Supports and Services
There are many different types of supports and services in community mental health ranging from very large specialized organizations to small grassroots agencies. This broad spectrum is the great strength of community mental health in that it provides choices and allows individuals to access the range and type of services and supports they wish.
Description
Alternative businesses refer to a combination of job development, job placement and supported education within the self-help context. They may also offer self-employment opportunities for consumers to earn income through independent contract work. Alternative businesses are often owned and operated by consumer/survivors.
Types of Providers
Alternative businesses do not have providers; they operate on a peer support basis.
Useful Resources
Ontario Council of Alternative Businesses,
203-1499 Queen St. W., Toronto, Ontario,
M6R 1A3,
telephone: 416-504-1693
email address: ocab@on.aibn.com
Description
Mental health Assertive Community Treatment (ACT) Teams are multidisciplinary treatment teams providing assertive outreach, individualized treatment, ongoing and continuous services, and linkages, and include a monitoring and evaluation component.
ACT teams deliver 75 percent or more of their services outside program offices.
Types of Providers
Provincial standards require the following staff for an ACT Team: a psychiatrist, a program/administrative assistant, a team coordinator, registered nurses, and, at a minimum, a social worker, an occupational therapist, a substance abuse specialist, a vocational specialist, a peer specialist and other clinical staff.
Useful Resources
Description
Case managers play a pivotal role in coordinating services from across the mental health system as well as other service systems (e.g. criminal justice, developmental services, addictions).
Case managers provide at a minimum the following functions:
- individualized assessment and planning;
- service co-ordination (linking people with services and supports);
- monitoring and evaluation of services provided; and
- systems advocacy/resource co-ordination.
Some community agencies provide case management services for individuals on Community Treatment Orders (CTOs). CTOs are agreements initiated by physicians in which an individual in hospital agrees to comply with a treatment plan once in the community with the understanding that if they do not comply they will be returned to the hospital. In addition to standard case management services, the case managers coordinate the procedural requirements of the CTO with the individual, the initiating physician and other members of the treatment team.
Types of Providers
Case managers may come from a wide range of educational backgrounds and experience.
See description of case management in the careers section
Useful Resources
Description
Clubhouses provide a multi-service, psychosocial rehabilitation function to people with serious mental illness. Based on psychosocial rehabilitation principles, services for members include:
- assistance to members to further their vocational and educational goals;
- assistance to members to secure housing; and
- social and recreational programs.
The International Centre for Clubhouse Development (2002) describes a Clubhouse as "a place where people who have had mental illness come to rebuild their lives. The participants are called members, not patients and the focus is on their strengths not their illness. Work in the clubhouse, whether it is clerical, data input, meal preparation or reaching out to their fellow members, provides the core healing process. Every opportunity provided is the result of the efforts of the members and small staff, who work side by side, in a unique partnership. One of the most important steps members take toward greater independence is transitional employment, where they work in the community at real jobs. Members also receive help in securing housing, advancing their education obtaining good psychiatric and medical care and maintaining government benefits. Membership is for life so members have all the time they need to secure their new life in the community."
There are a number of clubhouses in Ontario that are accredited by the International Centre for Clubhouse Development.
Types of Providers
Clubhouse staff work in concert with the members and share responsibility for employment, housing, staffing coverage and all other services.
Useful Resources
Description
Mental health services for persons with concurrent disorders refers to the provision of assessment, treatment and psychosocial rehabilitation for people in the community who have serious mental illness and a substance abuse disorder - including both substance abuse and substance dependence. Both disorders must be viewed as primary and there is a need for a treatment plan that is integrated and coordinated.
Types of Providers
Services for individuals with concurrent disorders cover the same spectrum as other mental health services and are delivered by providers from all areas. It is important to note that the providers have dual expertise with both substance abuse and mental health issues.
