SUPPORTS AND SERVICES FOR PERSONS WITH A DUAL DIAGNOSIS

SUPPORTS AND SERVICES FOR PERSONS WITH A DUAL DIAGNOSIS A Resurce Manual fr Yrk Regin Families The Yrk Regin Supprts and Services Resurce Handbk, 2003 Editin was prepared under the directin f the Simce Yrk Dual Diagnsis Educatin Cmmittee. This editin was updated in Fall 2009 by Yrk Supprt Services Netwrk staff

A Resurce Handbk fr Supprts and Services fr Persns with a Dual Diagnsis in Yrk Regin T a b l e f C n t e n t s SECTION 1: Intrductin Abut Yrk Regin Dual Diagnsis Cmmittee 1 Abut this Handbk 2 Dual Diagnsis An Overview 4 SECTION 2: Hw t Navigate the System When a Persn has a Dual Diagnsis Getting Started 6 Hw d yu knw if a persn might have an intellectual disability and/r mental health needs? D yu need a diagnsis t get services? D yu need an assessment? Tips n Getting Started Questins t Cnsider When Cntacting Organizatins Navigating the Sectrs 11 Schematic: Ministries respnsible fr Dual Diagnsis Funding & Plicies What d yu need t knw abut the system t get arund? What can a Case Manager d fr yu and hw t get ne? What t d in a crisis? Hw t access a cntract wrker? Tips n Hiring a Cntract Wrker Places t Lk r Advertise fr a Cntract Wrker Getting Started Thinking Abut What is Needed 18 The Supprts and Services Implementatin Guide Key Access Pints and Cmmittees 20 Three Key Specialized Services Key Cmmittees and Gvernment Cntacts Supprts and Services fr Persns with a Dual Diagnsis Table f Cntents i

A Resurce Handbk fr Supprts and Services fr Persns with a Dual Diagnsis in Yrk Regin T a b l e f C n t e n t s 2 Fr Family and Friends 23 What supprts d yu need? Respite Gvernment Prgrams and Plicies 25 Gvernment Structure Pliticians Legislatin re: Mental Health, Alternative Decisin making, Cnsent t Treatment and CTOs Financial Prgrams Abuse Plicy Other Imprtant Infrmatin 29 Wills and Trusts Newsletter The 12 Cmmandments fr Successful Lbbying SECTION 3: Index and List f Supprts and Services Imprtant Numbers at a Glance 31 Index f Supprts and Services by Type f Service 32 List f Supprts and Services (Alphabetical) 35 This is a list f specific rganizatins and prgrams that prvide supprts and services fr persns with a dual diagnsis. They are listed alphabetically and include a detailed descriptin f each rganizatin r service Supprts and Services fr Persns with a Dual Diagnsis Table f Cntents ii

A c k n w l e d g m e n t s We wish t extend ur thanks t Mr. Jim Jhnstn and Cncerned Parents f Trnt fr giving permissin t the Simce Yrk Dual Diagnsis Educatin Cmmittee t adapt their infrmatin bklet, A Resurce Handbk fr Supprts and Services fr Persns with a Dual Diagnsis in Trnt, 2002. In turn, we pass n their acknwledgements that sme f their material was btained and/r adapted frm the fllwing surces: Cmmunity Resurces Cnsultants f Trnt, Making Chices: A Cnsumer/ Survivr s Guide t Adult Mental Health Services and Supprts in Trnt, 1999 2000. MATCH Prject. Creating a Cntinuum f Supprts and Services, a Resurce Dcument, 1996. Lynn Eakin and Assciates, Trnt. The Twelve Cmmandments fr Successful Lbbying. We sincerely appreciate and acknwledge that sme material cntained in this handbk was btained and/r adapted frm YORKLINK A Cmmunity Services Directry, 2008, published by the Reginal Municipality f Yrk Cmmunity Services and Husing Department. Our thanks as well t Yrk Supprt Services Netwrk staff fr their assistance in the preparatin and prductin f this manual. Supprts and Services fr Persns with a Dual Diagnsis Table f Cntents iii

