The mental health services of the South Calgary Health Centre (SCHC) are designed to provide enhanced access to psychosocial intervention and brief psychotherapy for individuals and families with psychosocial and/or mental health concerns. While the location of the health centre is most suitable for those families residing in the south part of Calgary and nearby rural areas, all residents within the broader are able to utilize the services at South Calgary Health Centre. Services Provided Urgent mental health crisis assessment and psychosocial intervention are provided in South Calgary Health Centre Urgent Care. SCHC is not a designated facility and there is no psychiatrist on staff. Patients requesting or requiring same day psychiatric services should be directed to a Calgary Health Region Emergency Department. Hours of operation are , seven days per week No appointment needed Mental Health services are located on the main floor within Urgent Care. Go directly to the Urgent Care Triage Nurse.

120 Adult Mental Health PSYCHIATRIC EMERGENCY SERVICES - FMC, PLC, RGH URGENT CARE CENTRES Mental Health - SCHC, Sheldon Chumir NOTE: PES volumes are under-reported at Acute Care Sites (identifiers for PES clients under review) Client Contact Statistics Visits/Procedures FMC PLC RGH SCHC Sheldon C Residence Total # of Visits # of Visits Left Against Medical Advice Inpatient Admissions From Psych ER Admissions Through Psych ER n/a n/a Transfers From ER to Another Inpt Site FMC PLC RGH SCHC Sheldon C Urban Rural Other Alberta BC Other TOTAL visits source: HIR source: HIR source: HIR Age FMC PLC RGH SCHC Sheldon C 0-17 years >= TOTAL visits source: HIR Gender Female 53% 2736 Male 47% 2434 TOTAL visits 5170 source: HIR 120

121 PSYCHIATRIC EMERGENCY ROOM OUTREACH TEAM(S) What We Do Offer timely community based follow-up to clients who are referred by psychiatric emergency at all three acute care sites as well as South Calgary Health Centre and Sheldon Chumir. We are a mobile team that are able to meet with clients at their homes which allows us to effectively offer what the client needs due to having a first hand perspective. Services Provided We provide emotional or mental health support, intervention and problem solving. Education and information for client well being Linkages to services Client follow-up and support The services provided are on a short term basis with the client being followed for up to one month. If the client is needing further mental health support they will be connected to a longer term service. Who We Serve Persons from the full spectrum of mental health issues and disorders. Referral Process How to Make a Referral Referrals are made by the psychiatric emergency teams as a discharge support for when clients are seen in emergency. Admission Criteria Adults who are able to deal with their mental health issues when appropriate supports are available in the community. Exclusion Criteria Those individuals who are currently attached to another psychiatric service such as a clinic, and/or psychiatrist

122 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - FMC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 414 Indirect Time (hours) 36 Referral Source Not available Residence - Urban 80% (83) - Rural 11% (11) Other Alberta 9% (9) BC 1% (1) Other 0% (0) existing enrollments TOTAL 100.0% (104) Age and Gender Female Male Total 0-17 years 2 1 (3) (28) (23) (21) (15) (10) >= (4) existing enrollments TOTAL (104) 55% 45% 122

123 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - FMC Diagnoses by DSM-IV-TR N = 215 Diagnoses, 104 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 1.9% (2) Adjustment Disorders 38.5% (40) Anxiety Disorders 26.0% (27) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 3.8% (4) Dissociative Disorders Eating Disorders 3.8% (4) Factitious Disorders 1.0% (1) Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 52.9% (55) Other Conditions That May be a Focus 8.7% (9) Schizophrenia and Other Psychotic Disorders 8.7% (9) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 2.9% (3) Substance Related Disorders 22.1% (23) Axis II Axis II 7.7% (8) Axis III Axis III 7.0% (15) 123

124 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - PLC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 323 Indirect Time (hours) 16 Referral Source Not available Residence - Urban 87% (76) - Rural 3% (3) Other Alberta 9% (8) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (87) Age and Gender Female Male Total 0-17 years 2 1 (3) (16) (26) (11) (18) (4) >= (9) existing enrollments TOTAL (87) 56% 44% 124

125 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - PLC Diagnoses by DSM-IV-TR N = 145 Diagnoses, 87 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Adjustment Disorders 44.8% (39) Mood Disorders 48.3% (42) Additional Codes 4.6% (4) Substance Related Disorders 20.7% (18) Anxiety Disorders 16.1% (14) Schizophrenia and Other Psychotic Disorders 3.4% (3) Disorders Usually First Dx'd in Infancy 3.4% (3) Other Conditions That May be a Focus 6.9% (6) Impulse Control Disorders 1.1% (1) Eating Disorders 1.1% (1) Factitious Disorders Sexual and Gender Identity Disorders Delirium, Dementia, and Amnestic 1.1% (1) Dissociative Disorders Mental Disorders due to General Medical Sleep Disorders Somatoform Disorders 1.1% (1) Axis II Axis II 11.5% (10) Axis III Axis III 1.4% (2) 125

126 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - RGH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 499 Indirect Time (hours) 21 Referral Source Not available Residence - Urban 85% (116) - Rural 7% (10) Other Alberta 7% (10) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (136) Age and Gender Female Male Total 0-17 years 8 1 (9) (29) (27) (34) (14) (13) >= (10) existing enrollments TOTAL (136) 72% 37% 126

127 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - RGH Diagnoses by DSM-IV-TR N = 283 Diagnoses, 136 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 28.7% (39) Adjustment Disorders 47.8% (65) Anxiety Disorders 14.7% (20) Delirium, Dementia, and Amnestic 1.5% (2) Disorders Usually First Dx'd in Infancy. 1.5% (2) Dissociative Disorders Eating Disorders 0.7% (1) Factitious Disorders Impulse Control Disorders 0.7% (1) Mental Disorders due to General Medical Conditio Mood Disorders 42.6% (58) Other Conditions That May be a Focus 16.2% (22) Schizophrenia and Other Psychotic Disorders 8.1% (11) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 19.1% (26) Axis II Axis II 15.8% (19) Axis III Axis III 6.0% (17) 127

128 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - SCHC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 201 Indirect Time (hours) 9 Referral Source Not available Residence - Urban 88% (49) - Rural 5% (3) Other Alberta 7% (4) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (56) Age and Gender Female Male Total 0-17 years 0 2 (2) (13) (13) (13) (10) (3) >= (2) existing enrollments TOTAL (56) 62% 38% 128

129 Adult Mental Health PSYCHIATRIC EMERGENCY OUTREACH TEAM - SCHC Diagnoses by DSM-IV-TR N = 117 Diagnoses, 56 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 33.9% (19) Adjustment Disorders 35.7% (20) Anxiety Disorders 19.6% (11) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 1.8% (1) Factitious Disorders Impulse Control Disorders 3.6% (2) Mental Disorders due to General Medical Mood Disorders 51.8% (29) Other Conditions That May be a Focus 5.4% (3) Schizophrenia and Other Psychotic Disorders 14.3% (8) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 16.1% (9) Axis II Axis II 16.1% (9) Axis III Axis III 5.1% (6) 129

130 REGIONAL CAPACITY ASSESSMENT TEAM What We Do The Regional Capacity Assessment Team (RCAT) provides multi-disciplinary capacity assessments to clients within, as well as education and consultation services to professionals, caregivers, and service groups around capacity issues. Services Provided Capacity Assessments for clients with complex needs Formal educational presentations and in-services Consultations regarding specific clients in a variety of forums (e.g. case conferences, telephone consults) Scheduled informal consultation/educational sessions Second opinion requests Who We Serve Adult and geriatric clients across the health care continuum within. No exclusion criteria regarding diagnosis. Referral Process How to Make a Referral Referral can be made by faxing the RCAT Referral Form to (403) If there are questions whether this is the appropriate service please inquire at (403) RCAT must receive the following in order to process a referral: RCAT referral form completed in detail Copies of relevant prior formal assessments (e.g. specialists' reports, neuro-imaging results, discharge summaries from acute care sites or programs) Recent lab work results (e.g. CBC, electrolytes, folate, TSH, B12 and routine urinalysis) Exclusion Criteria Under 18 yrs of age.

131 Adult Mental Health REGIONAL CAPACITY ASSESSMENT TEAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 126 No Shows - Average Wait Time (dys) 22 Direct Procedures 84 Indirect Time (hours) - Referral Source Acute Care 50% (63) Community 50% (63) referrals TOTAL 100.0% (126) source: manual stats source: manual stats source: manual stats source: manual stats Residence - Urban 63% (80) - Rural 3% (4) Other Alberta 0% (0) BC 0% (0) Other/Unknown 0% (0) Discharges TOTAL 100.0% (84) source: manual stats Age Total 0-17 years 0% (0) % (1) % (2) % (8) % (10) % (15) >= 65 38% (48) Discharges TOTAL 100% (84) source: manual stats Gender Female 42% Male 58% source: manual stats 131

132 Adult Mental Health REGIONAL CAPACITY ASSESSMENT TEAM Diagnoses by DSM-IV-TR N = 168 Diagnoses, 84 Discharges Each Diagnosis is counted per DSM-IV-TR category. Axis I Additional Codes 64.3% (54) Adjustment Disorders 1.2% (1) Anxiety Disorders Delirium, Dementia, and Amnestic 20.2% (17) Disorders Usually First Dx'd in Infancy 3.6% (3) Dissociative Disorders Eating Disorders 1.2% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical 57.1% (48) Mood Disorders 10.7% (9) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 17.9% (15) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 23.8% (20) Axis II None reported Axis III None reported source: manual stats source: manual stats source: manual stats 132

133 REGIONAL MENTAL HEALTH HOUSING What We Do We contract with and monitor family homes to provide room, board, assistance and support in a family atmosphere to adults 18 and over with severe and persistent mental health problems. Services Provided Supervision of medication, diet, life skills and general activity. Clients have assigned community follow-up workers who work with the Approved Home Operator and client. Independent living support services are also provided. Who We Serve Adults 18 and over with severe or persistent mental health problems. Referral Process How to Make a Referral Clients must be referred by community follow up workers or discharge workers from inpatient programs. Admission Criteria Severe and persistent mental illness, stable, and will benefit from a supportive, structured family-like atmosphere. Exclusion Criteria No recent history of alcohol or drug abuse, aggressive behaviour or active forensic history.

134 Adult Mental Health REGIONAL MENTAL HEALTH HOUSING Mental Health Indicators New Enrollments 12 Existing Enrollments 111 Unique Active Enrollments - Carryovers - Discharges 8 Residence Referrals 39 Average Wait Time (days) - Direct Procedures - Indirect Procedure Time (hours) - - Urban/NFA Urban 20% (22) - Rural 4% (4) Claresholm Care Centre 0% (0) Other Alberta 4% (4) Unknown 73% (81) existing enrollments TOTAL 100.0% (111) Referral Source Claresholm Care Centre 5% (2) Calgary Inpatient Site 18% (7) Calgary Outpatient Service Area 62% (24) Alberta Hospital Ponoka 5% (2) Other 10% (4) referrals TOTAL 100.0% (39) Age Gender < 18 years 0% (0) % (2) % (6) % (10) % (31) % (54) >= 65 2% (8) existing enrollments 100.0% (111) Male 76% Female 35% Primary Diagnoses N= 111 Existing Enrollments Schizophrenia 85.6% (95) Bipolar Disorders 5.4% (6) Schizoaffective 5.4% (6) Other Diagnosis/Unknown 3.6% (4) existing enrollments 100.0% 111 source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats source: manual stats 134

135 REGIONAL PSYCHOLOGICAL ASSESSMENT SERVICE What We Do Provide psychological testing/assessment for: Psychiatric Assessment Service Primary Mental Health Care Urgent Therapy Psychiatric Assessment Clinic Treatment is done at the site where the client is already engaged in mental health treatment. Who We Serve Ages Clients already registered in the Psychiatric Assessment Service, Primary Mental Health Care, Urgent Therapy or the Psychiatric Assessment Clinic Referral Process How to Make a Referral Referrals are received from the therapists from the Psychiatric Assessment Service, Primary Mental Health Care, Urgent Therapy or the Psychiatric Assessment Clinic.

136 Adult Mental Health Mental Health Indicators REGIONAL PSYCHOLOGICAL ASSESSMENT SERVICE - FMC, RGH, Sunridge, Sheldon Chumir FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals - No Shows - Average Wait Time (days) - Direct Procedures 122 Indirect Procedure Time (hours) 149 source: manual stats Residence - Urban 100% (36) - Rural 0% (0) Other Alberta 0% (0) BC 0% (0) Other/Unknown 0% (1) existing enrollments TOTAL 100.0% (37) Age Female Male Total < (0) (7) (8) (6) (10) (6) >= (0) existing enrollments (37) 51% 49% 136

137 Adult Mental Health REGIONAL PSYCHOLOGICAL ASSESSMENT SERVICE - FMC, RGH, Sunridge, Sheldon Chumir Diagnoses by DSM-IV-TR N = 55 Diagnoses, 37 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 13.5% (5) Adjustment Disorders 5.4% (2) Anxiety Disorders 24.3% (9) Delirium, Dementia, and Amnestic 18.9% (7) Disorders Usually First Dx'd in Infancy 21.6% (8) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 35.1% (13) Other Conditions That May be a Focus 8.1% (3) Schizophrenia and Other Psychotic Disorders 2.7% (1) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 2.7% (1) Substance Related Disorders 2.7% (1) Axis II Axis II 10.8% (4) Axis III Axis III 1.8% (1) 137

138 RGH MENTAL HEALTH DAY TREATMENT SERVICE What We Do To provide intensive short-term treatment to individuals experiencing acute psychiatric symptoms who might otherwise require inpatient hospitalization. Services Provided Psychiatric assessment & consultation Individual counselling Therapeutic groups The program is structured as a full-day program to be completed in 4 weeks. The focus of the program is stabilization. Who We Serve Individuals are between the ages of 18 and 65 years Individuals who exhibit psychiatric symptoms of sufficient severity to bring about significant impairment in their ability to function day to day. Referral Process How to Make a Referral All referrals to this program must be screened by Access Mental Health - Adult & Senior Services. Physician referral only Completion of Referral History form (NB. Please ensure that all information is current e.g. telephone number, Health Care #) Program Facilitator will: 1. Conduct an assessment with the patient prior to the patient being admitted to determine appropriateness and patients commitment to change. 2. Establish a start date It is the assumption of the Day Program that the physician initiating the referral will be providing follow-up services. Any request arrangements for transfer of care are the responsibility of the referring physician. Admission Criteria Exhibiting psychiatric symptoms of sufficient severity to bring about significant impairment in their ability to function day to day Does not present as a danger to self to others Ability to tolerate a full day of activity Exclusion Criteria Danger to self and/or others Acutely psychotic Inability to make a commitment to a 4 week program Inability to address basic areas of self-care i.e. No social supports, lack of housing and/ or finances (including provision of medications) Currently using drugs and ETOH

139 No physician follow-up Diagnosis of anti-social personality Current ECT treatment Receiving treatment from other Mental Health Services that would conflict with the services and expectations of the program and/or be a duplication of service

140 Adult Mental Health RGH - MENTAL HEALTH DAY TREATMENT SERVICE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 313 No Shows 7 Average Wait Time (dys) 14 Direct Procedures Indirect Time (hours) 538 Referral Source Inpatient 52% (163) Psych ER 36% (112) MD Offfice/Psychiatrist 3% (10) Urgent Therapy - RGH 3% (8) Outpt Mental Health Services 5% (15) Other 2% (5) referrals TOTAL 100.0% (313) source: Triage source: Triage Residence - Urban 83% (220) - Rural 11% (28) Other Alberta 6% (17) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100% (265) Age and Gender Female Male Total 0-17 years 3 0 (3) (44) (74) (56) (57) (28) >= (3) existing enrollments TOTAL (265) 72% 28% 140

141 Adult Mental Health RGH - MENTAL HEALTH DAY TREATMENT SERVICE Diagnoses by DSM-IV-TR N = 481 Diagnoses, 265 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Each Axis III counted. Additional Codes 9.4% (25) Adjustment Disorders 31.7% (84) Anxiety Disorders 20.8% (55) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.4% (1) Dissociative Disorders Eating Disorders 2.3% (6) Factitious Disorders 0.4% (1) Impulse Control Disorders 0.4% (1) Mental Disorders due to General Medical Mood Disorders 61.1% (162) Other Conditions That May be a Focus 3.4% (9) Schizophrenia and Other Psychotic Disorders 2.3% (6) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.8% (2) Substance Related Disorders 7.2% (19) Axis II Axis II 31.7% (84) Axis III Axis III 5.4% (26) 141

142 SHARED MENTAL HEALTH CARE What We Do The Shared Mental Health Care (SMHC) program helps family physicians to assess, treat, and manage their patients' mental health concerns through regular consultation provided at the physician's practice. SMHC's two main objectives include (1) enhancing physician knowledge, basic skill level, and general comfort in managing mental health concerns and (2) improving mental health services for patients in primary care settings. Services Provided The Shared Mental Health Care program involves collaborative relationships between primary care providers (i.e., family physicians) and mental health consultants (e.g., psychiatric nurses, clinical social workers, psychologists, psychiatrists). SMHC consultation services include assessment, intervention, and educational activities, which occur during regular appointments attended by the family physician, shared care consultant, and the patient(s). Consultation can also occur without patients in the form of discussions regarding assessment, treatment, mental health resources, and referral issues. These services provide support for the family physician, who retains primary mental health care responsibility for patients. Finally, an Alternative Payment Plan enables the family physician to bill for participating in the previous SMHC consultation services. Who We Serve Family physicians within the represent our target population. Referral Process How to Make a Referral Family Physicians interested in joining Shared Mental Health Care can contact our office for more information. Admission Criteria Family Physician must practice within the and must have membership with the Medical Staff Association. They must also share a commitment to work collaboratively to address physician learning objectives and patient mental health concerns. Exclusion Criteria Family Physicians with members in the Department of Family Medicine.