See description of case management in the careers section
Useful Resources
Description
Court Diversion services are provided pre or post charge to link the person to community or institutional mental health services. The services provide a partnership between mental health workers and the criminal justice system. Pre charge diversion can include the police, court diversion workers and/or other community mental health workers providing referrals to appropriate services including short-term residential crisis beds. Workers are located in the courts to assist in the management and disposition of cases involving persons with mental illness. Core functions include but are not limited to:
- organizing or negotiating completion of court-ordered psychiatric fitness assessments;
- developing community management plans to allow for release including
- psychiatric follow-up, housing, funding, education/training; and
- short-term follow-up/intensive case management services.
Types of Providers
Court support and diversion workers come from a variety of backgrounds such as social service workers and social work. They often have some previous experience working both with individuals with mental illness and within the court or correctional systems.
Useful Resources
Description
Court Support describes services provided in the courts to assist the judiciary, clients and their families with the legal process, to link clients to services, and to provide services and supports to clients.
Types of Providers
Court support and court diversion workers come from a variety of backgrounds and may include a wide range of skills and educational backgrounds. For instance, they may be registered social workers or hold a related health or social science degree.
Useful Resources
Description
Crisis response services are a key part of the continuum of mental health services and supports for people with serious mental illness. Crisis response services provide immediate relief from symptoms, prevent the condition from worsening and resolve the crisis as soon as possible. Because mental health crisis differ in their origins and symptoms, crisis response services must be able to respond to individual need by providing a range of appropriate services in a variety of settings.
The crisis support team often collaborates with emergency teams, staff from hospital services, as well as with community partners to develop and implement appropriate treatment strategies. Consultation to the community is provided on mental health and psychosocial issues.
Crisis response services provide individuals with timely access to a variety of crisis service options such as telephone crisis response, walk-in services, mobile crisis outreach and crisis residential services.
Telephone crisis response centres offer emotional support, crisis intervention and referral by telephone. They may also offer training and education to the public on issues such as suicide, community mental health services and communication skills.
Mobile crisis outreach may provide support to individuals in the community needing help in a mental health crisis, their families, friends and caregivers. They often provide immediate telephone support with prompt response to a crisis. Responsibilities may also include pre-crisis and follow-up support and respite housing and hospitalization if needed. Mobile crisis outreach may also involve providing linkages to mental health and community services as well as medical psychiatric back-up and hospital services.
Types of Providers
Crisis response workers' backgrounds vary depending on the particular aspect of crisis intervention. Many distress centres have volunteers working in combination with paid staff. Mobile crisis teams are often multidisciplinary involving nursing, social work and psychology. Residential services may have social service workers.
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Description
Dual diagnosis refers to the provision of assessment, treatment and psychosocial rehabilitation for people who have mental health problems and a developmental disability.
Because developmental disabilities occur across a continuum from mild to severe, the needs of individuals requiring service varies. Many people live independently in the community with minimal assistance and others with severe disabilities live in residential environments and require significant support that can include complex medical care.
Types of Providers
Services for individuals with dual disorders cover the same spectrum as other mental health services and are delivered by providers from all areas. It is important to note that the providers require dual expertise with developmental disability and mental health issues.
The providers for this population of people include doctors, nurses, social workers, psychologists, housing workers, personal support workers, and social service workers.
Useful Resources
Description
Early intervention is the provision of specialized treatment and support services to persons experiencing a first psychotic episode and their families.
Types of Providers
Treatment is provided by a multi-disciplinary team that may include: a peer support worker (or a mentor), an occupational therapist, a social worker, an employment counsellor, a nurse and a psychiatrist.
Useful Resources
Description
Mental health services for eating disorders describe the provision of specialized assessment, treatment and support services to persons with an eating disorder(s).
Types of Providers
Recovery from eating disorders takes place over a continuum, as clients become more medically stable and transition from inpatient to ambulatory care, their needs change from requiring more medical intervention to more psychological, socio-behavioral therapy, with meal preparation and supervision provided by nutritional experts and dieticians.