P e r s n a l H e a l t h I n f r m a t i n Persnal Health Infrmatin Prtectin Act (PHIPA) became law n Nvember 1, 2004. PHIPA prvides a cmmn set f rules fr cllecting, using, disclsing, retaining and dispsing f persnal health infrmatin in the Ontari health system. The act ensures prtectin f privacy, while facilitating effective health care and supprting well being. Persnal health infrmatin is identifying infrmatin abut an individual in ral, written r electrnic frm. It is bradly defined and includes infrmatin related t the physical, mental and scial dmains f an individual. Given that persnal health infrmatin is ften required in rder t prvide service, many scial service agencies have mdified their privacy plicies t cmply with the requirements f the Act. PHIPA cmpliant agencies have respnsibilities such as: Ensuring that persnal health infrmatin is prtected at all times Obtaining cnsent frm the individual accrding t regulatins in the Act Cnsumers f service have rights under PHIPA such as: The right t understand the purpse fr cllectin f infrmatin The right t withdraw cnsent The right t cmplain abut a breach in privacy Fr additinal infrmatin cntact: Infrmatin and Privacy Cmmissiner/Ontari 2 Blr Street E, Suite 1400 Trnt, ON M4W 1A8 1 800 387 0073 www.ipc.n.ca Supprts and Services fr Persns with a Dual Diagnsis Table f Cntents iv

SECTION 1: Intrductin

Abut Yrk Regin Dual Diagnsis Cmmittee In 1997, the Ministry f Health and Lng Term Care, the Ministry f Cmmunity and Scial Services and the Ministry f Children and Yuth Services recgnized the need t wrk jintly n prgramming fr persns with a develpmental disability and mental health needs (dual diagnsis). They released jint prvincial plicy guidelines t plan fr the prvisin f services fr peple with dual diagnsis. It was identified that n ne agency r sectr culd adequately serve a persn with a dual diagnsis and that services must be flexible, seamless and must eliminate jurisdictinal barriers t create a cntinuum f supprts. In the fall f 1998, the Simce Yrk District Health Cuncil struck a Yrk Regin Dual Diagnsis Cmmittee, made up f health and scial service prviders as well as cnsumer family members, t prvide a frum fr implementatin f the new prvincial guidelines at the lcal level. A plan was develped (March 2001) that included identificatin f strengths and gaps within a cmprehensive system f required supprts and services t meet the cmplex needs f peple with a dual diagnsis. The Yrk Regin Dual Diagnsis Cmmittee cntinues t meet n a regular basis, t put the lcal plan int actin and t advise the Yrk Regin Mental Health Cmmittee and the Yrk Regin Cmmunity Planning Cuncil n issues related t supprting peple with a dual diagnsis. Supprts and Services fr Persns with a Dual Diagnsis Intrductin 1

Abut This Handbk This is the sixth editin f the resurce handbk fr persns with an intellectual disability and mental health needs (dual diagnsis) in Yrk Regin. We hpe it will be helpful t cnsumers, family, friends, advcates and service prviders. It identifies key rganizatins in Yrk Regin and effective strategies t help yu plan and get the supprts and services yu need. The fcus is primarily adults but des include sme services fr yuth as well. The handbk is nt intended t include all pssible rganizatins but rather rganizatins that are geared t, r have shwn a capacity t, serve individuals with a dual diagnsis. These include a range f supprts and services in bth the develpmental and mental health sectrs. Fr a full listing f all cmmunity rganizatins please see the Cmmunity Services Directry called YORKLINK 2008 in Yrk Regin. Yu can call them at (905) 830 4444 Ext. 2151 r tllfree at 1 877 GO 4 YORK (1 877 464 9675), Ext. 2151, r yu can visit their web site at www.regin.yrk.n.ca. It is imprtant t remember that each rganizatin prvides services based n certain entrance criteria such as age, individual needs and whether they have any space in their prgram. The nly way t find ut if an rganizatin is a gd fit and/r can prvide services t yu is t cntact the intake staff and discuss yur particular situatin. Yrk Regin Dual Diagnsis Cmmittee cannt assess yur situatin and needs and, thus, we cannt recmmend a specific agency. This editin f the Handbk is divided int three sectins. Sectin 1 is an intrductin Sectin 2 describes the tw sectrs invlved and prvides infrmatin n hw t navigate the sectrs such as: ~ hw t get a case manager ~ what t d in a crisis ~ indicatrs f a dual diagnsis ~ a supprts and services guide t help yu plan ~ sample questins yu might cnsider asking when calling an agency ~ wh t call t learn abut gvernment prgrams and plicies ~ ther resurces yu might find helpful. Sectin 3 has an index arranged by type f service and lists a number f key supprts and services that yu might cnsider cntacting. We have listed the rganizatins alphabetically. There is als an imprtant numbers at a glance page. Supprts and Services fr Persns with a Dual Diagnsis Intrductin 2