143 Adult Mental Health SHARED MENTAL HEALTH CARE Contact by Patient Type New Patient 41% (766) Follow Up Patient 42% (784) Unknown/None 16% (306) Total 100.0% (1856) Contact Type General Consultation (unrelated to specific pt) 11% (207) Patient Discussed 16% (300) Patient Referred 10% (190) Paitient Seen 62% (1153) Other 0% (6) Total 100.0% (1856) Activity Type Assessment/Diagnosis 20% (372) Education 0% (1) Medication Advice 9% (165) Patient Progress 10% (186) Therapy Issues 29% (543) Unknown/None/Other 32% (589) Total 100.0% (1856) source: Pgm Stats source: Pgm Stats source: Pgm Stats 143

144 SHORT STAY UNIT 37 - FOLLOW UP CLINIC What We Do The Short Stay Unit Follow-up Clinic will provide very time limited, interim support to clients so as to "bridge" the timeframe between discharge from the Inpatient Short Stay Unit until they are connected to the recommended community service/program. Services Provided Commence/Review/Monitor Medications Discuss clients' progress towards achieving goals which were outlined on the Unit 37 Discharge Plan. Discuss clients' progress with ATAC Work Sheets (if applicable). Discuss alternative resources as needed. Community to patients' doctor and other involved community supports upon Discharge from clinic. Clinic Process minute appointments offered, number of sessions to be decided on by team. Meet with whole team. Discuss the steps the patient is taking to address recommendations from their Discharge Summary. Provide Support and encouragement to patients to continue to strive toward attainment of stated individual clients goals. Provide Support for client to continue to abstain from substances (where applicable). Discuss medications. Complete a Clinic Discharge Plan. Communicate with GP/Psychiatrist and identified community resources.

145 Adult Mental Health SHORT STAY UNIT 37 - Follow-Up Clinic Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows - Average Wait Time (dys) - Direct Procedures 1022 Indirect Time (hours) 0 - Urban 82% (187) - Rural 9% (21) Other Alberta 8% (18) BC 0% (0) Other 0% (1) existing enrollments TOTAL 100% (227) Age and Gender Female Male Total 0-17 years 9 1 (10) (40) (67) (55) (43) (8) >= (4) existing enrollments TOTAL (227) 54% 46% 145

146 Adult Mental Health SHORT STAY UNIT 37 - Follow-Up Clinic Diagnoses by DSM-IV-TR Diagnoses, 227 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 0.4% (1) Adjustment Disorders 45.8% (104) Anxiety Disorders 5.3% (12) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.9% (2) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.4% (1) Mental Disorders due to General Medical Mood Disorders 23.8% (54) Other Conditions That May be a Focus 4.0% (9) Schizophrenia and Other Psychotic Disorders 2.2% (5) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 29.1% (66) Axis II Axis II 15.4% (35) Axis III Axis III 0.7% (2) 146

147 URGENT THERAPY SERVICES What We Do Provide brief therapy to persons in crisis. Services Provided Individual Therapy Martial Therapy Family Therapy Who We Serve Adolescents and adults (16-64) in urgent need of therapy but not requiring an inpatient admission or day hospital. Referral Process How to Make a Referral Family doctor or psychiatrist submits Mental Health referral history form to triage. Admission Criteria In crisis Exclusion Criteria Drug or alcohol as a primary issue Legal involvement Third party request Involvement in concurrent therapy

148 Adult Mental Health URGENT THERAPY SERVICES Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 343 No Shows 10 Average Wait Time (dys) 27 Direct Procedures 1351 Indirect Time (hours) 169 Referral Source MD Office 90% (310) Psychiatric Consultation Clinic 2% (8) Psych Emergency 6% (22) Other MH Service 1% (3) Inpatient 0% (0) referrals TOTAL 100.0% (343) Residence - Urban 83% (268) - Rural 7% (22) Other Alberta 10% (31) BC 0% (1) Other 0% (0) existing enrollments TOTAL 100.0% (322) Age and Gender Female Male Total 0-17 years 5 0 (5) (51) (86) (90) (51) (36) >= (3) existing enrollments TOTAL (322) 65% 35% source: Triage source: Triage 148

149 Adult Mental Health URGENT THERAPY SERVICES Diagnoses by DSM-IV-TR N = 454 Diagnoses, 322 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 0.6% (2) Adjustment Disorders 52.5% (169) Anxiety Disorders 17.4% (56) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders 0.3% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 29.8% (96) Other Conditions That May be a Focus 29.8% (96) Schizophrenia and Other Psychotic Disorders Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.3% (1) Substance Related Disorders 1.6% (5) Axis II Axis II 8.1% (26) Axis III Axis III 0.4% (2) 149

150 WALK-IN THERAPY South Calgary Health Centre INFORMATION FOR PROVIDERS The mental health services of the South Calgary Health Centre (SCHC) are designed to provide enhanced access to psychosocial intervention and brief psychotherapy for individuals and families with psychosocial and/or mental health concerns. While the location of the health centre is most suitable for those families residing in the south part of Calgary and nearby rural areas, all residents within the broader Calgary Health Region are able to utilize the services at South Calgary Health Centre. Walk-In Therapy For all ages Walk-in therapy on a single-session basis is offered to clients across the lifespan with familyfocused care. No appointment or referral is necessary. Hours of operations are Monday to Thursday and from on Sunday. Closed Statutory Holidays and long weekends. Walk-in services for children and adolescents are also available at these times. Use North entrance. Located on the 2nd Floor in the Mental Health area. Take elevator director to 2nd Floor and ask for Walk-In.

151 Adult Mental Health WALK IN SERVICE - South Calgary Health Centre Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals - No Shows - Direct Procedures - Indirect Procedure Time (hours) - Average Wait Time To be Seen > 100 minutes 1% (7) % (53) % (66) % (45) % (124) % (146) % (233) % (171) discharges TOTAL 100.0% (845) Discharge Disposition Home/Return to Walk In 27% (226) Mental Health Outpatient Service/Outpt 3% (22) Community Agency/Program 30% (250) SCHC- MH Urgent Care 4% (33) Physician Office 2% (17) Access Mental Health 23% (194) Other 12% (103) discharges TOTAL 100.0% (845) source: SPSS Pgm Stats source: SPSS Pgm Stats source: SPSS gm Stats source: SPSS gm Stats source: SPSS Pgm Stats Age and Gender Female Male Total 0-17 years (122) (117) (201) (175) (136) (65) >= (29) discharges TOTAL (845) 57% 43% source: SPSS Pgm Stats 151

152 Adult Mental Health WALK IN SERVICE - South Calgary Health Centre Presenting Problem N = 845 discharges Presenting Problem counted once per discharge. Abuse/Violent Issues: Perpetrator 0.2% (2) Abuse/Violet Issues: Victim 0.5% (4) Addictions: Alcohol 1.3% (11) Addictions: Drugs 0.2% (2) Addictions: Gambling 0.2% (2) Addictions: Solvent 0.0% (0) Anger Management 4.3% (36) Anxiety 11.2% (95) Bipolar Disorder 0.2% (2) Caregiver Issues 0.7% (6) Concern on Behalf of a Family Member/Friend 4.1% (35) Couples/Relationship Issues 9.6% (81) Depression 20.2% (171) Development Issues 0.8% (7) Divorce/Separation 2.5% (21) Eating Disorders 0.4% (3) Family Relationship Issues 5.7% (48) Financial Problems 0.2% (2) Grief 0.9% (8) Illegal Activity 0.2% (2) Information about Mental Health Illness 2.6% (22) Job Loss 0.5% (4) Other 11.2% (95) Panic Disorder 0.5% (4) Parent/Child Relationship 1.8% (15) Physical Health Problems 0.8% (7) Post Partum Depression 0.6% (5) PTDD 0.6% (5) Relationship BreakUp 0.5% (4) School Problems 1.2% (10) Sexual Abuse: Child 0.2% (2) Situational Crisis 0.5% (4) Sleep Problems 0.9% (8) Stress 3.8% (32) Suicidal/Self Harm 2.0% (17) Unknown 6.7% (57) Work Related Stress 1.7% (14) source: SPSS Pgm Stats 152

153 AHS-Calgary Child/Adolescent MH Services Summary Includes 3,674 Mental Health Clients with 4,803 Enrollments/Admissions in Fiscal Year Calgary Urban Social Districts: Most Common Diagnoses Number of Clients with Dx Number of clients Male Female 329 Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Childhood Dx Personality Eating Disorder 50 Age and Gender North Rural South Rural East Rural West Rural Non-Urban Clients Area Number of Clients <= >=18 Age group Outside Calgary Region Homeless (Documented) Missing Postal Code These results describe clients registered in urban child and adolescent MH Services using data extracted from the RAIS, CARA. ARMHIS, and CHR inpatient data systems. Child and adolescent clients enrolled in rural and forensic programs are not counted here, but are included in the summaries for those program groups.

154 ADOLESCENT DAY TREATMENT PROGRAM What We Do To provide intensive multidisciplinary day treatment for adolescents experiencing moderate to severe mental health difficulties. Services Provided 15 desk capacity 3 month stay adolescent centered, family focused integrated credit granting school full interdisciplinary treatment partial hospitalization step down from hospital Who We Serve youth 13 to 17 in grades 7-12 moderate to severe mental health problems serves primarily internalizing disorders limited capacity for externalizing disorders Referral Process How to Make a Referral All referrals to this service can be initiated by contacting Access Mental Health - Child & Adolescent Services. Please call , Extension 1, to initiate a referral. Admission Criteria voluntary admission moderate to severe difficulties family/guardian participation Exclusion Criteria significant cognitive impairment risk to milieu primary substance abuse

155 Child and Adolescent Mental Health ADOLESCENT DAY TREATMENT PROGRAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmt Carryovers Discharges Referrals 91 No Shows - Average Wait Time (days) 35 Direct Procedures 5019 Indirect Time (hours) 377 Referral Source MH Services 66% (60) ACH 16% (15) Family Physician/Psychiatrist/Pediatrician 14% (13) Calgary Board of Education 3% (3) Other/Unknown 0% (0) referrals TOTAL 100.0% (91) Residence Urban 67% (67) Rural 3% (3) Other Alberta 2% (2) BC 0% (0) Other/Unknown 28% (28) existing enrollments TOTAL 100.0% (100) Age and Gender Female Male Total years 9 4 (13) (16) (25) (29) (7) unknown 0 0 (10) existing enrollments TOTAL (100) 56% 44% Diagnoses by DSM-IV-TR N = 187 Diagnoses, 85 Existing Enrollments Primary Diagnoses are counted once per each DSM-IV-TR category. Axis I Additional Disorders Adjustment Disorders 13.0% (13) Anxiety Disorders 47.0% (47) source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats cont'd 155

156 Child and Adolescent Mental Health ADOLESCENT DAY TREATMENT PROGRAM Axis II Axis III Delirium, Dementia and Amnestic Disorders Dissociative Disorders Eating Disorders 1.0% (1) Factitious Disorders Impulse Control Disorders 4.0% (4) Mental Disorders due to General Medical Mood Disorders 38.0% (38) Other Conditions That May be a Focus 7.0% (7) Schizophrenia and Other Psychotic Disorders 5.0% (5) Sleep Disorders Somatoform Disorders 1.0% (1) Substance Related Disorders 9.0% (9) Axis II 5.0% (5) Axis III 16.6% (31) 156

157 CALGARY EATING DISORDER PROGRAM Inpatient Program, Day Treatment ACH, Community Based Treatment Introduction The Calgary Eating Disorder Program is part of the and a member of the Southern Alberta Eating Disorder Network. The program provides specialized services to meet the needs of Albertan s, of all ages, a diagnosis of anorexia nervosa, bulimia nervosa, or an eating disorder not otherwise specified. A continuum of care spanning from promotion and prevention to early intervention, and treatment options are offered. A referral from a community family physician is required to access treatment. Philosophy The Eating Disorder Program uses a multimodal, interdisciplinary team approach to provide services across the continuum of care. This interdisciplinary team includes: therapists, nurses, dietitians, recreation therapists, occupational therapists, psychiatrists, pediatricians, and physicians. We believe it is imperative to work collaboratively as a team and include the patient and family in this process. In this respect, we strive to have the patient and family in control of their own treatment and give choices and options, within the boundaries of responsible care. We utilize a bio-psycho-social approach to treatment including all necessary team members to meet the needs of the patient and family. Each patient will work with a multidisciplinary team that could include members of the program staff, other hospital staff and community resources as appropriate. We respect the vast difference between people and situations and work with each patient at their stage of change, responding to their evolving needs. We believe in continuous learning and striving to improve services through evaluation and research, as well as promoting ongoing learning and education around best practices in the field. Mission Statement The mission of the Calgary Eating Disorder Program is to provide leadership and excellence in the areas of promotion, prevention, early intervention, consultation and treatment of eating disorders. This includes the provision of education/teaching, outreach, clinical services, consultation and research. We believe in an interdisciplinary team approach that is client and family centered and based on the core principles of respect, collaboration, open communication, professional excellence and responsible caring. It is our goal to provide a safe, comfortable, nurturing environment to enhance emotional, psychological and interpersonal development and support and promote wellness. Our overarching approach to treatment is based on motivational enhancement and readiness for change principles. We use the modalities of individual, family and group therapy to provide both psycho-education and psychotherapy.

158 Child and Adolescent Mental Health CALGARY EATING DISORDERS PROGRAM EDP = Inpatient program FMC, Day treatment ACH, Community Based Treatment Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 318 No Shows - Average Wait Time (days) 96 Direct Procedures 794 Indirect Procedure Time (hours) 4 Referral Source Physician/Psychiatrist Community 67% (214) Physician - CHR 20% (65) Other 3% (8) Unknown 10% (31) referrals TOTAL 100.0% (318) source: RAIS source: RAIS source: RAIS source: RAIS Age and Gender Female Male Total 0-11 years 1 0 (1) (116) (327) (19) existing enrollments TOTAL (463) 98% 2% source: RAIS 158

159 Child and Adloescent Mental Health CALGARY EATING DISORDERS PROGRAM - INPT at FMC Mental Health Indicators Discharges 67 Occupancy* 92.8% Average Length of Stay (days) 30.2 Number of Beds 6 Age =<13 years 0% % % % % 4 > 44 years 0% 0 discharges TOTAL 100.0% 67 source: Pgm stats source: Pgm stats Gender Female 97% 65 Male 3% 2 discharges TOTAL 100.0% 67 source: Pgm stats 159

160 CHILD & ADOLESCENT MENTAL HEALTH URGENT SERVICE (CAMHUS) ACH, FMC, PLC What We Do To offer direct professional mental health consultation for children, adolescents and their families who have urgent or emergent mental health concerns. Services Provided The team assesses children and adolescents presenting with acute suicidal/homicidal ideation and/or a mental state or illness that prevents them from being able to function in the community (e.g. psychoses). Subsequently, our team makes recommendations regarding admission and/or community supports to emergency physicians, psychiatric residents and psychiatrists. If a child or adolescent is admitted to an urgent bed on the Mental Health Inpatient Unit (ACH) or the Young Adult Program (FMC) or a medical unit (ACH) or an adult psychiatric unit at any of the sites. CAMHUS provides inpatient counseling and discharge planning. Short term outpatient follow-up may be offered as required. Who We Serve CAMHUS staff at the Alberta Children's Hospital work with children and adolescents aged 0 to 17 inclusive. CAMHUS staff at the Foothills Medical Centre and the Peter Lougheed Centre work with adolescents aged 13 to 17 inclusive. Referral Process How to Make a Referral Access the nearest emergency department for acute mental health crisis. Alternatively contact Access Mental Health. Admission Criteria Children and adolescents must be medically cleared by the ER physician (including no acute intoxication), and be at imminent risk to safety of self or others or experiencing an inability to function in the community due to mental state/illness (e.g. psychosis). Exclusion Criteria Our program is limited by the ability of the service to contain/treat the patient (e.g. secure services may be recommended as an alternative).

