Faculty and Resident Orientation Manual Division of Child & Adolescent Psychiatry

Transcription

Faculty and Resident
Orientation Manual
Division of Child & Adolescent Psychiatry
The University of Western Ontario
Schulich School of Medicine and Dentistry
Department of Psychiatry
TABLE OF CONTENTS
WELCOME ...................................................................................................................................................................... 4
ORIENTATION FOR POSTGRADUATE RESIDENTS ............................................................................................................ 5
POSTGRADUATE EDUCATION ............................................................................................................................................ 5
EDUCATIONAL OPPORTUNITIES ........................................................................................................................................ 6
OTHER EDUCATIONAL OPPORTUNITIES FOR RESIDENTS ................................................................................................... 6
ADMINISTRATIVE ASPECTS OF THE UNIVERSITY OF WESTERN ONTARIO DIVISION OF CHILD AND ADOLESCENT
PSYCHIATRY ....................................................................................................................................................................... 7
LONDON HEALTH SCIENCES CENTRE – CHILD AND ADOLESCENT MENTAL HEALTH CARE PROGRAM ............................... 8
PSYCHIATRISTS AT LONDON HEALTH SCIENCES CENTRE ................................................................................................... 8
COMMUNITY BASED CAP PSYCHIATRISTS IN SOUTHWESTERN ONTARIO ....................................................................... 10
LHSC PROGRAMS ......................................................................................................................................................... 11
DAY TREATMENT PROGRAM ........................................................................................................................................... 11
INPATIENT MENTAL HEALTH CARE PROGRAM ................................................................................................................ 13
THE OUTPATIENT PROGRAM ........................................................................................................................................... 14
EATING DISORDERS PROGRAM........................................................................................................................................ 15
QUICK RESPONSE CLINIC.................................................................................................................................................. 17
MATERNAL CHILD MENTAL HEALTH PROGRAM .............................................................................................................. 18
TRANSITION AGE PROGRAM............................................................................................................................................ 19
CATCHMENT AREAS ......................................................................................................................................................... 19
REGIONAL MENTAL HEALTH CARE – LONDON (ST. JOSEPH’S HEALTH CARE) ................................................................ 25
THE CHILD AND PARENT RESOURCE INSTITUTE (CPRI) ................................................................................................. 25
VANIER CHILDREN’S SERVICES ..................................................................................................................................... 27
RESIDENCY TRAINING SITES IN WINDSOR .................................................................................................................... 28
CHILDREN FIRST (WWW.CHILDREN-FIRST.CA)......................................................................................................................... 28
SUMMIT CENTRE (WWW.SUMMITCENTRE.ORG) .................................................................................................................... 29
GLENGARDA CHILD AND FAMILY SERVICES (WWW.GLENGARDA.ON.CA) .............................................................................. 29
WINDSOR REGIONAL CHILDREN’S CENTRE (WWW.WRCHILDRENSCENTRE.ORG)..................................................................... 30
MARYVALE ADOLESCENT AND FAMILY SERVICES ............................................................................................................ 31
TEEN HEALTH CENTRE (WWW.TEENHEALTHCENTRE.COM) ...................................................................................................... 32
EMERGENCY GUIDELINES ............................................................................................................................................. 33
OTHER COMMUNITY AGENCIES ................................................................................................................................... 40
1. LHSC – VICTORIA HOSPITAL.......................................................................................................................................... 40
2. LHSC – UNIVERSITY HOSPITAL ...................................................................................................................................... 40
3. ST. JOSEPH’S HEALTH CARE .......................................................................................................................................... 40
4. ST. JOSEPH’S HEALTH CARE – REGIONAL MENTAL HEALTH CARE – LONDON SITE – ADOLESCENT UNIT ...................... 40