T help yu find a particular type f service, g t the Index f Supprts and Services (see Sectin 3, Page 32) that grups all the rganizatins under the different types f services they ffer. Fr example, if yu are lking fr a case manager lk in the index under Case Management Services and yu will find a list f mental health and develpmental service agencies that prvide case management. It will tell yu the page number t turn t fr details abut each agency. Just a few wrds abut the language and terms used in the handbk: We use the term intellectual disability t refer t cgnitive limitatins. (Other terms the reader might be familiar with are develpmental handicap, develpmental delay r mental retardatin.) The sectr that primarily prvides service and supprt fr persns with intellectual disabilities is called the develpmental sectr. The sectr that prvides service and supprt fr persns with mental health needs is called the mental health sectr. Individuals wh are receiving services in either sectr are referred t as the cnsumer. The infrmatin in this handbk is available n the Yrk Supprt Services Netwrk website www.yssn.ca. We hpe that yu find the Directry useful. We welcme yur cmments, feedback and suggestins. Please cntact the Cmmunicatins Department at Yrk Supprt Services Netwrk 905 898 6455 ext. 2236. Supprts and Services fr Persns with a Dual Diagnsis Intrductin 3

Dual Diagnsis An Overview The term dual diagnsis refers t an individual wh has an intellectual disability and mental health needs. They may r may nt have been frmally diagnsed with an intellectual disability, a mental illness r bth. Individuals with a dual diagnsis are a marginalized grup in ur sciety ften expsed t prejudices, abuse and scial islatin. They experience the same range f severe and prlnged mental health difficulties including depressin, md disrders and schizphrenia as the general ppulatin, but at much higher rates. Studies have shwn that between.8 and 1% f the ppulatin has a develpmental disability. Fr Yrk Regin, this translates int 9,102 peple. Of these, it is estimated that apprximately 30% als have a mental illness, r abut 2,731 peple. As the ppulatin in Yrk Regin grws s will the ppulatin with a dual diagnsis. A cnservative estimate is that by 2016, there will be clse t 3,000 individuals with a dual diagnsis in Yrk Regin. Unfrtunately, many individuals are never prperly identified and, as a result, d nt receive the cmprehensive treatment they need. While there have been recent imprvements in hw services are being prvided, many gaps and barriers remain in the service system resulting in cnsumers nt being able t access the range f services they need. Many cnsumers are undiagnsed r receive a diagnsis in ne aspect nly. Fr sme they were identified with an intellectual disability as children. Hwever, they may never have had their mental health needs thrughly identified r been reassessed as they age and experience stress at varius life stages r events. One reasn fr this is that mental health issues ften shw up as behaviral prblems. Peple then treat the behavir prblem withut identifying r treating the underlying mental health need. Other individuals have been diagnsed with a mental illness and n ne has suspected that they als have an intellectual disability. Still thers have been verlked entirely and have never had their intellectual r mental health status evaluated, but are, in fact, dually diagnsed. Supprts and Services fr Persns with a Dual Diagnsis Intrductin 4