161 Child and Adolescent Mental Health CAMHUS - ADOLESCENT URGENT SERVICES Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 1108 No Shows - Average Wait Time (days) 3 Direct Procedures 1840 Indirect Time (hours) 373 source: RAIS source: RAIS source: Pgm Stats Referral Source Hospital - Inpatient 17% (189) Crisis/Emergency Services 4% (43) ACH 65% (718) Physician/Psychiatrist 5% (59) Community Agency 2% (25) Other 7% (74) referrals TOTAL 100.0% (1108) source: RAIS Residence Not available source: RAIS Age and Gender Female Male Total 0-11 years (143) (896) (56) unknown 0 0 (3) existing enrollments TOTAL (1098) 53% 47% source: RAIS Diagnoses by DSM-IV-TR Not available 161

162 CHILD & ADOLESCENT - SHARED MENTAL HEALTH CARE What We Do The Child and Adolescent Shared Mental Health Care (CASMHC) program helps family physicians assess, treat and manage the mental health concerns of their patients age 18 and under, through regular consultation provided at the physician's office. Services Provided The CASMHC program develops collaborative relationships between family physicians and mental health consultants (psychologists, social workers, nurses, psychiatrists). Consultation to the physician includes child/family assessment, brief intervention and referral to other resources. The team also provides educational activities for physicians. An Alternative Payment Plan enables the family physician to bill for participating in Shared Care consultation services. Who We Serve Family physicians within the Calgary Health Region represent our target population. Referral Process How to Make a Referral Family physicians interested in joining the program can contact the office at for further information. Admission Criteria Family Physician must practice within the and must have membership with the Medical Staff Association. They must also share a commitment to work collaboratively.

163 Child and Adolescent Mental Health CHILD & ADOLESCENT - SHARED MENTAL HEALTH CARE Mental Health Indicators FY0708 FY0809 New Enrollments - 74 Existing Enrollments - 98 Unique Active Enrollmts - - Carryovers - - Discharges - 65 Referrals 74 No Shows - Average Wait Time (days) n/a Direct Procedures Indirect Time (hours) n/a n/a source: RAIS source: RAIS source: Pgm Stats Referral Source Physician - Calgary Area 15% (11) Physician Community 85% (63) ACH 0% (0) Physician/Psychiatrist 0% (0) Community Agency 0% (0) Other 0% (0) referrals TOTAL 100.0% (74) source: RAIS Residence Not available source: RAIS Age and Gender Female Male Total 0-11 years (50) (39) (9) existing enrollments TOTAL (98) 31% 69% source: RAIS Diagnoses by DSM-IV-TR Not available 163

164 COLLABORATIVE MENTAL HEALTH CARE What We Do Program provides infant mental health consultation to community professionals. Parents may not self-refer to this program. Services Provided Provides consultation to community professionals, direct screening of child and family, referral to other resources, community education regarding the mental health needs/issues in preschool children and in some cases, brief intervention. Who We Serve Target population is community professionals who are concerned about the mental health of preschoolers in their care. These children often present with behavioral and/or development concerns. Referral Process How to Make a Referral Community professionals may submit a written request for consultation directly to the program, or through Access Mental Health. Admission Criteria all children 0-3 where family or referral source reside in Calgary, referred through Access Mental Health all children 0-3 referred by Calgary & Area Child & Family Services all children 0-5 where family or referral source resides in Northeast Calgary Exclusion Criteria outside age range

165 Child and Adolescent Mental Health COLLABORATIVE MENTAL HEALTH CARE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Enrollments Carryovers Discharges Referrals 416 No Shows - Average Wait Time (days) 30 Direct Procedures 4309 Indirect Procedure Time (hours) 718 Referral Source Calgary & Area Child and Family Svcs 13% (51) Physicians/Health Care 15% (56) Community Agencies/Programs 66% (251) Other 15% (56) Unknown 1% (2) referrals TOTAL 100.0% (416) Residence Urban 28% (135) Rural 1% (6) Other Alberta 0% (1) BC 0% (0) Unknown 70% (340) existing enrollments TOTAL 100.0% (483) Age and Gender Female Male Total Under 1 year (33) (89) (63) (97) (104) (66) (19) Over (12) existing enrollments TOTAL (483) 41% 59% source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats source: Pgm Stats Diagnoses by DSM-IV-TR None reported 165

166 COMPLEX KIDS What We Do Utilizes a consultation model providing support to Services, Child & Adolescent Mental Health, plus Calgary and Area Children's Services Authority for children and youth, who present with a matrix of complex concerns. Services Provided consultation and program information systems navigation case advocacy complex kids is unique in that it is not a program, nor an initiative, but a model for how collaborative services may be provided Who We Serve 0-18 years children's services status externalizing behaviours family system concerns involvement with multiple services Referral Process How to Make a Referral Referrals may be made to team clinicians who then review each referral at weekly intake meetings attended by all team members and team managers. Admission Criteria Target population serves as admission criteria. Exclusion Criteria Must have mental health involvement and children's services status.

167 Child and Adolescent Mental Health COMPLEX KIDS Complex Kids Number of Identified Complex Kids Transitional Youth Number of Identified Transition Youth source: RAIS source: RAIS 167

168 FAMILY, ADOLESCENT & CHILD SERVICES What We Do The program is a community-based outpatient mental health service for children, adolescents and families. Services Provided Provides individual, play, family and group therapy in a community clinic setting. Treatment approach is brief (12 sessions approximately) and episodic. Who We Serve Target population is children, adolescents and families experiencing moderate to severe mental health problems. Referral Process How to Make a Referral Referrals can be made from the community through Access Mental Health or internally from other Mental Health Programs. Admission Criteria children, adolescents, families moderate to severe mental health problems Exclusion Criteria 18 years of age and older mild mental health problems

169 Child and Adolescent Mental Health FAMILY, ADOLESCENT AND CHILD SERVICES (FACS) Mental Health Indicators Residence FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 674 No Shows - Average Wait Time (days) 7 Direct Procedures 6042 Indirect Procedure Time (hours) Calgary 107% (720) - Rural 8% (59) Other Alberta 0% (0) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (779) Referral Source Physician\Psychiatrist 23% (154) Acute Care Hospital 15% (99) Mental Health Outpatient Services 6% (40) Other Calgary Agency 2% (14) School Board (s) 3% (20) Other/Unknown 51% (347) referrals TOTAL 100.0% (674) Reason for Closure Client Withdrew from Service 30% (137) Consultation Only 15% (68) Deceased - Suicide 0% (0) Declined Services 3% (16) Mutual Agreement 51% (237) Referred for Further Services 9% (44) Single Session - Walk In 0% (0) discharges TOTAL 100.0% (464) source: RAIS/ARMHIS source: RAIS 169

170 Child and Adolescent Mental Health FAMILY, ADOLESCENT AND CHILD SERVICES (FACS) Age and Gender Female Male Total 0-7 years (54) (78) (123) (124) (193) (165) (28) > (11) unknown 2 1 (3) existing enrollments TOTAL (779) 54% 46% Diagnoses by DSM-IV-TR N = 579 Diagnoses, 779 Existing Enrollments (200 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 6.2% (48) Anxiety Disorders 16.2% (126) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 22.8% (178) Dissociative Disorders Eating Disorders 0.1% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 14.8% (115) Other Conditions That May be a Focus 11.9% (93) Schizophrenia and Other Psychotic Disorders 0.5% (4) Sexual Disorders Sleep Disorders 0.1% (1) Somatoform Disorders 0.5% (4) Substance Related Disorders 1.0% (8) Axis II 0.1% 1 None reported 170

171 HEALTHY MINDS / HEALTHY CHILDREN About Our Program Healthy Minds/Healthy Children offers a variety of resources and services to support and build capacity in primary care in the area of child and adolescent mental health. Our goals are: To help children and adolescents and their families access more services closer to home To build coordination within and across health regions and First Nations in Southern Alberta (e.g. supporting referrals/discharges to/from specialized or tertiary care) To facilitate the acquisition and sharing of knowledge and skills in children s mental health among primary care practitioners across Alberta. Services and resources include: Consultation (in-office, telephone, video conference/telehealth) to primary care physicians and clinicians Case or theme based in servicing or presentations on selected topics Internet-based professional development modules in children s mental health Practitioners Desk Reference to aid in efficient identification and management of children s mental health concerns Information prescriptions on various topics in children s mental health that practitioners can provide to their patients and clients What We Offer Online Continuing Professional Development modules in children s mental health. Busy professionals can access these modules at their convenience on any computer with Internet and audio capability. They are also able to interact with specialists and colleagues on the topics and related practice issues. Past registrants have come from all over Alberta, represent various health professions, and have been very satisfied with the convenience and ease of learning. Clinical consultations to primary care professionals in Southern Alberta on children s mental health cases. To date, hundreds of consultations have been conducted involving primary care physicians, clinicians and school personnel in communities and First Nations across Southern Alberta. Our clinical consultants are pleased to arrange presentations to professionals and clinical outreach to clinicians. Multidisciplinary Telehealth consultation services to primary care practitioners and families in Southern Alberta. This service introduces the use of interprofessional virtual

172 teams (children s mental health specialists from across Southern Alberta) who bring a diversity of expertise to the primary care practitioner. Information Prescriptions on a variety of mental health topics. These are handy short listings of information sources (books, websites, videos, etc.) busy practitioners can give to their patients and clients to help them understand more about their mental health concern. These lists are reviewed by children s mental health professionals to ensure they are relevant, accurate and current. A Desk Reference, published in April 2006, with plans for additional chapters and regular updates, provides primary care practitioners with practical information and tools for screening, identifying and managing mental health issues with children and youth

173 Child and Adolescent Mental Health HEALTHY MINDS, HEALTHY CHILDREN OUTREACH SERVICE Calgary - Urban Activity by Contacts Contacts 57 HM/HC Team Activity by Contacts Contacts 382 Total 439 source: Pgm Stats Activity by Contact Type Unspecified In-office 26 Phone 6 Total 439 source: Pgm Stats 173

174 MENTAL HEALTH INPATIENT CARE UNIT - ACH What We Do To provide tertiary treatment to children and their families for those with complex and severe mental health difficulties. Services Provided Family centered treatment interventions designed to increase child's capacity to grow, develop and have increased function socially and emotionally at home, at school and in the community. Who We Serve Children and teens under the age of 18 years who have social, emotional and behavioral challenges that are so severe they extend into and interfere with their ability to function safely at home, school and in their community. e.g. Depression, Adjustment Disorder, Reactive Attachment Disorder, ODD. Referral Process How to Make a Referral Referrals to this service can be initiated by contacting Access Mental Health - Child & Adolescent Services. Will need a family doctor/physician Parents/guardians required to be involved with treatment plans, process and goals of admission, and family therapy. Admission Criteria Under age of 18 years with severe emotional, social and behavioral difficulties whose difficulties have not been resolved in community based treatment facilities. Exclusion Criteria Over 18 years old Those who are medically unstable

175 Child and Adolescent Mental Health MHIPU - ACH Mental Health Indicators Discharges 363 Occupancy* 86.5% Beds 12 Average Length of Stay 11 Residence note: occupancy rate for unit are calculated using census days * nine beds funded Monday-Friday, three beds funded Saturday-Sunday. Urban 91% (267) Rural 24% (69) Other Alberta 9% (25) BC 1% (2) Other 0% (0) discharges TOTAL 100.0% (363) Age and Gender Female Male Total Under 6 years 2 7 (9) (36) (38) (61) (93) > = (126) discharges TOTAL (363) 50% 46% Diagnoses by DSM-IV-TR N = 947 Diagnoses, 363 Discharges Diagnoses (first 5) are counted once per DSM-IV-TR category per discharge. Axis I Additional Codes 0.6% (2) Adjustment Disorders 13.8% (50) Anxiety Disorders 27.5% (100) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy. 52.1% (189) Dissociative Disorders 0.8% (3) Eating Disorders 2.8% (10) Factitious Disorders Impulse Control Disorders 0.6% (2) Mental Disorders due to General Medical 0.6% (2) Mood Disorders 37.7% (137) Other Conditions That May be a Focus 48.5% (176) Schizophrenia and Other Psychotic Disorders 3.6% (13) Sexual and Gender Identity Disorders 0.8% (3) Sleep Disorders Somatoform Disorders Substance Related Disorders 13.2% (48) source: HIR source: HIR source: HIR source: HIR 175

176 Child and Adolescent Mental Health Axis II Axis III MHIPU - ACH Axis II 6.9% (25) Axis III 19.7% (187) source: HIR source: HIR No Electroconvulsive Therapy (ECT) procedures were performed on MHIP Unit patients during this reporting period. 176

177 MENTAL HEALTH DAY PATIENT ACH Not available

178 Child and Adolescent Mental Health MENTAL HEALTH DAY PATIENT - ACH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 87 No Shows - Average Wait Time (days) 50 Direct Procedures 147 Indirect Procedure Time (hours) 4 Referral Source Physician/Psychiatrist 19% (13) Alberta Children's Hospital 78% (54) Physician 6% (4) Community Mental Health Clinic 6% (4) Other/unknown 17% (12) referrals TOTAL 100.0% (87) source: RAIS source: RAIS source: RAIS source: RAIS Residence Not available source: RAIS Age and Gender Female Male Total 0-11 years 9 41 (50) (37) (1) existing enrollments TOTAL (88) 27% 73% source: RAIS Diagnosis by DSM-IV-TR Not available 178

179 MULTIDISCIPLINARY CONSULTATION SERVICE (MDCS) What We Do MDCS provides specialized outpatient multidisciplinary consultation (assessment and short term treatment) services. Services Provided The service is organized into five specialty clinics each with multidisciplinary membership: Attention Deficit Disorder Clinic Mood & Anxiety Disorder Clinic Oppositional Defiant/Conduct Diagnosis Clinic Diagnostic Clinic Consultation Liaison Clinic Consultation may include: assessment, and/or brief episodic treatment as required. Staff also engages in related clinical research, education and training. Who We Serve Youth (0-18) with moderate to severe treatment resistant mental health disorders. In most cases community based services will have been exhausted prior to referral. Referral Process How to Make a Referral Referrals are made by either Child & Adolescent Mental Health staff/physicians, other Calgary Zone services, or through Access Mental Health. Admission Criteria Youth under 18 years of age with moderate to severe treatment resistant mental health disorders.

