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Niagara agencies collaborating on mental health and addiction issues

Sometimes it takes a team of professionals to help people achieve better health and well-being. On Monday April 29th, 2019, Niagara's four Community Health Centres (Bridges CHC, Quest CHC, Niagara Falls CHC , and Centre de santé communautaire Hamilton/Niagara) held an official launch event for the Interprofessional Primary Care (IPC) Mental Health & Addictions Team (see page two for event details). This innovative project connects the patients of primary care providers who work in solo practice in Niagara, with interprofessional health services and community programs that meet their mild to moderate mental health needs.

“The recent health system restructuring announcement focused on building a more integrated and coordinated health care system in Ontario. This work is already happening at Niagara's four Community Health Centres (CHCs) through the IPC Mental Health & Addictions Team,” says Marcel Castonguay, Executive Director of Centre de santé communautaire Hamilton/Niagara- the project's lead agency. “The IPC Mental Health & Addictions Team aims to build stronger and more deeply integrated relationships with primary care providers in Niagara, but its focus isn’t on providers alone. Integrating the patient’s experience of health services across providers is where the project goes beyond a mere referral system to create a truly coordinated, person-centred health system experience.”
The IPC Mental Health & Addictions Team works with family physicians with no access to team supports to address the complex challenges many of their patients face. The team includes Mental Health Counsellors who provide individual therapeutic counselling, as well as Mental Health Outreach Workers who provide additional psychosocial support to clients such as advocacy, system navigation and connections to community programs/services. These services can all be accessed at no cost in St.Catharines, Welland, Niagara Falls, Fort Erie and Port Colborne. While patients receive team-based care and social supports from the IPC Mental Health & Addictions Team, they keep their relationship with their regular family physician or nurse practitioner. The team sends updates and a discharge summary to the referring provider in order to ensure continuity of care.

The IPC Mental Health & Addictions Team is funded through the Ministry of Health & Long-Term Care (MOHLTC). Since the program started in September 2018, it has already received over 900 referrals from more than 95 primary care providers in the Niagara Region and many clients and providers have already felt the positive impacts.

"I knew I needed help and was so happy when my doctor suggested seeing a counsellor. The experience was more helpful than I could have imagined." says one client. "Having services so easily accessible and local to me were vital in helping me through my difficulties." says another.

"In the last year, I have been pleased to utilize the counselling services offered by the IPC Mental Health & Addictions Team for my patients. They have addressed some of the important barriers to accessing this resource, including provision of services in the community where it is required, and at no cost to the user." says Dr. Anjali Kundi, a primary care physician working in Welland since 2009. " I am thankful that this service is here [...] and would advocate for increased funding so that the team based services could expand to other communities of need and potentially widen its reach to serve more patients.”

‎Innovative projects, like the IPC Mental Health & Addictions Team are now being implemented by members of the Alliance for Healthier Communities in more than 30 communities across Ontario. This real-time network makes health and social care accessible to the people who need it most.

“Alliance members have always offered interprofessional, team-based care to their clients. That’s how we know it works,” says Adrianna Tetley, CEO of the Alliance for Healthier Communities. “Team care ensures more people in Ontario, especially those with medical and social complexities, can receive the services and supports they need. And by shifting care one step upstream to less expensive and more appropriate team members, we can achieve positive health outcomes, fewer emergency room visits, and better discharge care, which helps save health care costs down the road.”

Innovative projects, like Niagara's IPC Mental Health & Addictions Team, contribute to system savings by serving people in the community, not the hospitals. The model works, however, mental health needs in Niagara are extensive and after 6 months the program has already hit capacity and has a waitlist. Niagara's CHCs highly recommend that the province set $30M dollars annually to spread this successful model through CHCs using 32 provincial service areas and to set an additional $18M dollars annually to increase the capacity of existing IPC teams. This will ensure rapid access to services, which will eliminate complicated care pathways and ensure patients are accessing the right level of care at the right time.

"In all 19 years of my practice I have never had this kind of support." says Dr. Jeremy Child of Tremont Medical in St.Catharines. "I am so grateful for this program and the difference it is making for my clients. I could keep this team busy with my patients alone. To be able to handle the level of need here in Niagara they need to be able to hire more staff and that means they need more support from the Ministry."

Furthermore, the team leading the IPC Mental Health & Addictions Team suggests that the Ministry invest $48M to fund a similar model to address chronic pain in the province. In a recent survey of the primary care providers who have referred to the IPC Mental Health & Addictions Team, over 70% of respondents indicated that they would benefit from access to interprofessional team-based care to support them in the care of their patients with pain management. According to the University of Toronto, the incremental costs of chronic pain in Ontario are estimated to be $11B dollars in direct medical health care costs annually. Chronic pain is incurable regardless of the frequency of doctor's appointments, ER visits and hospitalisations. According to Dr. Ted Jones, American leading psychological expert on pain and addiction "how patients think about their pain is critical to success" and as a result, Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT) as well as other non-medical approaches have been used to help many patients deal successfully with their conditions.. By implementing non-medical care models, Ontario will restore accountability and trust to end the culture of waste and mismanagement in healthcare.