Several factrs cntribute t nt prperly identifying persns with a dual diagnsis and the many gaps and barriers t service in bth the develpmental and mental health sectrs. Here are a few f the key issues: It can be quite cmplicated t understand hw a persn's intellectual disability and mental health interact tgether. When an individual with an intellectual disability has a mental illness the symptms are usually less bvius and different frm the general ppulatin. Individuals ften present as higher functining r they deny their cgnitive difficulties. They use their strengths and splinter skills t mask their denial f their intellectual disability and/r their sadness. This is referred t as a clak f cmpetence. The clak fls peple. It sets up a chain reactin arund denial f the intellectual disability and high expectatins. These individuals may be struggling t cpe in the cmmunity r living n the streets and many mre are thught t be in the justice system. There are many service issues that act as barriers such as lng waiting lists, requiring a diagnsis in rder t get service and getting stuck in ne sectr when yu need services frm bth sectrs. The result is that many still are undiagnsed and untreated. Persns with a dual diagnsis have been a greatly underserved grup and remain very vulnerable and at risk. Unfrtunately, there are nt many prfessinals (e.g., psychiatrists, nurses and scial wrkers) wh are experienced and knwledgeable in assessing, diagnsing and treating individuals with a dual diagnsis. Treatment takes much lnger fr these cnsumers than fr thers. Unfrtunately, they ften fall thrugh the cracks in ur sciety and dn't get the treatment they need. Hwever with the right apprach, a persn with a dual diagnsis can certainly get help with their mental health needs. It can be cnfusing fr everyne invlved finding the right kind f help and supprt. There are a few key things t remember when helping plan services with a persn with a dual diagnsis: Everyne invlved needs t wrk tgether as a team; Several different types f services may need t be invlved; and Smetimes specific changes in a prgram r activity will help imprve the fit with the persn s needs. Supprts and Services fr Persns with a Dual Diagnsis Intrductin 5

SECTION 2: Hw t Navigate the System when a persn has a Dual Diagnsis

Getting Started Q. Hw d yu knw if a persn might have an intellectual disability and/r mental health needs? The fllwing are sme questins that can help yu identify cmmn indicatrs. Often family, friends and staff at agencies d nt knw what the signs are f a mental health need r an intellectual disability. These indicatrs will help yu decide if yu need t cnsult a prfessinal fr a mre thrugh assessment. Keep in mind that these are nly suggested indicatrs and d nt cnstitute a diagnsis. Cgnitive Indicatrs Des he/she cmmunicate in shrt sentences and seem egcentric in his/her thinking? Des he/she seem n the surface t be able t d things he/she really can't? Des he/she have truble generalizing? Des he/she seem t learn slwly? Des he/she have truble with abstract thinking? (Fr example, recgnizing hw tw things are similar.) Des he/she d better n cncrete and structured tasks? (Fr example, when yu are very specific and break things dwn int steps?) Des he/she have memry prblems? Des he/she have a splinter skill that fls peple but has been learned by rte? Is he/she a pr prblem slver? Des he/she shw pr judgment? Des he/she have truble understanding 'why' questins? Is he/she gd at picking up nn verbal scial cues? D peple disagree abut whether this persn is higher functining r nt? Mental Health Needs Indicatrs Is he/she verly dependent fr his/her capabilities? Is he/she verly independent fr his/her capabilities? Is change really hard fr him/her? Des he/she lack peers and friends? Is he/she impulsive? Is he/she withdrawn? Is he/she aggressive, verbally r physically? Des he/she have truble with anger? Is he/she irritable? Has he/she been in truble with the law? Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 6