180 Child and Adolescent Mental Health MULTIDISCIPLINARY CONSULTATION SERVICE - MENTAL HEALTH SPECIALTY RRDTC Specialty Clinics: ADHD, MH Diagnostics, Mood/Anxiety,ODD/CD, Consultation Liaison Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 395 No Shows - Average Wait Time (days) 109 Direct Procedures 1834 Indirect Procedure Time (hours) 20 Referral Source Physician/Psychiatrist Community 53% (211) Alberta Children's Hospital 10% (40) Physician CHR 11% (45) Community Mental Health Clinic 6% (23) Other 19% (76) referrals TOTAL 100.0% (395) source: RAIS source: RAIS source: RAIS source: RAIS Residence Not available source: RAIS Age and Gender Female Male Total 0-11 years (259) (335) (24) > (9) existing enrollments TOTAL (627) 33% 67% source: RAIS Diagnosis by DSM-IV-TR Not available 180

181 PEDIATRIC BEHAVIORAL DEVELOPMENT CLINIC What We Do The clinic provides assessment, case management and counselling to families with children with mild to moderate behavioral and developmental difficulties. Services Provided pediatric, social work and nursing assessment and treatment consultation with schools and other community resources parent education individual and family counselling Who We Serve children aged 12 years and under children who require diagnostic clarification and management beyond that available in a primary care environment children with behavioral and academic difficulties children with suspected developmental delay Referral Process How to Make a Referral Community referrals through Access Mental Health Internal referrals directly to clinic Admission Criteria children 12 and under and their families mild to moderate behavioral and developmental difficulties Exclusion Criteria over 12 years of age severe mental health problems or child requiring multidisciplinary assessment and treatment

182 Child and Adolescent Mental Health PEDIATRIC BEHAVIOURAL DEVELOPMENT CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 90 No Shows - Average Wait Time (days) 86 Direct Procedures 972 Indirect Procedure Time (hours) 152 Referral Source Physician/Psychiatrist - Community 43% (39) Alberta Children's Hospital 11% (10) Other 33% (30) Physician/Psychiatrist - CHR 9% (8) Community Agency/Professional 3% (3) referrals TOTAL 100.0% (90) Residence Urban 92% (189) Rural 6% (13) Other Alberta 2% (4) BC 0% (0) Other 0% (0) existing enrollments TOTAL 100.0% (206) Age and Gender Female Male Total 0-11 years yrs yrs unknown existing enrollments TOTAL % 75% source: RAIS source: RAIS 182

183 Child and Adolescent Mental Health PEDIATRIC BEHAVIOURAL DEVELOPMENT CLINIC Diagnosis by DSM-IV-TR N = 213 Diagnoses, 206 Existing Enrollments Axis I Axis II Axis III Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Additional Codes 1.0% (2) Adjustment Disorders 4.9% (10) Anxiety Disorders 0.5% (1) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 87.9% (181) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders Other Conditions That May be a Focus 9.2% (19) Schizophrenia and Other Psychotic Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders None Reported None Reported 183

184 STUDENT HEALTH PARTNERSHIP What We Do The Calgary Rocky View Student Health Partnership (SHP) Mental Health Services works with students ECS through Grade 12 with mild to moderate mental health needs. Services are school based. Services Provided Services are school based and range from consultation, individual therapy and case management. The service focuses on short term goals that will have a lasting impact on helping students reach their learning potential. Who We Serve Students who present with mild to moderate mental health concerns. Any student with an unmet health need who is registered in school from ECS to Grade 12. Referral Process How to Make a Referral Referrals are made through the school. The school team will help to determine whether SHP is the best fit. Admission Criteria Any student with an unmet health need who is registered in a school program from ECS to Grade 12. The student's health needs impact their educational outcomes. Exclusion Criteria The student must not require crisis intervention. The student is receiving other services.

185 Child and Adolescent Mental Health STUDENT HEALTH PARTNERSHIP - MENTAL HEALTH Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 273 No Shows - Average Wait Time (days) 13 Direct Procedures 146 Indirect Procedure Time (hours) 9 source: RAIS source: RAIS source: RAIS Referral Source Calgary Board of Education 60% (164) Separate School Board 36% (71) Other 19% (37) unknown 1% (1) referrals TOTAL 100.0% (273) source: RAIS Age and Gender Female Male Total 0-11 years (172) (189) (14) existing enrollments TOTAL (375) 36% 64% source: RAIS Diagnosis by DSM-IV-TR Not available 185

186 UNIT 26 YOUNG ADULT PROGRAM - FMC What We Do To provide brief inpatient stabilization, assessment and treatment to adolescents experiencing severe mental health disorders. Services Provided 3 bed short stay service Stabilization, initial assessment, treatment recommendations. 12 Acute Care Beds Full multidisciplinary assessment and treatment services Credit granting school Who We Serve Youth Parental/guardian consent Presenting with acute psychiatric symptoms Suffering from a severe mental health disorder Referral Process How to Make a Referral All referrals are made through Access Mental Health. Admission Criteria Parental consent or certification under the Mental Health Act Unsuitable for less intrusive services Presentation of acute psychiatric symptoms Exclusion Criteria Adolescents engaging in criminal behaviour Significant cognitive impairment/intellectual challenges Primary substance abuse issues Placement concerns

187 Child and Adolescent Mental Health UNIT 26 FMC - YOUNG ADULT PROGRAM Mental Health Indicators Discharges 163 Occupancy* 99.2% Beds 15 Average Length of Stay 32.4 Residence note: occupancy rate for unit are calculated using census days Urban 76% (128) Rural 15% (26) Other Alberta 5% (8) BC 1% (1) Other 0% (0) discharges TOTAL 100.0% (163) Age and Gender Female Male Total <13 years & Over discharges TOTAL % 43% Diagnoses by DSM-IV-TR N = 459 Diagnoses, 163 Discharges Diagnoses (first 5) are counted once per DSM-IV-TR category per discharge. Each Axis III counted. Axis I Additional Codes Adjustment Disorders 19.0% (31) Anxiety Disorders 38.7% (63) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy. 45.4% (74) Dissociative Disorders 0.6% (1) Eating Disorders 5.5% (9) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical 1.8% (3) Mood Disorders 42.3% (69) Other Conditions That May be a Focus 18.4% (30) Schizophrenia and Other Psychotic Disorders 14.1% (23) Sexual and Gender Identity Disorders 1.2% (2) Sleep Disorders 1.2% (2) Somatoform Disorders 0.6% (1) Substance Related Disorders 34.4% (56) source: HIR source: HIR source: HIR source: HIR 187

188 Child and Adolescent Mental Health UNIT 26 FMC - YOUNG ADULT PROGRAM Axis II Axis III Axis II 10.4% (17) Axis III 17.0% (78) Mental Health Act of Alberta N = 163 discharges Formal Patients 45% (73) 24 Hour Hold 9% (14) source: HIR source: HIR source: HIR No Electroconvulsive Therapy (ECT) procedures were performed on YAP patients during this reporting period. 188

189 YOUNG ADULT SERVICES - OUTPATIENT What We Do To provide transitory outpatient treatment to adolescents discharged from Unit 26, Foothills Medical Centre or those who are at high risk for admission to hospital. Services Provided Limited capacity outpatient service Annual capacity limit of 15 clients Psychiatry, psychology and family counselor resources provided by Young Adult Program, Unit 26 staff Who We Serve Youth Parental/guardian consent Acute psychiatric symptoms Severe mental health disorder Referral Process How to Make a Referral Child & Adolescent Mental Health Program internal referral only. Admission Criteria Voluntary Parental/guardian consent Unsuitable for less intrusive service Acute psychiatric symptoms Exclusion Criteria Adolescents engaging in criminal behaviour Significant cognitive impairment/intellectual challenges Primary substance abuse issues Placement concerns

190 Child and Adolescent Mental Health YOUNG ADULT SERVICES - OUTPATIENT Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 24 No Shows - Average Wait Time (days) - Direct Procedures 899 Indirect Procedure Time (hours) 24 Referral Source Physician Calgary Area 92% (22) Psychiatrist 4% (1) Community Agency 4% (1) referrals TOTAL 100.0% (24) Residence Urban 78% (86) Rural 16% (18) Other Alberta 5% (5) BC 0% (0) Other/Rest of Canada 1% (1) existing enrollments TOTAL 100.0% (110) source: RAIS source: RAIS Age and Gender Female Male Total <=12 years 0 0 (0) (8) (9) (13) (21) (22) >= (37) unknown 0 0 (0) existing enrollments TOTAL (110) 56% 44% 190

191 Child and Adolescent Mental Health YOUNG ADULT SERVICES - OUTPATIENT Diagnoses by DSM-IV-TR N = 169 Diagnoses, 110 Existing Enrollments Axis I Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Each Axis III counted. Axis I Additional Codes Adjustment Disorders 12.7% (14) Anxiety Disorders 37.3% (41) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy. 25.5% (28) Dissociative Disorders Eating Disorders 1.8% (2) Factitious Disorders 0.9% (1) Impulse Control Disorders 0.9% (1) Mental Disorders due to General Medical Mood Disorders 47.3% (52) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 8.2% (9) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 11.8% (13) Axis II Axis II 9.6% (8) Axis III Axis III 2.7% (4) 191

192 AHS-Calgary Forensic MH Services Summary Includes 2,733 Mental Health Clients with 3,009 Enrollments/Admissions in Fiscal Year Calgary Urban Social Districts: Most Common Diagnoses Number of Clients with Dx Number of clients Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Childhood Dx Personality Impulse Control Age and Gender Male Female <= >=65 Age group 24 North Rural South Rural East Rural West Rural Non-Urban Clients Area Outside Calgary Region Homeless (Documented) Missing Postal Code Number of Clients These results describe clients registered in four urban forensic MH Services (FAP, FAOS, SAFPC, and the Calgary Diversion Program) using data extracted from the Triage, ARMHIS, and CHR inpatient data systems.

193 CALGARY DIVERSION SERVICE What We Do Calgary Diversion Services strives to divert mentally ill offenders with low risk non violent offences from the Justice system to the Mental Health system through coordinated community action. Services Provided individual assessment identify needs identify goals link to appropriate services if goals met, recommend withdrawal of charges Who We Serve Adults, 18 years of age or older suffering from an Axis I mental illness who is charged with a less serious criminal offence. Referral Process How to Make a Referral All referrals must be approved by the Crown Prosecutor's office and before sentencing or plea either in court or call us at Admission Criteria Adult Axis I diagnosis low risk non violent offence crown approved referral Exclusion Criteria No Axis I diagnosis violent or high risk offence Crown Prosecutor does not approve or case has already been plead and sentenced in court Mental Health & Addictions Services Calgary Health Region Year End Service Summary

194 Southern Alberta Forensic Psychiatry Services CALGARY DIVERSION SERVICE Mental Health Indicators Residence FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals n/a No Shows n/a Average Wait Time (days) 18 Direct Procedures - Indirect Procedure Time (hours) - Calgary 75% (127) Rural 24% (40) Other Alberta 1% (2) BC 0% (0) Unknown/Rest of Canada 1% (1) existing enrollments TOTAL 100.0% (170) Reason for Closure Referred for Further Services 25% (26) Consultation Only 10% (11) Client Withdrew from Service 9% (10) Declined Services 4% (4) Mutual Agreement 42% (44) discharges TOTAL 100.0% (106) Age and Gender Female Male Total 0-17 years 6 1 (7) (32) (53) (29) (26) (14) >= (3) Unknown 3 3 (6) existing enrollments TOTAL (170) 42% 58% source: Pgm Stats 194

195 Southern Alberta Forensic Psychiatry Services CALGARY DIVERSION SERVICE Diagnoses by DSM-IV-TR N = 159 Diagnoses, 170 Existing Enrollments (11 - Primary diagnosis unknown) Diagnoses are counted once to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 9.4% (16) Anxiety Disorders 10.0% (17) Delirium, Dementia, and Amnestic 0.6% (1) Disorders Usually First Dx'd in Infancy 2.4% (4) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 34.7% (59) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 30.6% (52) Sexual and Gender Identity Disorders 0.6% (1) Sleep Disorders Somatoform Disorders Substance Related Disorders 4.7% (8) Axis II 0.6% (1) None reported 195

196 COMMUNITY GEOGRAPHIC TEAM RESOURCES What We Do The Community Geographic Team Resources, Southern Alberta Forensic Services provides mental health services to mandated clients in the Southern Health Zones via satellite clinics in Red Deer, Lethbridge and Medicine Hat and by traveling clinics to rural areas and Treaty Seven First Nation Communities. Services Provided Community Geographic Teams (CGT) are defined as dedicated resources which include direct and indirect services to rural areas, regional centres and aboriginal communities for those individuals who have difficulty accessing assessment and treatment due to distance, transportation, and lack of locally available forensic mental health expertise. Telemental Health (TMH) is an important component of service delivery. Telemental Health services use audio visual conference technology to deliver mental health services. It is an established and efficient option in situations where geographical distances preclude the delivery of necessary and timely services for forensic mental health assessment, treatment, consultation and educational services in regional centres and rural areas of Southern Alberta Health Zones. Who We Serve Individuals 12 years of age or older Individuals in conflict with the law Individuals thought to have mental health problems Individuals legally mandated for assessment and treatment services Individuals who require assessment and treatment for mental health or behavioral problems Referral Process How to Make a Referral Referral is by a court order for Pre-trial and Pre-sentence assessments. It is helpful if a clear referral question is asked and, where available, all background information be attached (e.g. details of the offence, police reports, court transcripts, and criminal record of the accused). When probation officers or other agencies are making a referral, where possible, the standard FAOS referral form should be used. Again it is helpful if background information is sent (e.g. PSR, PDR, PIS, PO) and a clear reason for the referral. Admission Criteria Clients mandated to attend by a court order/request for mental health issues and are subject to the Criminal Code of Canada and the Youth Criminal Justice Act. (However, will consult on complex cases where there is a possible high risk of offending behaviour) Addiction && Mental Health

197 Exclusion Criteria Non Mandated clients Self referrals Referrals from the family court or child welfare with requests related to parenting skills or suitability Do not see persons on federal orders (i.e. parole) Addiction && Mental Health

198 Southern Alberta Forensic Psychiatry Services Zones 1-4 COMMUNITY GEOGRAPHIC TEAM RESOURCES - SOUTHERN ALBERTA Contact Information Registered Patients (admissions) 557 Referrals 558 Discharges 454 No Shows/Cancellations 941 source: Pgm Stats Contacts by Health Region Indirect Direct Lethbridge Area (102) (1169) Medicine Hat Area (30) (882) Calgary Area (542) (1020) Red Deer Area (1058) (1047) contacts TOTAL (1732) (4118) source: Pgm Stats Referral Source By Service Provider Probation 94% (527) Court (pre-sentence) 4% (25) Self 0% (0) Community Agency/Community MH Clinics 1% (6) referrals TOTAL 100.0% (558) Client Type Adult 88% (491) Adolescent 12% (66) admissions TOTAL 100.0% (557) Reason for Discharge Treatment Discontinued by Client 27% (121) Treatment Concluded 38% (173) Mandate Expired 17% (75) Assessment Completed 8% (37) Moved 11% (48) discharges TOTAL 100.0% (454) source: Pgm Stats source: Pgm Stats source: Pgm Stats Telemental Health Events Consultations/Case Review 81% (26) Assessments 19% (6) Treatment 0% (0) TOTAL 100.0% (32) source: Pgm Stats 198

199 FORENSIC ADOLESCENT PROGRAM What We Do The Forensic Adolescent Program is part of the Southern Alberta Forensic Psychiatry Services,, providing mental health outpatient services to youth who are legally mandated for assessment and/or treatment services. Services Provided Psychiatric/Psychological Court Order Assessments Individual/Family/Group Therapy Psychiatric Management Services Recreational Assessment and Planning Services Consultation Services to Community Agencies Outreach Mental Health Services Who We Serve Youth who are between 12 and 18 years of age and are residents of Southern Alberta and in conflict with the law and thought to have mental health problem(s). Referral Process How to Make a Referral Referrals are made directly by the courts, probation, and other community agencies. Completed referrals can be mailed or faxed in. Or one can contact our triage coordinator to make a referral or to consult over the telephone. Admission Criteria Between the ages of Must be in conflict with the legal/court/justice system Preferably mandated for assessment and treatment Exclusion Criteria As we are only an outpatient service, youth who have high mental health needs, require more intensive services or deemed to require inpatient services are not accepted. We do not provide Emergency Mental Health Services. Addiction && Mental Health

200 Southern Alberta Forensic Psychiatry Services FORENSIC ADOLESCENT PROGRAM (FAP) Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 432 No Shows - Average Wait Time (days) 15 Direct Procedures 2270 Indirect Procedure Time (hours) - Referral Source Probation/Court/Correction Centre 49% (212) Section 13 Psych 34% (146) Mental Health Service/Inpatient 4% (19) Self/Parent 0% (1) Youth Services 11% (47) Other 2% (7) referrals TOTAL 100.0% (432) Residence Urban 36% (194) Rural 8% (44) Other Alberta 2% (9) BC 0% (0) Unknown 55% (297) existing enrollments TOTAL 100.0% (544) Age and Gender Female Male Total 0-15 years (251) (293) (0) existing enrollments TOTAL (544) 19% 81% source: Triage source: Triage source: Pgm Stats source: Triage source: Triage source: Triage 200

201 Southern Alberta Forensic Psychiatry Services FORENSIC ADOLESCENT PROGRAM (FAP) Diagnoses by DSM-IV-TR N = 596 Diagnoses, 544 Existing Enrollments (38 missing Primary Dx) Diagnoses are counted by frequency per DSM-IV-TR category Axis I & II. Axis I Additional Codes 2.2% (12) Adjustment Disorders 3.7% (20) Anxiety Disorders 3.7% (20) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 5.9% (32) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 38.4% (209) Mental Disorders due to General Medical Mood Disorders 3.7% (20) Other Conditions That May be a Focus 5.7% (31) Schizophrenia and Other Psychotic Disorders 0.4% (2) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Abuse/Dependency 29.4% (160) Axis II Axis II 19.6% (90) Axis III None reported source: Triage source: Triage source: Triage 201