Useful Resources
Description
Family health teams will provide a continuum of care addressing health promotion, disease prevention, and treatment. Primary mental health care is one of the Comprehensive Care Services that will be provided, coordinated or overseen by health providers in family health teams.
Types of Providers
Family health teams are interdisciplinary teams of doctors, nurses, nurse practitioners and other professionals that will be providing primary care around the clock through extended office hours and the telephone health advisory service.
Family health teams may include, as appropriate, mental health workers, physicians specialists, diagnostic services, linkages to home care services, and some outpatient surgery services.
Useful Resources
Description
Family Initiatives pertain to family groups participating in planning and evaluation of care delivery as well as the provision of services such as self-help, peer support, advocacy, education, referrals and supportive counseling to families that have a mentally ill relative. Some family support organizations are professionally based and facilitated, often as part of a clinic or other treatment program. Others are peer run in the self-help model. Similar to self-help among people with mental illnesses, family self-help can range from small supportive groups to large organizations.
Useful Resources
Description
Forensic mental health services include the assessment, management and treatment of mentally disordered persons in conflict with the law . Forensic clients may have multiple and complex overlapping needs relating to aggression, legal status and clinical / risk management. Serving these clients requires coordination and cooperation among health, social service and judicial systems.
Types of Providers
Forensic service providers are mental health professionals with experience or training in this specialized area and include psychiatrists, psychiatric nurses, psychologists, and social workers.
Useful Resources
Description
Housing supports and services may be for clients in congregate or individual accommodation and may include varying levels of support.
Housing support services may include:
- individualized assessment and planning;
- hand on assistance with activities of daily living;
- co-ordination and support, ensuring a stable housing environment;
- crisis management; and,
- facilitating peer and group support and resident input to their housing environment.
Housing supports may also include support services provided to individuals who are homeless or at a risk of being homeless. This may include services such as connecting with landlords, matching people to housing, housing advocacy, and teaching life skills.
Types of Providers
Housing support workers can come from a variety of areas and include social service workers, personal support workers and many others.
Useful Resources
Description
Mental health services are delivered to children and youth by numerous community agencies located throughout the province. Services are available to children up to the age of 18 who are experiencing social, emotional, behavioural or psychiatric problems. Children who require services may have eating disorders, conduct disorders (such as aggression, fire setting), have been physically and/or sexually abused, have witnessed family violence, or are unable to cope with separation and/or divorce or the death of a family member.
Mental health services are provided by agencies funded by the Ministry of Children and Youth Services (MCYS) and the Ministry of Health and Long-Term Care (MOHLTC). There is no direct funding to parents, children and youth.
The types of services offered include:
- Assessment and treatment interventions.
- Prevention and early intervention.
- Clinical services including psychiatric treatment, substance abuse counselling, individual therapy, crisis intervention, anger management, group therapy, family counselling, behaviour management, residential care and day treatment.
- Social supports and prevention services such as parent education and training, life skills training and problem solving skills.
Types of Providers
Community mental health services for children and youth occur across a broad spectrum. Consequently, many types of providers work in this area including child psychiatrists, case managers, counsellors, social workers, social support workers, etc.
Useful Resources
Description
Interpreter services in mental health settings provide a language and cultural bridge between a deaf person and a hearing person in order for the person who is deaf or hard of hearing to utilize mental health and addiction services, such as court appearances, medical appointments, counselling or therapy sessions.
Intervenor services are provided to deaf, deafened, hard of hearing, visually impaired or blind individuals in mental health settings. The services include socialization, mobility training, acquisition/maintenance of life skills, as well as interpreting services. Intervenors generally provide services for the full range of life activities.