Des he/she have prblems with inapprpriate scial r sexual behavir? Des he/she deny being intellectually disabled? Des he/she appear higher functining than he/she is? Is there a diagnsed mental illness? Des he/she hurt himself/herself? Is he/she sleeping mre r less? Has there been a change in his/her appetite? Des he/she seem veractive? Is he/she verly fearful? Is he/she extremely cnfused r disriented? Des he/she hear vices that are nt there? (This is nt t be cnfused with talking t neself fr cmpany r t reduce anxiety) Has there been difficulty in getting prfessinals t agree ver the years abut a diagnsis fr bth the range f cgnitive functining and their mental health? Are there family prblems that interfere with his/her functining? Is there a parent with an intellectual disability r a mental health prblem? Q. D yu need a diagnsis t get services? Unfrtunately this is nt an easy questin t answer. Sme rganizatins require a diagnsis and sme d nt. N matter which agency yu cntact, the cnsumer will need t meet certain criteria that the agency has decided is required fr a persn t receive their services. Fr example, a develpmental service agency may require prf f an intellectual disability such as a psychlgical r psychiatric assessment f the persn's level f functining. Hwever, they might als accept mre infrmal infrmatin that indicates that the persn is functining in this range. Many mental health agencies require a psychiatric diagnsis in rder t access mental health services. Sme may accept mre infrmal descriptin f behavir that might indicate that there is a mental health cncern. Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 7

What if the individual r persn has ne diagnsis and nt the ther? With ne diagnsis yu can usually access services in the sectr that is assciated with the diagnsis. Fr example, if yu have a diagnsis f an intellectual disability yu shuld be able t access a range f services in the develpmental service sectr. If yu have a diagnsis f mental illness yu shuld be able t access a range f services in the mental health sectr. The difficulty here is that yu may get stuck receiving services in nly ne sectr when in fact yu need sme supprt frm the ther sectr as well. If yu have a diagnsis f bth an intellectual disability and a mental illness, yu can access a range f services specifically designed fr persns with a dual diagnsis. Unfrtunately, there is ften a waiting list fr many services in bth sectrs. Smetimes agencies in the develpmental service sectr will be cncerned abut their ability t manage a mental health prblem because they feel they dn't have the knwledge and experience that is needed. Or, n the ther hand, a mental health agency may wrry they dn't knw hw t help a persn with an intellectual disability. There may be situatins where this is true. They will need sme help frm the "ther" sectr in rder t help the cnsumer. In these situatins yu may need t get ne agency t start t wrk with yur relative/friend with sme back up supprt frm the ther sectr. If the cnsumer already has services with ne sectr, yu culd advcate finding a partner service in the ther sectr t help prvide mre f what the individual needs. The added advantage f this is that yu begin t develp a team apprach that wrks very well with individuals with a dual diagnsis. Yu may still hear agencies use the term "primary diagnsis" and yu may be asked if their intellectual disability r their mental illness is their "primary diagnsis". Hw yu answer this questin may determine whether yu get service frm this rganizatin. Q. D yu need an assessment? It is always very imprtant t have a gd verall assessment r an accurate picture f the persn and all their needs. Otherwise, yu wn't knw hw t put tgether the right services t really help the persn and their mental health will likely get wrse. A gd assessment needs t include physical and mental health and an understanding f the nature f the persn's intellectual disability. Imprtant areas t cnsider fr a cmprehensive assessment include medical, psychiatry, psychlgy, cmmunicatin, medicatin, vcatinal, behaviral, neurlgical, endcrinlgy, genetic, envirnmental, systems, family, scial, cultural and sexuality. Yu can get an assessment at an agency that specializes in dual diagnsis r yu may have t gather infrmatin and reprts frm different peple such as a family dctr, cmmunity agency reprts and/r a psychiatrist and put it all tgether. Even if the individual has had a thrugh assessment in the past, they may require a new assessment as their situatin changes. Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 8