202 FORENSIC ASSESSMENT AND OUTPATIENT SERVICE What We Do The Forensic Assessment and Outpatient Service (FAOS) provides court-mandated and court requested assessment and treatment to persons with mental health issues and are in trouble with the law. Services Provided Individual counselling Couples counselling Sex Offender Treatment Program The Family Violence Treatment Program Cognitive-Behavioural Therapy groups Who We Serve Individuals 18 years of age or older Individuals in conflict with the law Individuals thought to have mental health problems Individuals legally mandated for assessment and treatment services Individuals requiring assessment and treatment for mental health or behavioural problems Referral Process How to Make a Referral Referral is by a court order for Pre-trial and Pre-sentence assessments. It is helpful if a clear referral question is asked and, where available, all background information be attached (e.g. details of the offence, police reports, court transcripts, and criminal record of the accused). When probation officers or other agencies are making a referral, where possible, the standard FAOS referral form should be used. Again it is helpful if background information is sent (e.g. PSR, PDR, PIS, PO) and a clear reason for the referral. Admission Criteria Clients mandated to attend by a court order/request for mental health issues and are subject to the Criminal Code of Canada. (However, will consult on complex cases where there is a possible high risk of offending behaviour) Exclusion Criteria Non Mandated clients Self referrals Referrals from the family court or child welfare with requests related to parenting skills or suitability Do not see persons on federal orders (i.e. parole) Addiction && Mental Health

203 Southern Alberta Forensic Psychiatry Services FORENSIC ASSESSMENT & OUTPATIENT SERVICE (FAOS) Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Referrals 944 No Shows - Average Wait Time (days) 50 Direct Procedures 9749 Indirect Procedure Time (hours) - Referral Source Probation Officer 64% (604) Judge/Court 21% (194) Inpatient 5% (46) MH Service/Community Pgm 3% (28) Physician/Psychologist/Psychiatrist 3% (25) Other /Unknown 5% (47) referrals TOTAL 100.0% (944) Residence Urban 68% (1383) Rural 3% (68) Other Alberta 1% (28) BC 0% (2) Unknown 28% (565) existing enrollments TOTAL 100.0% (2046) Age and Gender Female Male Total 0-17 years 0 6 (6) (353) (592) (551) (374) (132) >= (38) existing enrollments TOTAL (2046) 18% 82% source: Triage source: Triage source: Pgm Stats source: Triage source: Triage source: Triage 203

204 Southern Alberta Forensic Psychiatry Services FORENSIC ASSESSMENT & OUTPATIENT SERVICE (FAOS) Diagnoses by DSM-IV-TR N = 910 Diagnoses, 2044 Existing Enrollments (906 Primary Dx Unknown) Diagnoses are counted by frequency per DSM-IV-TR category Axis I & II. Axis I Additional Codes 8.8% (168) Adjustment Disorders 6.1% (116) Anxiety Disorders 1.0% (19) Delirium, Dementia, and Amnestic 0.2% (3) Disorders Usually First Dx'd in Infancy 0.3% (5) Dissociative Disorders 0.2% (3) Eating Disorders 0.2% (3) Factitious Disorders Impulse Control Disorders 0.6% (12) Mental Disorders due to General Medical 0.0% (0) Mood Disorders 5.4% (103) Other Conditions That May be a Focus 10.0% (192) Schizophrenia and Other Psychotic Disorders 1.6% (31) Sexual and Gender Identity Disorders 1.8% (34) Sleep Disorders Somatoform Disorders 0.2% (3) Substance Related Disorders 11.1% (213) Axis II Axis II 13.4% (256) Axis III None reported source: Triage source: Triage source: Triage 204

205 SOUTHERN ALBERTA FORENSIC PSYCHIATRY CENTRE (SAFPC) What We Do Provision of court order psychiatric assessment and psychiatric stabilization for adults (18 years and over). Services Provided Services are provided to the entire southern portion of the Province of Alberta. Assessment to determine Fitness to Stand Trial, Criminal Responsibility, Dangerous Offender, Long-Term Offender assessments, and Pre-sentence Risk assessments. Stabilization of acutely mentally ill offenders or those who have become certified under the Mental Health Act while incarcerated. Who We Serve Male and female adults who have a Warrant of Detention and acute mental health concerns or those with a warrant remanding them to the Southern Alberta Forensic Psychiatry Centre (SAFPC) for assessment. Referral Process How to Make a Referral ordered by a judge transfer under a Director's letter on a temporary absence from a correctional facility or remand centre Admission Criteria current criminal charges, Warrant of Detention and Mental Health Certificate or acute mental illness warrant remanding accused to SAFPC Exclusion Criteria under 18 years of age adult offenders answering to young offender charges those with a Notice to Appear rather than a Warrant of Remand Addiction && Mental Health

206 Southern Alberta Forensic Psychiatry Services SOUTHERN ALBERTA FORENSIC PSYCHIATRIC CENTRE Mental Health Indicators Discharges 305 Occupancy* 99% Beds 29 Average Length of Stay days 30 * occupancy based on monthly bed census reports Residence Urban 65% (196) Rural 8% (25) Other Alberta 25% (74) BC 1% (4) Other 2% (6) discharges TOTAL 100.0% (305) Age and Gender Female Male Total 0-17 years 0 1 (1) (80) (105) (68) (34) (10) >= (7) discharges TOTAL (305) 9% 91% Diagnoses by DSM-IV-TR N = 700 Diagnoses, 305 Discharges Diagnoses (first 5) are counted once per DSM-IV-TR category per discharge. Axis I Additional Codes 10.8% (33) Adjustment Disorders 3.9% (12) Anxiety Disorders 2.6% (8) Delirium, Dementia, and Amnestic 2.0% (6) Disorders Usually First Dx'd in Infancy 9.2% (28) Dissociative Disorders 0.3% (1) Eating Disorders Factitious Disorders 0.3% (1) Impulse Control Disorders 0.7% (2) Mental Disorders due to General Medical 0.3% (1) Mood Disorders 15.7% (48) Other Conditions That May be a Focus 9.2% (28) Schizophrenia and Other Psychotic Disorders 23.3% (71) Sexual and Gender Identity Disorders 5.2% (16) Sleep Disorders Somatoform Disorders Substance Related Disorders 67.5% (206) continued source: HIR source: HIR source: HIR source: HIR 206

207 Southern Alberta Forensic Psychiatry Services SOUTHERN ALBERTA FORENSIC PSYCHIATRIC CENTRE Axis II Axis III Axis II 40.0% (122) Axis III 16.7% (117) Mental Health Act of Alberta N = 305 discharges Formal 4.9% (15) 24 Hour Hold 3.0% (9) source: HIR source: HIR source: HIR No Electroconvulsive Therapy (ECT) procedures were performed on SAFPC patients during this reporting period. 207

208 AHS-Calgary Geriatric MH Services Summary Includes 2,021 Mental Health Clients with 2,450 Enrollments/Admissions in Fiscal Year Calgary Urban Social Districts: Number of Clients with Dx Number of clients Most Common Diagnoses Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Dementia/Delirium Personality General Med. Male Female Age and Gender North Rural South Rural East Rural West Rural Non-Urban Clients Area Outside Calgary Region Number of Clients <= >= 95 Age group Homeless (Documented) Missing Postal Code 0 33 These results describe clients registered in seven urban geriatric MH Services (Community Geriatric Mental Health Services, Geriatric Mental Health Outreach Team, Geriatric Mental Health Consulting Services, Geriatric Rural Consultation/Outreach Service, South Calgary Community Geriatric Mental Health, Sunridge Community Geriatric Mental Health, Geriatric Psychiatric Care Unit (RGH Unit 48)) using data extracted from the GMHIS and CHR inpatient data systems. Most rural geriatric MH clients are not included here, but are in the rural summary.

209 Carewest GERIATRIC MENTAL HEALTH REHABILITATION & RECOVERY UNIT What We Do Active Rehabilitation - intermediate step between acute inpatient services and the community, allowing patients additional time for assessment and rehabilitation prior to discharge. Services Provided Screening, assessment and implementation of an individual's treatment program. Case management focuses on the whole person in a broad context of function, goals and life situation, as well as the management and monitoring of partially resolved acute psychiatric and medication conditions. Who We Serve Age 65 and over, with psychiatric disorders who are stable, responding to treatment, yet need a period of time to "settle", have high psychosocial needs and will likely benefit from rehabilitation services. Referral Process How to Make a Referral Have to be seen by psychiatry prior to referral. Form to be completed and faxed to unit with accompanying information (i.e. indicator of waitlist time and acceptance sent to referring party). Admission Criteria Stable from both medical and psychiatric perspective have potential for improvement in functional abilities willing and able to participate in rehab program need additional time to improve ADLs, IADLs and life skills Exclusion Criteria primary disorder of dementia or substance abuse complex medical and/or psych problems requiring further significant investigation degree of dementia that impedes rehab potential behavior that puts self or others at risk

210 Geriatric Mental Health CAREWEST GERIATRIC MENTAL HEALTH RECOVERY & REHABILITATION UNIT Occupancy Referrals 162 Discharges 154 Occupancy 98% # of Beds 20 ALOS 46 Discharge Disposition Discharge to Home 47% (73) Discharge Home with Support 35% (54) Transfer to Another Acute Care Site 4% (6) Transfer to Continuing Care Facility 3% (5) Transferred to Other Care 5% (8) Signed Out 5% (8) discharges TOTAL 100.0% (154) source: Carewest source: HIR source: HIR Residence Urban 91% (140) Rural 9% (14) Other Alberta 0% (0) BC 0% (0) Other 0% (0) discharges TOTAL 100.0% (154) source: HIR Age and Gender Female Male Total Under 65 years 6 6 (12) (74) (56) (11) 95 & Over 1 0 (1) discharges TOTAL (154) 69% 31% source: HIR 210 CalgaryZone

211 Geriatric Mental Health CAREWEST GERIATRIC MENTAL HEALTH RECOVERY & REHABILITATION UNIT Diagnoses by DSM-IV-TR N = 154 Diagnoses, 154 Discharges Most Responsible Diagnoses counted per DSM-IV-TR category per discharge. Axis I Additional Codes Adjustment Disorders 1.9% (3) Anxiety Disorders 20.1% (31) Delirium, Dementia, and Amnestic 1.9% (3) Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.6% (1) Mental Disorders due to General Medical 1.3% (2) Mood Disorders 68.2% (105) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 1.3% (2) Sleep Disorders Somatoform Disorders Substance Related Disorders 2.6% (4) Axis II Axis II 0.0% (0) Axis III Axis III 1.9% (3) source: HIR source: HIR source: HIR 211 CalgaryZone

212 COMMUNITY GERIATRIC MENTAL HEALTH SERVICES What We Do We provide mental health services to seniors who are living in North East Calgary with moderate to severe age related mental health concerns. Consultation with clinicians is provided on a limited basis to Sunridge professionals. Services Provided Comprehensive assessment, treatment, outreach and follow-up services includes caregiver support Individual and group treatment services for seniors with mood disorders, other long standing mental health conditions, and those with age related dementia. Interdisciplinary team including psychiatry provide clinic based and in-home services. Involve the family physician and other caregivers in the assessment and treatment plan. Provide educational resources to the client, caregiver and community partners on mental health issues affecting seniors. This program does not provide crisis intervention.

213 Geriatric Mental Health COMMUNITY GERIATRIC MENTAL HEALTH SERVICES Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 658 No Shows - Average Wait Time (days) 59 Direct Procedures 7972 Indirect Procedure Time (hours) 899 Referral Source Acute Care Facility 0% (0) Physician/Psychiatrist 41% (275) Self/Family/Significant Other 0% (0) Community/Regional Service 0% (1) Specialized Geriatric Service 1% (5) Supported Living Services 0% (0) Unknown 57% (377) referrals TOTAL 100.0% (658) Residence Urban 96% (624) Rural 0% (3) Other Alberta 0% (3) BC 0% (0) Other/Unknown 3% (21) existing enrollments TOTAL 100.0% (651) Age and Gender Female Male Total < 65 years (31) (252) (260) (102) 95 >= 4 0 (4) unknown 0 0 (2) existing enrollments TOTAL (651) 72% 28% source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS 213

214 Geriatric Mental Health COMMUNITY GERIATRIC MENTAL HEALTH SERVICES Diagnoses by DSM-IV-TR N = 1272 Diagnoses, 651 Existing Enrollments All Diagnoses are counted per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 5.4% (35) Adjustment Disorders 7.4% (48) Anxiety Disorders 10.3% (67) Delirium, Dementia, and Amnestic 16.4% (107) Disorders Usually First Dx'd in Infancy Dissociative Disorders 0.5% (3) Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 36.7% (239) Other Conditions That May be a Focus 2.3% (15) Schizophrenia and Other Psychotic Disorders 8.4% (55) Sexual and Gender Identity Disorders 0.3% (2) Sleep Disorders Somatoform Disorders 0.3% (2) Substance Related Disorders 1.8% (12) Axis II Axis II 24.1% (157) Axis III Axis III 41.7% (530) source: GMHIS source: GMHIS source: GMHIS 214

215 COMMUNITY GERIATRIC MENTAL HEALTH SERVICE South Calgary Health Centre What We Do We provide mental Health services to seniors who are living in south Calgary with moderate to severe age-related mental health concerns. Consultation with clinicians or Geriatric psychiatrist is provided on a limited basis to SCHC professionals. Services Provided Comprehensive assessment, treatment, outreach and follow-up services, including caregiver support. Individual and group treatment services for seniors with mood disorders, other long standing mental health conditions, and those with age related dementia. Interdisciplinary team (including psychiatry) provide clinic based and in-home services. Involvement of the family physician and other caregivers in the assessment and treatment plan. Provide educational resources to the client, caregiver and community partners on mental health issues affecting seniors. This program does not provide crisis intervention. Who We Serve Clients 65 years of age and older with an age related mental health problems or under 65 with a progressive dementia. Referral Process How to Make a Referral All referrals are directed to the main referral line at Admission Criteria Clients 65 years of age and older with an age related mental health problems or under 65 with a progressive dementia. Must be living in the community (private dwelling, lodge, DAL, group home).

216 Geriatric Mental Health COMMUNITY GERIATRIC MENTAL HEALTH SERVICES - South Calgary Health Centre Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 141 No Shows - Average Wait Time (days) 39 Direct Procedures 1371 Indirect Procedure Time (hours) 399 Referral Source Self/Family 39% (55) Physician 54% (76) Regional Service 4% (5) Community Agency 1% (1) Acute Care 0% (0) Specialized Geriatric Services 3% (4) Supported Living Services 0% (0) referrals TOTAL 100.0% (141) Residence Urban 98% (120) Rural 1% (1) Other Alberta 0% (0) BC 0% (0) Other/Unknown 2% (2) existing enrollments TOTAL 100.0% (123) Age and Gender Female Male Total < 65 years 5 2 (7) (37) (51) (26) 95 >= 0 1 (1) unknown 0 0 (1) existing enrollments TOTAL (123) 72% 28% source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS 216

217 Geriatric Mental Health COMMUNITY GERIATRIC MENTAL HEALTH SERVICES - South Calgary Health Centre Diagnoses by DSM-IV-TR N = 403 Diagnoses, 123 Existing Enrollments All Diagnoses counted per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 4.9% (6) Adjustment Disorders 14.6% (18) Anxiety Disorders 10.6% (13) Delirium, Dementia, and Amnestic 46.3% (57) Disorders Usually First Dx'd in Infancy 1.6% (2) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 25.2% (31) Other Conditions That May be a Focus 3.3% (4) Schizophrenia and Other Psychotic Disorders 2.4% (3) Sexual Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 4.1% (5) Axis II Axis II 43.1% (53) Axis III Axis III 52.4% (211) source: GMHIS source: GMHIS source: GMHIS 217

218 COMMUNITY GERIATRIC MENTAL HEALTH SERVICES Sunridge Mall What We Do We provide mental health services to seniors who are living in the community with moderate to severe age-related mental health concerns. Services Provided Comprehensive assessment, treatment, outreach and follow-up services, including caregiver support. Individual and group treatment services for seniors with mood disorders, other long standing mental health conditions, and those with age related dementia. Interdisciplinary team, including psychiatry, provide clinic based and in-home services. Involve the family physician and other caregivers in the assessment and treatment plan. Provide educational resources to the client, caregiver and community partners on mental health issues affecting seniors. This program does not provide crisis intervention. Who We Serve Client 65 years and older with age-related mental health problems or under 65 with a progressive dementia. Must be living in the community (includes private dwelling, lodge, DAL, group home). Referral Process How to Make a Referral Anyone may initiate a direct referral to the program. It is strongly recommended that the family physician be involved in the referral process. This program works closely with Senior's Health One Line Referral to support client access to appropriate service. Admission Criteria 65 or older with an age-related mental health concern or disorder, living in the community (urban). All referrals made in agreement with the family physician. Exclusion Criteria Seniors who are a patient of another psychiatrist.

