Page 64 - 2017-2018 Department of Psychiatry Annual Report

the collaborative care planning that We have ensured that experienced staff; and establishing mentors
is increasingly being offered by crisis clinicians, with the knowledge and within clinical teams for specific
services – both of which herald a skill to triage and direct referrals psychotherapies. We have instituted
changing culture of communication appropriately, review all referrals random monthly chart audits for all
in service of the patients and families into CMH&A and work to develop disciplines, including psychiatry, and
we care for. strong collaborative relationships have begun the process of reviewing
with our partner services within the individual psychiatry caseloads
We continue to do our best to provide MH&A program and primary care. We and will establish internal case
timely, appropriate, high quality have moved away from promoting review processes for psychiatry.
care for patients with moderate to the promulgation of the generalist We are implementing medication
severe mental illness in collaboration mental health clinician in favor of reconciliation processes and use
with R&I, specialty services, crisis promoting and developing strong of the Drug Information System for
services, acute care services and multidisciplinary teams with each medication prescription and renewal
primary care. System level shifts individual team member working at across all clinic sites.
over the past decade, however, the top of their discipline’s scope
have compromised our capacity to of practice. Examples include The provincial MH&A program is
focus on this core mandate. Lack of implementation of guidelines for developing a model for a centralized
access to family doctors is a serious psychiatric consultation within teams; intake system that should help with
barrier to healthcare for our patient promoting interdisciplinary co- standardizing and streamlining intake
population. Often, we are the only management of patients; establishing processes across MH&A services.
stable healthcare service with which nursing and psychiatry teams to co- In anticipation of, and in preparation
our patients regularly interface and in manage and oversee the longitudinal for, this change, we have reviewed
many cases we are their only medical care of persons with severe and the intake processes for each of our
home. Compounding this barrier is persistent mental illness (such as Central Zone CMH&A clinic sites.
the paucity of available and affordable schizophrenia and other psychotic Not surprisingly, we found that the
community-based counseling and disorders) requiring long-acting processes and mechanisms in place
support services for individuals and injectable medications, clozapine for reviewing, accepting, triaging
families struggling with a myriad and regular psychiatric/medical and booking referrals had, over time,
of acute and chronic stressors. monitoring; safeguarding psychiatry become customized by each team
Consequently, a growing number of time to provide direct consultation to and divergent from one another. As a
patients accessing CMH&A services family doctors for medication review measure to standardize the process
rely on our five CMH&A clinic sites and diagnostic clarification; promoting of intake we have implemented the
for ongoing care and support more proficiency in the standard mental following:
appropriately provided in community health assessment across all clinical
and primary care. Continuing to hold
patients within CMH&A who no longer To standardize the process of
meet our core mandate creates
bottlenecks for service, inflates wait
specialized care provision, and forces intake we have implemented:
times, redirects resources away from
service redesign to manage distress
rather than mental illness. Without Establishing appropriate
the support of a robust primary care
system and a network of community-
based services, our capacity to clinical oversight at intake;
provide timely, appropriate, high
quality specialized mental health
care to individuals and families open standardized booking;
most in need of specialized mental
health services will continue to be
compromised. and coordinating psychiatry
Over the past year we have actively
worked to mitigate system pressures job plans.
by strengthening and safeguarding
core services for persons affected by
moderate and severe mental illness.

64 DEPARTMENT OF PSYCHIATRY