Tips n Getting Started A persn with an intellectual disability and mental health needs may want t cntact an rganizatin n their wn. Mre ften they will need sme assistance frm their natural supprts (family / friends) r a staff persn at an agency. Fr example, they may need sme caching abut what t say; have yu sit with them while they call r they may need yu t be the persn t speak n their behalf. When calling n behalf f a family member/friend: Prepare yurself and be clear abut what yur relative/friend needs befre yu call. Make a list abut what activities they like, what things they d well and what the prblems are. Think clearly abut what yu want/need frm the rganizatin. Fr example, yur family wuld like tw hurs f supprt each day r yur family/friend needs a day prgram. Remember this is a chance fr yu t see if the rganizatin feels like a gd fit fr yur relative/friend and the rganizatin is als trying t decide if yur relative/friend wuld be a gd fit in their prgram. Share imprtant infrmatin and be sure t balance the infrmatin abut bth yur relative/friend's strengths and areas f difficulty. Ask t speak t smene wh is infrmed abut what services are ffered and that can answer yur questins. Take the time t talk t staff s yu can get a sense f hw the rganizatin wrks its "culture". Or yu may need t meet with a wrker in the rganizatin yu are calling t discuss what yur relative/friend needs. Yu may decide t get a case manager t help yu with this whle prcess. A case manager can help yu srt ut what yur relative/friend needs, what yu as a family need and hw t match that with the supprts and services that are available. There are case managers in bth the mental health and develpmental sectrs that can help. (Fr mre infrmatin see What can a Case Manager d fr yu and hw t get ne; page 13). If yu dn't get a gd respnse when yu call an rganizatin, what d yu d? Call anther agency r yu can advcate fr yur relative/friend. Remember t recrd the wrker's name, phne number, date and respnse. Questins t Cnsider When Cntacting Organizatins The fllwing is a list f questins t review befre yu call an rganizatin t ask abut their services. Yu may already have sme questins f yur wn. Have a lk at this list and see if there are any ther questins that yu might like t ask. Are yu the intake persn and can yu answer my questins abut yur rganizatin? What is yur name? What area d yu serve? Can yur prgram serve smene with a dual diagnsis? Can we cme and visit? What chices d we have abut which prgrams yu ffer? Can we chse urselves r d yu d an assessment and then assign? Can yu d an assessment t help decide what is needed? Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 9

Is yur prgram flexible and can it be tailred t suit an individual? Is there a fee fr any services? What age are mst f the peple in the prgram? What is the physical set up f the prgram? D yu ffer jb training r placement? Hw many peple have yu placed? What recreatinal r scial prgrams d yu have? What kind f activities d yu d? Des this prgram perate five days a week? D yu have weekend r evening activities? Can yu manage many different types f behavir? Hw d the medical and mental health needs f individuals get met? In what areas are yur staff specially trained and what are their qualificatins? What is the rati f staff t clients? D yu have cnsultants t yur prgram? Fr example, d yu have a psychlgist r psychiatrist n call? Is yur agency accredited? Hw are yu funded? What is the rle f parents in yur rganizatin? What can I d if I have a cmplaint? If I can't get int yur services, can I get in if I pay a fee fr the prgram? Wh dn't yu serve and why? Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 10

Navigating the Sectrs The Tw Ministries Respnsible fr Funding and Plicies Related t Dual Diagnsis Ministry f Health and Lng Term Care (MOHLTC) Medical assessment General hspitals Mental Health Sectr Assessment Treatment Crisis Ministry f Cmmunity and Scial Services (MCSS) & Ministry f Children and Yuth Services Includes mst children s mental health services, except hspitals) Develpmental Sectr Lng term supprt re daily living Residential Vcatinal Dual Diagnsis Services Assessment Treatment Day Prgrams Inpatient (Prvincial Psychiatric Hspitals) Dual Diagnsis Services These specialized services can be: A specialized prgram fr individuals with a dual diagnsis based in either the mental health r develpmental service sectr A grup f agencies that are partnering t prvide a range f services in bth sectrs Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 11