219 Geriatric Mental Health Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 131 No Shows - Average Wait Time (days) 59 Direct Procedures 1164 Indirect Procedure Time (hours) 150 Referral Source Community Agency/Regional Service 1% (1) Physician/Psychiatrist 45% (59) Self/Family/Other 2% (2) Special Geriatric Mental Health Service 1% (1) Supported Living Services 1% (1) Unknown 51% (67) referrals TOTAL 100.0% (131) Residence COMMUNITY GERIATRIC MENTAL HEALTH SERVICES Sunridge Mall Urban 93% (99) Rural 2% (2) Other Alberta 0% (0) BC 0% (0) Other/Unknown 6% (6) existing enrollments TOTAL 100.0% (107) Age and Gender Female Male Total < 65 years 1 3 (4) (52) (32) (18) 95 >= 0 1 (1) existing enrollments TOTAL (107) 70% 30% source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS 219

220 Geriatric Mental Health COMMUNITY GERIATRIC MENTAL HEALTH SERVICES Sunridge Mall Diagnoses by DSM-IV-TR N = 282 Diagnoses, 107 Existing Enrollments All Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 3.7% (4) Adjustment Disorders 3.7% (4) Anxiety Disorders 19.6% (21) Delirium, Dementia, and Amnestic 17.8% (19) Disorders Usually First Dx'd in Infancy 0.9% (1) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.9% (1) Mental Disorders due to General Medical Mood Disorders 30.8% (33) Other Conditions That May be a Focus 2.8% (3) Schizophrenia and Other Psychotic Disorders 11.2% (12) Sleep Disorders Somatoform Disorders Substance Related Disorders 0.9% (1) Axis II Axis II 30.8% (33) Axis III Axis III 53.2% (150) source: GMHIS source: GMHIS source: GMHIS 220

221 GERIATRIC MENTAL HEALTH CONSULTING SERVICE What We Do This team provides multidisciplinary consultation to continuing care centres for residents >65 years, with psychiatric/behavioural problems secondary to a wide range of organic and functional mental health disorders. The service also provides consultation and education to care centre staff regarding behavior management and other mental health issues. Services Provided Consultation and education services to support care centres in dealing with elderly residents with mental health concerns. Who We Serve Clients 65 years of age and older living in a care centre environment or those under 65 with a progressive dementia or age related mental illness. Primarily serve clients with late stage dementia. Referral Process How to Make a Referral Physician Referral required. Care Center staff phone or fax referrals to program. Admission Criteria 65 years or older, residing in a Continuing Care facility or on a Transition Unit within the Calgary Zone (urban). Exclusion Criteria Residents in Continuing Care facilities or Transition Units under age 65 (unless there is a progressive dementia associated with aging), or who are under the care of a psychiatrist. Not an urgent service.

222 Geriatric Mental Health GERIATRIC MENTAL HEALTH CONSULTING SERVICES Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 796 No Shows - Average Wait Time (days) 12 Direct Procedures 7645 Indirect Procedure Time (hours) 895 Referral Source Physician 98% (784) Other Regional Service 0% (1) Other 0% (2) Unknown 1% (9) referrals TOTAL 100.0% (796) Residence Age and Gender Urban 100% (1024) Rural 0% (1) Other Alberta 0% (0) BC 0% (0) Other/Unknown 0% (4) existing enrollments TOTAL 100.0% (1029) Female Male Total < 65 years 11 9 (20) (159) (446) (343) >= (31) Unknown 0 0 (30) existing enrollments TOTAL (1029) 68% 32% source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS 222 Mental Health

223 Geriatric Mental Health GERIATRIC MENTAL HEALTH CONSULTING SERVICES Diagnoses by DSM-IV-TR N = 5651 Diagnoses, 1029 Existing Enrollments All Diagnoses counted per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 5.5% (57) Adjustment Disorders 7.8% (80) Anxiety Disorders 3.0% (31) Delirium, Dementia, and Amnesic 73.7% (758) Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 26.0% (268) Other Conditions That May be a Focus 1.9% (20) Schizophrenia and Other Psychotic Disorders 3.1% (32) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.7% (7) Substance Related Disorders 2.2% (23) Axis II Axis II 3.1% (32) Axis III Axis III 75.3% (4253) source: GMHIS source: GMHIS source: GMHIS 223 Mental Health

224 GERIATRIC MENTAL HEALTH DAY TREATMENT Not available

225 Geriatric Mental Health GERIATRIC MENTAL HEALTH DAY TREATMENT Mental Health Indicators FY0809* New Enrollments * new serv 64 Existing Enrollments 65 Unique Active Enrollments 52 Carryovers 10 Discharges 55 Referrals 72 No Shows - Average Wait Time (days) 22 Direct Procedures 1325 Indirect Procedure Time (hours) 119 Referral Source Physician 33% (24) RGH - PCU 48 3% (2) Other Regional Service 4% (3) Specialized Geriatric Services 3% (2) Other/Unknown 57% (41) referrals TOTAL 100.0% (72) Residence Age and Gender Urban 92% (60) Rural 2% (1) Other Alberta 0% (0) BC 0% (0) Other /Unknown 6% (4) existing enrollments TOTAL 100.0% (65) Female Male Total < 65 years 3 5 (8) (30) (23) (4) >= (0) Unknown 0 0 (0) existing enrollments TOTAL (65) 65% 35% source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS source: GMHIS 225

226 Geriatric Mental Health GERIATRIC MENTAL HEALTH DAY TREATMENT Diagnoses by DSM-IV-TR N = 171 Diagnoses, 65 Existing Enrollments All Diagnoses counted per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 6.2% (4) Adjustment Disorders 7.7% (5) Anxiety Disorders 23.1% (15) Delirium, Dementia, and Amnesic 3.1% (2) Disorders Usually First Dx'd in Infancy Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 69.2% (45) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 1.5% (1) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders Axis II Axis II 44.6% (29) Axis III Axis III 40.9% (70) source: GMHIS source: GMHIS source: GMHIS 226

227 GERIATRIC MENTAL HEALTH OUTREACH TEAM What We Do The Geriatric Mental Health Outreach Team is a short term post discharge follow up component of Unit 48 Acute Inpatient Service. Community nurses provide brief follow up, on a psychiatrist referral basis, to recently discharged psycho-geriatric patients from Unit 48, other RGH patients, as well as patients discharged from the Glenmore Carewest Mental Health Recovery and Rehabilitation Unit. Services Provided Brief case management, for the duration of approximately 90 days, is provided to recently discharged psycho-geriatric clients. Case management included medications monitoring, community services brokerage, supportive counselling, caregiver support, and liaison with referring psychiatrists. Operating in compliance with the AIM standards of the Canadian Council on Health Services Accreditation, the Geriatric Mental Health Outreach Team primarily facilitates the transition of patients from hospital to community. Who We Serve Clients referred from Geriatric Mental Health Inpatient Services and Geriatric Mental Health Consultation Liaison Services of the Rockyview General Hospital, and The Glenmore Carewest Mental Health Recovery and Rehabilitation Unit. Referral Process Psychiatrists with admitting privileges to Geriatric Mental Health Inpatient Service and Geriatric Health Consultation Liaison psychiatrists from Rockyview General Hospital, as well as Glenmore Carewest Recovery and Rehabilitation Mental Health Services psychiatrists may refer clients. Admission Criteria The Geriatric Mental Health Outreach Team accepts patients upon discharge from previously identified Inpatient Services who present with an Axis I DSM-IV-TR diagnosis that is complicated by the aging process. Except in extraordinary circumstances determined on a case by case basis, clients must be 65 years or older. Exclusion Criteria Primary diagnosis of Dementia

228 Geriatric Mental Health GERIATRIC MENTAL HEALTH OUTREACH TEAM Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmen Carryovers Discharges Referrals 151 No Shows - Average Wait Time (days) 9 Direct Procedures 1499 Indirect Procedure Time (hours) 180 source: GMHIS source: GMHIS source: GMHIS Enrollments - Reason for Referral Anxiety Symptoms 5% (8) Cognitive Impairment 3% (5) Depressive Symptoms 8% (13) ECT Treatment 1% (1) Medication Issues 1% (1) Transitional FollowUp 80% (128) Unknown 3% (4) existing enrollments TOTAL 100.0% (160) source: GMHIS Residence Urban 91% (146) Rural 2% (3) Other Alberta 1% (1) BC 0% (0) Unknown 6% (10) existing enrollments TOTAL 100.0% (160) 63% 37% source: GMHIS Age and Gender Female Male Total < 65 years 4 5 (9) (54) (63) (32) Unknown 0 0 (1) existing enrollments (160) 60% 40% source: GMHIS 228

229 Geriatric Mental Health GERIATRIC MENTAL HEALTH OUTREACH TEAM Diagnoses by DSM-IV-TR N = 362 Diagnoses, 160 Existing Enrollments All Diagnoses are counted once per DSM-IV-TR category per existing enrollment. Axis I Additional Codes 0.6% (1) Adjustment Disorders 32.5% (52) Anxiety Disorders 13.1% (21) Delirium, Dementia, and Amnestic 14.4% (23) Disorders Usually First Dx'd in Infancy... Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 33.1% (53) Other Conditions That May be a Focus Schizophrenia and Other Psychotic Disorders 5.0% (8) Sexual Disorder Sleep Disorders 0.6% (1) Somatoform Disorders Substance Related Disorders 3.1% (5) Axis II Axis II 9.4% (15) Axis III Axis III 50.4% (183) source: GMHIS source: GMHIS source: GMHIS 229

230 UNIT 48 GERIATRIC MENTAL HEALTH INPATIENT SERVICES - RGH What We Do Geriatric Mental Health Inpatient Services: Unit 48 at the Rockyview Hospital offers psychogeriatric services to persons within the urban and rural areas. Unit 48 is a 20 bed unit for persons aged 65 and older, who are presenting with an Axis I DSM-R IV diagnosis complicated by the aging process. Services Provided Multidisciplinary assessment and treatment for psychogeriatric patients are provided in a holistic care model, and operating in compliance with the AIM standards of the Canadian Council on Health Service Accreditation. Primary nursing, individual and group therapy, pharmacotherapy, functional assessment, recreation therapy, pastoral care, medical and psychiatric consultation, and Electroconvulsant treatment are therapy modalities. Who We Serve Persons aged 65 years and older presenting with an Axis I DSM-IV-TR diagnosis complicated by the aging process within the are served. Referral Process Each psychiatrist who has an allotted number of beds on Unit 48 manages admission to these acute care beds. At times, patients are admitted from Emergency Services by the psychiatrist on call. Admission Criteria Unit 48 admits older adults presenting with Axis I DSM-IV TR diagnosis complicated by the aging process. Persons with organic mental conditions may be admitted when those conditions are complicated by a psychiatric disorder. Other patients who are generally aged 65 or older, and assessed by a program psychiatrist may be considered if inpatient assessment, treatment and stabilization are identified needs. Patients are admitted on a voluntary basis, as well as Dependent Adults, and those certified under the Mental Health Act. Exclusion Criteria Primary diagnosis of Dementia

231 Geriatric Mental Health UNIT 48 GERIATRIC MENTAL HEALTH INPATIENT SERVICES - RGH Occupancy Discharges 133 Occupancy* 104.0% # of Beds 20 Average Length of Stay (days) 51 Residence * Note: Occupancy rate based on bed census days Urban 92% (120) Rural 9% (12) Other Alberta 1% (1) BC 0% (0) Other 0% (0) discharges TOTAL 100.0% (133) Age and Gender Female Male Total Under 65 years 1 0 (1) (71) (45) (16) 95 & Over 0 0 (0) discharges TOTAL (133) 64% 36% Diagnoses by DSM-IV-TR N = 340 Diagnoses, 133 Discharges Diagnoses (first 5) are counted once per DSM-IV-TR category per discharge. Axis I Additional Codes Adjustment Disorders 4.5% (6) Anxiety Disorders 14.3% (19) Delirium, Dementia, and Amnestic 36.8% (49) Disorders Usually First Dx'd in Infancy 2.3% (3) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical 2.3% (3) Mood Disorders 55.6% (74) Other Conditions That May be a Focus 9.0% (12) Schizophrenia and Other Psychotic Disorders 22.6% (30) Sleep Disorders 0.8% (1) Somatoform Disorders 1.5% (2) Substance Related Disorders 7.5% (10) cont'd source: HIR source: HIR source: HIR source: HR 231

232 Geriatric Mental Health UNIT 48 GERIATRIC MENTAL HEALTH INPATIENT SERVICES - RGH Axis II Axis III Axis II 11.3% (15) Axis III 34.1% (116) source: HIR source: HIR Mental Health Act of Alberta N=133 discharges Formal Patients 41% (54) 24 Hour Hold 8% (10) source: HIR Electroconvulsive Therapy PCU 48 Total # ECT Procedures 245 # Patients Receiving ECT 31 source: HIR 232

233 AHS-Calgary Rural Mental Health Services Summary Includes 5,205 Clients Enrolled in Fiscal Year Most Common Diagnoses Calgary Rural Geographic Service Areas: ,966 Number of Clients with Dx Number of clients , Mood Other Conditions Substance Related Anxiety Adjustment Schizophrenia Dementia/Delirium Personality Childhood Dx Male Female Age and Gender <= >=65 Age group 261 Rural Clinic Client Residence: Area Urban North Rural South Rural East Rural West Rural Outside Calgary Region Homeless (Documented) Missing Postal Code Number of Clients 182 2, , These results describe clients registered in 14 rural MH services using data extracted from the ARMHIS data system. and geriatric MH clients are included. Child/adolescent, adult,

234 AIRDRIE MENTAL HEALTH CLINIC What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals of all ages and their families. Provide professional consultation to service providers regarding mental health issues. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and or depression, suicidal thoughts, persistent or severe mental illness. Provide group therapy depending on need and availability. Who We Serve Individuals of all ages and their families Residents of the M.D. of Rockyview Referral Process How to Make a Referral Contact the Airdrie Mental Health Clinic at We accept referrals from family physicians, agencies, family members and individuals themselves. If the person is over 18 they are encouraged to contact the clinic to complete the intake process. Admission Criteria Individuals and their families experiencing mental health difficulties and/or illness. Exclusion Criteria We do not provide marital counseling or third party assessments. We are a voluntary service so mandated clients must be willing participants.

235 Rural Mental Health AIRDRIE MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 670 Average Wait Time (dys) 20 Direct Procedures 4186 Indirect Time (hours) 2022 Airdrie 79% (748) - Calgary 2% (19) - Rural 16% (156) Other Alberta 1% (11) BC 0% (0) Unknown 2% (18) existing enrollments TOTAL 100.0% (952) Reason for Closure Client Withdrew from Service 68% (408) Mutual Agreement 21% (125) Consultation Only 4% (23) Referred for Further Services 1% (8) Deceased 1% (5) Declined Services 5% (30) discharges TOTAL 100.0% (599) Age and Gender Female Male Total 0-17 years (179) (92) (195) (191) (153) (58) >= (73) Unknown 11 0 (11) existing enrollments TOTAL (952) 64% 36% 235

236 Rural Mental Health AIRDRIE MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 931 Diagnoses, 952 Existing Enrollments (21 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment once by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 11.6% (110) Anxiety Disorders 13.0% (124) Delirium, Dementia, and Amnestic 1.6% (15) Disorders Usually First Dx'd in Infancy 4.3% (41) Dissociative Disorders Eating Disorders 0.1% (1) Factitious Disorders Impulse Control Disorders 0.9% (9) Mental Disorders due to General Medical 0.1% (1) Mood Disorders 28.0% (267) Other Conditions That May be Focus 33.8% (322) Schizophrenia and Other Psychotic Disorders 1.9% (18) Sexual and Gender Identity Disorders 0.1% (1) Sleep Disorders 0.1% (1) Somatoform Disorders 0.2% (2) Substance Related Disorders 2.0% (19) None reported None reported 236

237 BLACK DIAMOND MENTAL HEALTH CENTRE Services Provided Accessible, community-based, change oriented brief psychotherapy services (1-10 sessions) including: mental health assessment, intervention, information, referral and follow-up for individuals and/or groups of all ages. Therapeutic programs and services to promote mental wellness for individuals and their support networks. Who We Serve Individuals and their families experiencing mental health difficulties and/or illness. Referral Process How to Make a Referral Individuals are required to personally contact the intake line at Inclusion Criteria Individual has the ability to benefit from brief (up to 10 sessions), change oriented therapy. The individual is not involved in other therapy. Priority is given to residents of rural communities south of Calgary. Exclusion Criteria Substance use/abuse is the primary concern. Third party evaluations or treatment. Substance use/abuse is accepted from family physicians, community agencies, as well as any individual interested in accessing services. Individuals who are seeking marital counseling are referred to community resources that specialize in this area.