Types of Providers
The interpreter functions as part of a professional team (e.g., education, legal, medical and mental health settings) where it may be appropriate for him or her to comment on the overall effectiveness of communication, the interpreting process and to suggest appropriate resources and referrals. Interpreters may be employed as part of an emergency service team or other mental health settings where clear and accurate communication assists professionals in determining correct medication or other interventions. This is done within the context of the professional team. Interpreters use American Sign Language (ASL, or LSQ for francophones) to translate the spoken word for those who cannot hear.
The Canadian Hearing Society provides Ontario Interpreter Services. (OIS) Interpreters are generally required to graduate from an accredited Interpreter Education Program and pass a competency test. They must adhere to a professional code of conduct and ethics that ensures accuracy, confidentiality and impartiality.
Useful Resources
Description
Mental health promotion and education involves promoting mental health through educating the community, including both the general public, health professionals and other sectors which impact on the health of individuals and populations. Health promotion may be for general awareness or targeted to specific populations such as women's mental health.
Types of Providers
Mental health promotion and education often occurs as part of other services such as case management and psychosocial rehabilitation consequently providers vary in background.
Useful Resources
Description
Specialized geriatric mental health outreach programs provide assessment, consultation, treatment and education to seniors with serious mental illness, as well as to their families and service providers, through an interdisciplinary/multidisciplinary approach. In most cases, seniors with mental illness or their families can be referred to these programs directly or they can be referred through their family doctor.
Types of Providers
The providers in this area come from many areas, including in psychiatry, psychology, social work, and nursing who are trained to treat late-life mental disorders.
Useful Resources
Description
Peer support describes the provision of a range of consumer directed and consumer driven initiatives including self-help initiatives, drop-in centres and public and provider education about self-help.
Peer support workers or peer support counsellors have experienced mental illness and by sharing their experiences with others are uniquely positioned to support individuals in the process of recovery. This approach supports a wellness model and assumes individuals with mental illness are normal which is a different perspective than the medical model which sees them as sick.
Types of Providers
Providers in this area are those with personal experience of the mental illness and/or the mental health system.
Useful Resources
Description
Psychosocial supports are designed to help individuals pursue their life goals. Included are the following types of supports:
- educational /academic;
- vocational / employment;
- housing;
- recreational;
- social (e.g., activities focused on spirituality or those centred on the development of skills needed to establish social / intimate relationships); and,
- peer or mentor support / self-help supports.
These supports help individuals achieve self-defined cognitive, vocational, social, educational, emotional and other goals.
Types of Providers
This is a description of a type of an overall approach and it is generally translated into more specific programs such as case management. It also describes a group of programs offered by an agency/organization and even a philosophical approach.
Description
Social Rehabilitation and Recreation pertains to the provision and promotion of opportunities for persons with a serious mental illness to develop inter-personal, social, and leadership skills, in order to interact fully in their communities as defined by themselves. Social rehabilitation/recreation requires any or all of the following client-directed services:
- assessment,
- counselling,
- planning,
- consultation with other service providers,
- service co-ordination,
- advocacy,
- monitoring, and
- evaluation.
Services may include development of linkages with other service providers to maximize opportunities for social rehabilitation to isolated persons.
Types of Providers
This is a description of an aspect of other services like peer support, case management and vocational rehabilitation consequently providers come from many different areas.
Description
Transition aged youth pertain to the provision of services to youth with mental health needs between 16-24 years of age.
Types of Providers
This is a particular population consequently all aspects of mental health services are covered. Providers come from all areas but have particular training and/or experience with mental health issues and this age group.
Useful Resources
Description
Vocational rehabilitation and employment initiatives strive to remedy unemployment among persons with a serious mental illness. Vocational rehabilitation may involve a number of different elements, including:
- job development or creation and employer outreach;
- skills development or training for employment or educational opportunities;
- skills training on the job;
- job search skills and job placement;
- employment planning or career counselling;
- supported education;
- supports to sustaining education or employment; and
- leadership training.
Types of Providers
Providers can come from a variety of different training and experiential backgrounds.
Useful Resources