Q. What d yu need t knw abut the system t get arund? There are tw separate sectrs that prvide funding and plicy directin fr services fr persns with a dual diagnsis. They are: the health sectr (including mental health) funded by the Ontari Ministry f Health and Lng Term Care and the develpmental sectr funded by the Ontari Ministry f Cmmunity and Scial Services and Ministry f Children and Yuth Services The fact that tw ministries are invlved can make it quite cmplicated t knw hw t get services and where t begin t lk fr them. Smetimes peple get cnnected t ne sectr r the ther, but usually nt t bth. When this happens they will nt get the help they need because they are missing what is needed frm the ther sectr. Fr example, if a persn with an intellectual disability has a wrker in the develpmental sectr they might nt knw the signs fr depressin and what t d t help. In anther situatin, a persn, diagnsed with schizphrenia, might have a mental health wrker frm the health sectr that is helping them cpe with the symptms f schizphrenia and making sure their medicatin is right but they might nt knw what t lk fr t knw if the persn als has an intellectual disability. It can be difficult and cnfusing fr everyne invlved finding the right kind f help and supprt. It really wrks best if there is a special cmbined apprach with bth the health and develpmental sectr and fr everyne t wrk tgether as a team. Each sectr has areas f special knwledge that they can ffer. Fr example, the develpmental sectr can help with future planning such as where t live and what supprts the cnsumer needs in the cmmunity, while the health sectr (mental health) can assist in areas such as mental illness and medicatin. Anther imprtant pint is that many agencies d nt include family members as part f the planning prcess. It wrks best if everyne is included. In the last few years in Yrk Regin many peple have been trying t prvide better services fr peple with a dual diagnsis. There are still a lt f changes needed but sme things are better. In 1994 the Ministry f Health changed its definitin f wh shuld be the first nes t get mental health services and they included individuals with a dual diagnsis in the definitin f serius mental health prblems that shuld be a pririty. This change has led t many pprtunities fr mental health agencies t wrk tgether with agencies in the develpmental sectr. Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 12

There is a recent initiative within the Ministry f Cmmunity and Scial Services and Ministry f Children and Yuth Services that will be helpful t cnsumers and families. Nw when yu cntact a develpmental sectr agency, that agency is bliged t stay cnnected t yu. Either they will prvide the service r they will find an alternate service t fit yur needs. This initiative will help prevent the stress, frustratin and disappintment f reaching ut fr help nly t be tld that that agency can't help yu. While these changes remve sme barriers and there is a better range f services nw, mre jint wrk is still needed s that all the required services can be available. There may be sme cnfusin abut which sectr t turn t fr lng term care services. Please nte that (despite the name) the Ministry f Health and Lng Term Care is nt the primary prvider f lng term care fr persns with an intellectual disability. Mst f the lng term care services are prvided by the develpmental sectr thrugh the Ministry f Cmmunity and Scial Services and Ministry f Children and Yuth Services. Hwever sme individuals with an intellectual disability and serius mental health difficulties d receive lngterm care services thrugh the Ministry f Health and Lng Term Care, but relatively few. The Ministry f Health and Lng Term Care prvides lng term care services fr cnsumers with serius psychiatric disabilities and thse wh need nursing hme care such as the elderly. Please remember that the system is always changing. This describes the system at the time this handbk was written. There will undubtedly be mre changes in the future, sme psitive and sme negative in regard t services fr persns with a dual diagnsis. There may be new plicies that have a direct impact r a new prgram that might be available. Check with smene wh is aware f the system such as a case manager, agency staff r a representative f the Ministry t clarify the current plicies and prgrams. Q. What can a Case Manager d fr yu and hw t get ne? It can be very cnfusing t srt ut what services the cnsumer needs and if thse services are available. Yu may find that yu wuld like a Case Manager t help yu decide wh t cntact and als t help yu begin t get everyne wrking tgether. Case management is a service prvided by staff wrking at agencies. They are usually referred t as Case Managers. Althugh case management services may differ smewhat frm agency t agency and within the mental health sectr and the develpmental sectr, they serve as a central pint t integrate all the stakehlders including cnsumers, families and service prviders. There are sme cmmn functins which all Case Managers fulfill. Supprts and Services fr Persns with a Dual Diagnsis Hw t Navigate the System 13