238 Rural Mental Health BLACK DIAMOND MENTAL HEALTH CENTRE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 58 Average Wait Time (dys) 22 Direct Procedures 414 Indirect Time (hours) 196 Black Diamond 45% (52) - Calgary 4% (5) - Rural 50% (58) Other Alberta 0% (0) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (115) Reason for Closure Mutual Agreement 49% (46) Client Withdrew from Service 30% (28) Consultation Only 10% (9) Referred for Further Services 8% (7) Declined Services 1% (1) Deceased 2% (2) Single Session/Walk-in 0% (0) Unknown 0% (0) discharges TOTAL 100.0% (93) Age and Gender Female Male Total 0-17 years (23) (3) (8) (14) (18) (10) >= (39) Unknown 0 0 (0) existing enrollments TOTAL (115) 58% 42% 238 Addictin & Mental Health

239 Rural Mental Health BLACK DIAMOND MENTAL HEALTH CENTRE Diagnoses by DSM-IV-TR N = 106 Diagnoses, 115 Existing Enrollments (9 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 10.4% (12) Anxiety Disorders 12.2% (14) Delirium, Dementia, and Amnestic 21.7% (25) Disorders Usually First Dx'd in Infancy 1.7% (2) Dissociative Disorders Eating Disorders 0.9% (1) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 17.4% (20) Other Conditions That May be a Focus 19.1% (22) Schizophrenia and Other Psychotic Disorders 4.3% (5) Sexual and Gender Identity disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 4.3% (5) None reported None reported 239 Addictin & Mental Health

240 BOW VALLEY MENTAL HEALTH CLINICS BANFF/LAKE LOUISE AND CANMORE What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals or all ages and their families. Urgent mental health assessment and crisis intervention. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and/or depression, suicidal thoughts, persistent or severe mental illness. Risk assessment and crisis intervention. Who We Serve We provide service to Bow Valley residents of all ages and their families. Referral Process How to Make a Referral In Canmore contact the Canmore Mental Health Clinic at (403) In Banff and Lake Louise call (403) For urgent mental health intervention go to Canmore Hospital or Banff Mineral Springs Hospital. Admission Criteria Individuals and their families experiencing mental health problems or mental illness. Exclusion Criteria We do not provide marital therapy or third party assessments. We are a voluntary service so mandated clients must be willing participants.

241 Rural Mental Health BOW VALLEY MENTAL HEALTH CLINICS - BANFF/LAKE LOUISE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 143 Average Wait Time (dys) 6 Direct Procedures 1102 Indirect Time (hours) 1113 Banff 61% (305) - Calgary 3% (14) - Rural 25% (124) Other Alberta 2% (8) Outside Alberta/Canada 6% (31) BC 1% (7) Unknown 1% (7) existing enrollments TOTAL 100.0% (496) Reason for Closure Client Withdrew from Service 21% (80) Mutual Agreement 19% (73) Referred for Further Services 9% (34) Consultation Only 1% (2) Declined Services 3% (10) Single Session/Walk-in 47% (181) Deceased 1% (2) Deceased - Suicide 0% (1) discharges TOTAL 100.0% (383) Age and Gender Female Male Total 0-17 years 5 2 (7) (121) (159) (86) (74) (29) >= (19) Unknown 1 0 (1) existing enrollments TOTAL (496) 56% 44% source:armhis source:armhis source:armhis 241

242 Rural Mental Health BOW VALLEY MENTAL HEALTH CLINICS - BANFF/LAKE LOUISE Diagnoses by DSM-IV-TR N = 225 Diagnoses, 496 Existing Enrollments (271 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 12.3% (61) Anxiety Disorders 7.5% (37) Delirium, Dementia, and Amnestic Disorders Usually First Dx'd in Infancy 0.8% (4) Dissociative Disorders 0.2% (1) Eating Disorders 0.8% (4) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 11.7% (58) Other Conditions That May be a Focus 6.9% (34) Schizophrenia and Other Psychotic Disorders 0.8% (4) Sleep Disorders Somatoform Disorders Substance Related Disorders 4.2% (21) Axis II 0.2% (1) None reported 242

243 Rural Mental Health BOW VALLEY MENTAL HEALTH CLINICS - CANMORE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 371 Average Wait Time (dys) 10 Direct Procedures 2721 Indirect Time (hours) 1890 Canmore 67% (586) - Calgary 3% (29) - Rural 23% (205) Other Alberta 1% (10) BC 0% (3) Unknown/Other Canada 5% (44) existing enrollments TOTAL 100.0% (877) Reason for Closure Mutual Agreement 20% (106) Client Withdrew from Service 24% (123) Declined Services 4% (21) Referred for Further Services 12% (64) Consultation Only 9% (45) Deceased 0% (1) Single Session - Walk In 31% (160) discharges TOTAL 100.0% (520) Age and Gender Female Male Total 0-17 years (122) (93) (209) (157) (149) (60) >= (76) Unknown 4 7 (11) existing enrollments TOTAL (877) 57% 43% 243

244 Rural Mental Health BOW VALLEY MENTAL HEALTH CLINICS - CANMORE Diagnoses by DSM-IV-TR N = 421 Diagnoses, 877 Existing Enrollments (456 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 6.0% (53) Anxiety Disorders 5.6% (49) Delirium, Dementia, and Amnestic 0.2% (2) Disorders Usually First Dx'd in Infancy 2.5% (22) Dissociative Disorders Eating Disorders 0.7% (6) Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 13.7% (120) Other Conditions That May be a Focus 12.5% (110) Schizophrenia and Other Psychotic Disorders 1.0% (9) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.1% (1) Substance Realted Disorders 5.0% (44) Axis II 0.6% (5) None reported 244

245 CHESTERMERE MENTAL HEALTH CLINIC What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals of all ages and their families. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and/or depression, suicidal thoughts, persistent or severe mental illness. Provide group therapy depending on need and availability. Who We Serve Individuals of all ages and their families. Residents of the M.D. of Rockyview. Referral Process How to Make a Referral Contact Chestermere Mental Health Clinic at (403) We accept referrals from family physicians, agencies, family members and individuals themselves. If the person is over 18 they are encouraged to contact the clinic to complete the intake process. Admission Criteria Individuals and their families experiencing mental health difficulties and/or illness. Exclusion Criteria We do not provide marital counselling or third party assessments. We are a voluntary service so mandated clients must be willing participants in the process.

246 Rural Mental Health CHESTERMERE MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 149 Average Wait Time (dys) 17 Direct Procedures 1044 Indirect Time (hours) 1067 Chestermere 55% (112) - Calgary 23% (47) - Rural 19% (39) Other Alberta 0% (1) BC 0% (0) Unknown 1% (3) existing enrollments TOTAL 100.0% (202) Reason for Closure Client Withdrew from Service 80% (82) Mutual Agreement 10% (10) Consultation Only 7% (7) Referred for Further Services 2% (2) Declined Services 1% (1) Unknown 0% (0) discharges TOTAL 100.0% (102) Age and Gender Female Male Total 0-17 years (61) (10) (28) (47) (32) (15) >= (5) Unknown 2 2 (4) existing enrollments TOTAL (202) 66% 34% 246

247 Rural Mental Health CHESTERMERE MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 192 Diagnoses, 202 Existing Enrollments (10 - Primary Axis I Dx unknown) Diagnoses are counted to a DSM-IV category per existing enrollment once by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 5.0% (10) Anxiety Disorders 16.3% (33) Delirium, Dementia, and Amnestic 0.5% (1) Disorders Usually First Dx'd in Infancy 7.9% (16) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders Mental Disorders due to General Medical Mood Disorders 30.7% (62) Other Conditions That May be Focus 29.2% (59) Schizophrenia and Other Psychotic Disorders 1.5% (3) Sexual and Gender Identity Disorders Sleep Disorders 0.5% (1) Somatoform Disorders 1.0% (2) Substance Related Disorders 2.5% (5) None reported None reported 247

248 CLARESHOLM MENTAL HEALTH CLINIC Services Provided Accessible, community-based, change oriented brief psychotherapy services (1-10 sessions) including: mental health assessment, intervention, information, referral and follow-up for individuals and/or groups of all ages. Therapeutic programs and services to promote mental wellness for individuals and their support networks. Who We Serve Individuals and their families experiencing mental health difficulties and/or illness. Referral Process How to Make a Referral Individuals are required to personally contact the intake line at Inclusion Criteria Individual has the ability to benefit from brief (up to 10 sessions), change oriented therapy. The individual is not involved in other therapy. Priority is given to residents of rural communities south of Calgary. Exclusion Criteria Substance use/abuse are the primary concern. Third party evaluations or treatment. Substance use/abuse are accepted from family physicians, community agencies, as well as any individual interested in accessing services. Individuals who are seeking marital counselling are referred to community resources that specialize in this area.

249 Rural Mental Health CLARESHOLM MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 61 Average Wait Time (dys) 10 Direct Procedures 2710 Indirect Time (hours) 1202 Claresholm 46% (126) - Calgary 1% (3) - Rural 49% (132) Other Alberta 4% (11) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (272) Reason for Closure Referred for Further Services 35% (77) Client Withdrew from Service 15% (33) Mutual Agreement 17% (37) Consultation Only 4% (8) Deceased 2% (4) Declined Services 0% (0) Single Session Walk-in 28% (61) discharges TOTAL 100.0% (220) Age and Gender Female Male Total 0-17 years (28) (8) (31) (40) (40) (41) >= (82) Unknown 2 0 (2) existing enrollments TOTAL (272) 58% 42% source:armhis source:armhis source:armhis source:armhis 249

250 Rural Mental Health CLARESHOLM MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 204 Diagnoses, 272 Existing Enrollments (68 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 1.8% (5) Anxiety Disorders 7.0% (19) Delirium, Dementia, and Amnestic 18.8% (51) Disorders Usually First Dx'd in Infancy 1.8% (5) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.7% (2) Mental Disorders due to General Medical Mood Disorders 23.2% (63) Other Conditions That May be a Focus 8.1% (22) Schizophrenia and Other Psychotic Disorders 12.1% (33) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 0.7% (2) Axis II 0.7% (2) None reported Note: The clinic's ability to staff influenced enrollment volumes in New service model introduced in

251 COCHRANE MENTAL HEALTH CLINIC What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals of all ages and their families. Provide professional consultation to service providers regarding mental health issues. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and/or depression, suicidal thoughts, persistent or severe mental illness. Who We Serve Individuals of all ages and their families. Referral Process How to Make a Referral Contact Cochrane Mental Health Clinic at We accept referrals from family physicians, agencies, family members and individuals themselves. If the person is over 18 they are encouraged to contact the clinic to complete the intake process. Admission Criteria Individuals and their families experiencing mental health difficulties and/or illness. Exclusion Criteria We do not provide marital therapy or third party assessments. Voluntary service therefore mandated clients must be willing participants in process.

252 Rural Mental Health COCHRANE MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 274 Average Wait Time (dys) 17 Direct Procedures 2271 Indirect Time (hours) 1583 Cochrane 80% (381) - Calgary 5% (25) - Rural 9% (41) Other Alberta 5% (24) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (479) Reason for Closure Client Withdrew from Service 70% (203) Consultation Only 16% (46) Mutual Agreement 11% (32) Referred for Further Services 1% (2) Deceased 1% (2) Declined Services 1% (3) discharges TOTAL 100.0% (288) Age and Gender Female Male Total 0-17 years (102) (52) (71) (78) (74) (44) >= (56) Unknown 0 2 (2) existing enrollments TOTAL (479) 63% 37% source:armhis source:armhis source:armhis source:armhis 252

253 Rural Mental Health COCHRANE MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 467 Diagnoses, 479 Existing Enrollments (12 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 10.9% (52) Anxiety Disorders 7.3% (35) Delirium, Dementia, and Amnestic 2.7% (13) Disorders Usually First Dx'd in Infancy 1.0% (5) Dissociative Disorders Eating Disorders 0.6% (3) Factitious Disorders 0.4% (2) Impulse Control Disorders Mental Disorders due to General Medical 0.2% (1) Mood Disorders 16.9% (81) Other Conditions That May be a Focus 52.4% (251) Schizophrenia and Other Psychotic Disorders 1.7% (8) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders Substance Related Disorders 3.1% (15) Axis II 0.2% (1) None reported 253

254 DIDSBURY MENTAL HEALTH CLINIC What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals of all ages and their families. Provide professional consultation to service providers regarding mental health issues. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and/or depression, suicidal thoughts, persistent or severe mental illness. Provide group therapy depending on need and availability. Who We Serve Individuals of all ages and their families Residents of the southern half of the Mountain View County (Didsbury, Carstairs, Cremona and Water Valley). Referral Process How to Make a Referral Contact Didsbury Mental Health Clinic at (403) We accept referrals from family physicians, agencies, family members and individuals themselves. If the person is over 18 they are encouraged to contact the clinic to complete the intake process. Admission Criteria Individuals and their families experiencing mental health difficulties and/or illness. Exclusion Criteria We do not provide marital therapy or third party assessments. Voluntary service therefore mandated clients must be willing participants in process.

255 Rural Mental Health DIDSBURY MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 189 Average Wait Time (dys) 18 Direct Procedures 1623 Indirect Time (hours) 1230 Didsbury 61% (199) - Calgary 0% (1) - Rural 35% (116) Other Alberta 4% (12) BC 0% (0) Unknown 0% (0) existing enrollments TOTAL 100.0% (328) Reason for Closure Client Withdrew from Service 43% (89) Consultation Only 26% (54) Mutual Agreement 23% (48) Referred for Further Services 6% (12) Deceased 2% (4) Deceased - Suicide 0% (0) Declined Services 0% (0) Unknown 0% (0) discharges TOTAL 100.0% (207) Age and Gender Female Male Total 0-17 years (79) (23) (37) (42) (39) (38) >= (70) unknown 0 0 (0) existing enrollments TOTAL (328) 59% 41% source:armhis source:armhis source:armhis source:armhis 255

256 Rural Mental Health DIDSBURY MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 310 Diagnoses, 328 Existing Enrollments (18 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 15.5% (51) Anxiety Disorders 9.5% (31) Delirium, Dementia, and Amnestic 7.6% (25) Disorders Usually First Dx'd in Infancy 6.4% (21) Dissociative Disorders Eating Disorders Factitious Disorders Impulse Control Disorders 0.3% (1) Mental Disorders due to General Medical Mood Disorders 26.5% (87) Other Conditions That May be a Focus 25.0% (82) Schizophrenia and Other Psychotic Disorders 2.1% (7) Sexual and Gender Identity Disorders 0.6% (2) Sleep Disorders Somatoform Disorders Substance Related Disorders 0.9% (3) None reported None reported 256

257 HIGH RIVER MENTAL HEALTH CLINIC Services Provided Accessible, community-based, change oriented brief psychotherapy services (1-10 sessions) including: mental health assessment, intervention, information, referral and follow-up for individuals and/or groups of all ages. Therapeutic programs and services to promote mental wellness for individuals and their support networks. Who We Serve Individuals and their families experiencing mental health difficulties and/or illness. Referral Process How to Make a Referral Individuals are required to personally contact the intake line at Inclusion Criteria Individual has the ability to benefit from brief (up to 10 sessions), change oriented therapy. The individual is not involved in other therapy. Priority is given to residents of rural communities south of Calgary. Exclusion Criteria Substance use/abuse are the primary concern. Third party evaluations or treatment. Substance use/abuse are accepted from family physicians, community agencies, as well as any individual interested in accessing services. Individuals who are seeking marital counselling are referred to community resources that specialize in this area.

258 Rural Mental Health HIGH RIVER MENTAL HEALTH CENTRE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmts Carryovers Discharges Residence Referrals - No Shows 210 Average Wait Time (dys) 16 Direct Procedures 2278 Indirect Time (hours) 1867 High River 43% (259) - Calgary 1% (3) - Rural 55% (330) Other Alberta 1% (4) BC 0% (0) Unknown 1% (4) existing enrollments TOTAL 100.0% (600) Reason for Closure Client Withdrew from Service 24% (130) Consultation Only 31% (166) Deceased 0% (2) Declined Services 1% (6) Mutual Agreement 22% (117) Referred for Further Services 8% (44) Single Session/Walk-In 13% (70) discharges TOTAL 100.0% (535) Age and Gender Female Male Total 0-17 years (86) (51) (133) (113) (98) (56) >= (61) unknown 2 0 (2) existing enrollments TOTAL (600) 71% 29% source:armhis source:armhis source:armhis source:armhis source:armhis 258

259 Rural Mental Health HIGH RIVER MENTAL HEALTH CENTRE Diagnoses by DSM-IV-TR N = 413 Diagnoses, 600 Existing Enrollments (187 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 7.5% (45) Anxiety Disorders 10.3% (62) Delirium, Dementia, and Amnestic 2.2% (13) Disorders Usually First Dx'd in Infancy 2.5% (15) Dissociative Disorders Eating Disorders 0.2% (1) Factitious Disorders Impulse Control Disorders 0.2% (1) Mental Disorders due to General Medical 0.2% (1) Mood Disorders 16.5% (99) Other Conditions That May Be a Focus 22.5% (135) Schizophrenia and Other Psychotic Disorders 2.3% (14) Sexual and Gender Identity Disorders 0.2% (1) Sleep Disorders 0.3% (2) Somatoform Disorders 0.3% (2) Substance Related Disorders 2.8% (17) Axis II 0.8% (5) None reported Note: Increasing Enrollment volumes a reflection of vacant staffing positions being filled. 259

260 NANTON/VULCAN MENTAL HEALTH CENTRES Services Provided Accessible, community-based, change oriented brief psychotherapy services (1-10 sessions) including: mental health assessment, intervention, information, referral and follow-up for individuals and/or groups of all ages. Therapeutic programs and services to promote mental wellness for individuals and their support networks. Who We Serve Individuals and their families experiencing mental health difficulties and/or illness. Referral Process How to Make a Referral Individuals are required to personally contact the intake line at Inclusion Criteria Individual has the ability to benefit from brief (up to 10 sessions), change oriented therapy. The individual is not involved in other therapy. Priority is given to residents of rural communities south of Calgary. Exclusion Criteria Substance use/abuse are the primary concern. Third party evaluations or treatment. Substance use/abuse are accepted from family physicians, community agencies, as well as any individual interested in accessing services. Individuals who are seeking marital counselling are referred to community resources that specialize in this area.

261 Rural Mental Health NANTON / VULCAN MENTAL HEALTH CENTRE Note: Staffing constraints prohibited offering Mental Health Services at this location. Patient population served by the Claresholm and High River Mental Health Clinics. 261 Year End Summary

262 OKOTOKS MENTAL HEALTH CENTRE Services Provided Accessible, community-based, change oriented brief psychotherapy services (1-10 sessions) including: mental health assessment, intervention, information, referral and follow-up for individuals and/or groups of all ages. Therapeutic programs and services to promote mental wellness for individuals and their support networks. Who We Serve Individuals and their families experiencing mental health difficulties and/or illness. Referral Process How to Make a Referral Individuals are required to personally contact the intake line at Inclusion Criteria Individual has the ability to benefit from brief (up to 10 sessions), change oriented therapy. The individual is not involved in other therapy. Priority is given to residents of rural communities south of Calgary. Exclusion Criteria Substance use/abuse are the primary concern. Third party evaluations or treatment. Substance use/abuse are accepted from family physicians, community agencies, as well as any individual interested in accessing services. Individuals who are seeking marital counselling are referred to community resources that specialize in this area.

263 Rural Mental Health OKOTOKS MENTAL HEALTH CENTRE Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmt Carryovers Discharges Referrals - No Shows 255 Average Wait Time (dys) 13 Direct Procedures 2036 Indirect Time (hours) 1973 Residence Okotoks 57% (354) - Calgary 5% (31) - Rural 36% (224) Other Alberta 0% (2) BC 0% (1) Unknown/Rest of Canada 1% (6) existing enrollments TOTAL 100.0% (618) Reason for Closure Client Withdrew from Service 15% (78) Consultation Only 30% (159) Mutual Agreement 24% (127) Referred for Further Services 8% (41) Single session/walk-in 23% (118) Deceased 0% (0) Declined Services 0% (1) discharges TOTAL 100.0% (524) Age and Gender Female Male Total 0-17 years (145) (67) (88) (145) (73) (58) >= (42) existing enrollments TOTAL (618) 65% 35% 263

264 Rural Mental Health OKOTOKS MENTAL HEALTH CENTRE Diagnoses by DSM-IV-TR N = 448 Diagnoses, 618 Existing Enrollments (170 - Primary diagnosis unknown) Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 10.2% (63) Anxiety Disorders 11.8% (73) Delirium, Dementia, and Amnestic 2.6% (16) Disorders Usually First Dx'd in Infancy 1.5% (9) Dissociative Disorders Eating Disorders 0.5% (3) Factitious Disorders Impulse Control Disorders 0.2% (1) Mental Disorders due to General Medical Mood Disorders 16.3% (101) Other Conditions That May be a Focus 25.6% (158) Schizophrenia and Other Psychotic Disorders 2.3% (14) Sexual and Gender Identity disorders Sleep Disorders Somatoform Disorders 0.2% (1) Substance Related Disorders 1.5% (9) None reported None reported 264

265 STRATHMORE MENTAL HEALTH CLINIC What We Do Accessible mental health services including assessment, treatment, information, referral and follow-up of mental health problems for individuals of all ages and their families. Provide professional consultation to service providers regarding mental health issues. Services Provided Provide therapy to individuals of all ages and their families related to abuse/violence, addiction, grief, stress, aging, relationships, anxiety and/or depression, suicidal thoughts, persistent or severe mental illness. Provide group therapy depending on need and availability. Who We Serve Individuals of all ages and their families County of Wheatland, Siksika, Gleichen, Standard, Hussar & Rockyford Referral Process How to Make a Referral Contact Strathmore Mental Health Clinic at We accept referrals from family physicians, agencies, family members and individuals themselves. If the person is over 18 they are encouraged to contact the clinic to complete the intake process. Admission Criteria Individuals and their families experiencing mental health difficulties and/or illness. Exclusion Criteria We do not provide marital counseling or third party assessments. We are a voluntary service so mandated clients must be willing participants.

266 Rural Mental Health STRATHMORE MENTAL HEALTH CLINIC Mental Health Indicators FY0506 FY0607 FY0708 FY0809 New Enrollments Existing Enrollments Unique Active Enrollmt Carryovers Discharges Referrals - No Shows 408 Average Wait Time (dys) 21 Direct Procedures 3518 Indirect Time (hours) 2648 Residence Strathmore 75% (494) - Calgary 5% (35) - Rural 16% (105) Other Alberta 3% (21) BC 0% (0) Unknown 1% (7) existing enrollments TOTAL 100.0% (662) Reason for Closure Client Withdrew from Service 64% (255) Consultation Only 1% (2) Mutual Agreement 19% (77) Referred for Further Services 13% (51) Declines Services 2% (8) Single Session/ Walk-in 1% (2) Deceased 0% (1) discharges TOTAL 100.0% (396) Age and Gender Female Male Total 0-17 years (164) (65) (123) (135) (98) (57) >= (39) Unknown 0 1 (1) existing enrollments TOTAL (662) 65% 35% 266

267 Rural Mental Health STRATHMORE MENTAL HEALTH CLINIC Diagnoses by DSM-IV-TR N = 662 Diagnoses, 662 Existing Enrollments Diagnoses are counted to a DSM-IV category per existing enrollment by Primary Diagnosis. Primary Diagnosis assignment mandatory for Axis I diagnosis unless Diagnosis deferred coded. Axis I Axis II Axis III Additional Codes Adjustment Disorders 9.2% (61) Anxiety Disorders 7.1% (47) Delirium, Dementia, and Amnestic 0.9% (6) Disorders Usually First Dx'd in Infancy 2.4% (16) Dissociative Disorders Eating Disorders 0.5% (3) Factitious Disorders Impulse Control Disorders 0.3% (2) Mental Disorders due to General Medical Mood Disorders 25.7% (170) Other Conditions That May be a Focus 48.2% (319) Schizophrenia and Other Psychotic Disorders 2.0% (13) Sexual and Gender Identity Disorders Sleep Disorders Somatoform Disorders 0.2% (1) Substance Related Disorders 3.6% (24) None reported None reported 267

268 CONTRACTS with for MENTAL HEALTH SERVICES ASPEN - Eating Disorders Program Calgary Alternate Support Services - Creative Community Living Activities Calgary Association of Self Help - Community Support and Skill Development Calgary Association of Self Help - Occupational & Leisure Skills Calgary Association of Self Help - Resource/Activity Centre Calgary Clubhouse - Potential Place Canadian Mental Health Association - Continuing Connections Canadian Mental Health Association - ILS Community Onsite Canadian Mental Health Association - ILS: NW Clinic Canadian Mental Health Association - ILS: Sunridge Adult Community MH Centre Canadian Mental Health Association - ILS: Community MH (ATT & DBT) Canadian Mental Health Association - ILS: Carnat Centre Canadian Mental Health Association - ILS: Reality Challenged Canadian Mental Health Association - ILS: Northwest Clinic Canadian Mental Health Association - Lasting Impressions Canadian Mental Health Association - Leisure Recreation Canadian Mental Health Association - Peer Options Canadian Mental Health Association - Post Discharge Transition Program (Hamilton House) Canadian Mental Health Association - Street Outreach Stabilization Canadian Mental Health Association - Street Outreach Stabilization -Aboriginal Program Canadian Mental Health Association - Supported Housing: Aggregate Canadian Mental Health Association - Supported Housing: Albert House Canadian Mental Health Association - Supported Housing: Art Smith Canadian Mental Health Association - Supported Housing: Bob Ward Residence Canadian Mental Health Association - Supported Housing: Horizon 8 Canadian Mental Health Association - Supported Housing: Horizon West Canadian Mental Health Association - Supported Housing: House of Good Cheer Canadian Mental Health Association - Supported Housing: Hunter House Canadian Mental Health Association - Supported Housing: Keith House Canadian Mental Health Association - Supported Housing: Marguerite House Canadian Mental Health Association - Supported Housing: Miner House Canadian Mental Health Association - Supported Housing: Horizon 14 Community Living Alternatives for the Mentally Disabled Association (LAMDA) CVS - Prospect Human Services Society - Career Links Family Therapy - U of Calgary Hull Child & Family Services - Bridging the Gap Momentum - Money Matters Prairie Winds Clubhouse Vocational Rehabilitation and Research Institute - Arnika Centre Woods Homes - Community Resource Team Woods Homes - Eastside/Westside Family Centres Woods Homes - Exceptional Needs Woods Homes - Home Connections Woods Homes - Stabilization Woods Homes - William Taylor Learning Centre YWCA of Calgary - Community Parent and School Support Program (COMPASS) 268,

269 GRANTS with for MENTAL HEALTH SERVICES Bow Valley Victim's Services Calgary Alternate Support Services - Langin Place Calgary Women's Emergency Shelter Canadian Mental Health Association - Suicide Services: Education/Bereavement Claresholm & District - Family & Community Support Services Distress Centre Foothills Regional Victim's Services Foothills School Division Hull - Secure Treatment Okotoks Healthy Family Resource Centre Organization for Bipolar Affective Disorders (OBAD) Palliser North Family School Liaison Program Schizophrenia Society of Alberta, Calgary Chapter - Family Support Schizophrenia Society of Alberta, Calgary Chapter - Partnership Program Schizophrenia Society of Alberta, Calgary Chapter - Peer Support Outreach Schizophrenia Society of Alberta, Calgary Chapter - Unsung Heroes Vulcan Regional Victims Services Society - Victims Services Woods - Exit Program

270 Glossary Inpatient Definitions Available Beds: The number of inpatient beds are staffed and in operation (i.e. set-up) at the end of the reporting period. These are the beds that are actually available for patient accommodation, whether or not the bed is actually occupied at the time. [Note: these beds are adjusted to reflect when beds are closed for maintenance, staffing shortages, etc.] Average Length of Stay (LOS): Average length of stay is calculated as: The total days stay at end of the reporting period divided by the number of discharges in the report period. Calculated by patient care unit (PCU). Total Days Stay (by PCU): Assigned to the unit of discharge, the accumulated inpatient days since admission of the inpatients who were discharged from the unit during the reporting period, even if admitted in a previous reporting period. The day of admission is counted as a day of stay, but the day of discharge is not. When the patient is admitted and discharged on the same day, one patient day is counted. Formal Patient (2 Certificates): The total number of patients within the reporting period detained in a designated facility on the authority of 2 admission or 2 renewal certificates under the Mental Health Act of Alberta. 24 Hour Hold (1 Certificate): The total number of inpatients within the reporting period conveyed and detained in a facility on the authority of a Mental Health Warrant (Form 7&8), a Peace Officer's Power (Form 10), or one Admission Certificate (Form 1). These patients never become formal during this admission. Occupancy Rates: Patient Days for the reporting period divided by Bed Days for the reporting period x 100. Patient Days: One day of stay as an inpatient in the hospital, during the reporting period. The period of service between the census hours on two successive days; the day of admission is counted as a patient day, but the day of separation is not. When the patient is admitted and separated on the same day, one patient day is counted. Available Bed Days: Generally the number of beds set up in the reporting period multiplied by the number of days in the reporting period. However, this figure is adjusted for any days that certain beds were closed during the reporting period. Total Number of ECT Treatments: The total number of ECT procedures performed during the reporting period. Total Number of Patients Receiving ECT Treatments: The total number of patients receiving ECT procedures within the reporting period where each patient is counted once - (i.e.) for all ECT procedures performed within the reporting period, how many unique patients received treatment. 270,

271 Glossary Ambulatory Care/Community Definitions NOTE: The current "Recommended Mental Health Outpatient Utilization Indicators" are bolded. Appointments/Sessions/Contacts/Procedures: Total number of appointments/sessions with all clients/patients in a service during the given report period. CARA data is total number of direct interventions received by clients. (Group is counted by the number of clients receiving group therapy.) Average Wait Time: The length of time on a waiting list prior to enrollment into the service in the given reporting period. Measured as the time between the referral date and enrollment date. Currently wait time includes both program and patient driven waits. ARMHIS database records wait time from referral date to enrollment date on 'existing enrollments'. Carryovers: The number of clients/patients at the end of the reporting period who are not yet discharged and will continue to be enrolled for the next reporting period. Discharges: The total number of clients/patients discharged from the service within the reporting period. ARMHIS discharges include "transfer out" which are clients leaving the program and moving to a new ARMHIS data collection program therefore considered discharged from that program. New Enrollments: The number of clients/patients enrolled into the service during the given reporting period. ARMHIS data for New Enrollments also include "transfers in", which are those clients moving from another ARMHIS data collection program. Existing Active Enrollments: A count of all clients/patients with an open enrollment in the service during the given reporting period who have attended at least one appointment or session. Existing Enrollments (previously Existing Registrants): A count of all clients/patients with an open enrollment in the service during the given reporting period. Unique Active Enrollments: A count of all unique clients/patients with an open enrollment in the service during the given reporting period who have attended at least one appointment or session. Indirect Procedures (ACCS): Total number of indirect contacts or interventions occurring within the service during the reporting period. Indirect Procedure Time: Total time recorded of activities related to, but not involving the client/patient during the reporting period. 271,

272 Glossary No-show for Initial Appointment: The number of clients/patients who are scheduled but do not materialize for their initial appointment. Primary Diagnosis: ARMHIS data collection system has diagnostic information available by Primary Diagnosis. Only one diagnosis may be assigned as Primary. Not all enrollments are assigned a Primary Diagnosis within the given report period. All Axis I diagnosis have a primary assigned unless Diagnosis is Deferred. Not all clients have an Axis I diagnosis. Referrals: The number of referrals received into the service during the given reporting period. Crisis & Psychiatric Emergency Services Definitions Admissions Through Psychiatric Emergency Services: The total number of visits through Psychiatric Emergency Services admitted to any patient care unit (medical or psychiatric) during the reporting period. Number of Visits Left Against Medical Advice: The total number of registered Psychiatric Emergency visits who left after being seen by a physician, but prior to formal discharge, for any reason. Total Number of Visits: The total number of visits to Psychiatric Emergency Services per site within the reporting period. # Transfers from Emergency Department to Another Site: The total number of Psychiatric Emergency patients transferred inter-city from the indicated hospital to another hospital site, as an inpatient during the reporting period. 272,