5. CPRI * - CHILD AND PARENT RESOURCE INSTITUTE ...................................................................................................... 40
6. MERRYMOUNT CHILDREN’S CENTRE ........................................................................................................................... 41
7. HARDY GEDDES HOUSE ................................................................................................................................................ 41
8. WESTERN AREA YOUTH SERVICES (WAYS) * ................................................................................................................ 41
2
9. CRAIGWOOD YOUTH SERVICES * ................................................................................................................................. 41
10. VANIER CHILDREN’S SERVICES ................................................................................................................................... 42
11. CHILDREN’S AID SOCIETY, LONDON AND MIDDLESEX ................................................................................................ 42
12. CRISIS-INTAKE TEAM (CIT) .......................................................................................................................................... 42
13. CENTRE FOR CHILDREN AND FAMILIES IN THE JUSTICE SYSTEM * ............................................................................. 42
14. FAMILY SERVICE LONDON .......................................................................................................................................... 42
15. GENEST DETENTION CENTRE FOR YOUTH (YOUTH 12-15) ......................................................................................... 43
16. KING STREET DETENTION CENTRE FOR YOUTH (YOUTH 12-15) ................................................................................. 43
17. GUNN STREET GIRLS HOME ....................................................................................................................................... 43
18. MAITLAND STREET GROUP HOME ............................................................................................................................. 43
19. OXFORD AND ELGIN CHILD AND YOUTH CENTRE * .................................................................................................... 43
20. HURON-PERTH CENTRE (HPC) * ................................................................................................................................. 43
21. GREY BRUCE CHILDREN’S SERVICES *......................................................................................................................... 43
22. ANAGO GROUP HOME * ............................................................................................................................................ 44
23. SCIP (SCHOOL COMMUNITY INTERVENTION PROGRAM) .......................................................................................... 44
24. CHILDREN’S SERVICES COORDINATING NETWORK (CSCN) ........................................................................................ 44
ONTARIO CHILD AND YOUTH TELEPSYCHIATRY PROGRAM – WESTERN HUB ............................................................... 45
3
WELCOME
The Residents, Faculty and Staff of the Division of Child and Adolescent Psychiatry welcome you to
London, and hope you will take some time to review our programs and give serious consideration to the
excellent educational opportunities available in our Division.
There are a number of sites in the London and Southwestern Ontario mental health community, offering
experiences in a variety of specialties. We offer the chance to explore areas new to you by taking elective
rotations, dictated primarily by your interests and career goals. Your rotation in Child and Adolescent
Psychiatry will offer the opportunity to gain exposure and expertise in inpatient, day treatment, outpatient
or residential areas; and provide you with experience with patients ranging from toddlers to young adults.
You may spend time in several sites within the city of London; or take advantage of placements in
Windsor, Chatham, or in other communities in Southwestern Ontario. Telepsychiatry is embedded within
the core training of Child and Adolescent Psychiatry. Various treatment modalities are available including
family therapy, play therapy, supportive therapy, insight-oriented therapy, cognitive-behavioural therapy,
interpersonal psychotherapy, and dialectical-behavioural therapy. The Division of Child and Adolescent
Psychiatry offers training for both General Adult Psychiatry residents and residents specializing in Child
and Adolescent Psychiatry.
Your education in the Division of Child and Adolescent Psychiatry will provide the opportunity to work
with an exceptional group of residents from across North America and around the world. The residents
here enjoy a convivial and collegial relationship, both professionally and socially. You will reap the
benefits of the support of a dedicated and committed peer group, and will have the chance to participate
in social events organized by and for this diverse group.
We hope this provides information about how our programs can best meet your needs and objectives.
We invite you to contact our Division Chair, Dr. Sandra Fisman, or the Postgraduate Education Director,
Dr. Patricia Hall, to talk about the career and educational opportunities in London and area.
Child and Parent Resource Institute (CPRI)
Centre for Children and Families in the Justice System
Children’s Aid Society
London District Catholic School Board
London Health Sciences Centre
Vanier Children’s Services
Residency Training Site in Windsor
St. Joseph’s Regional Mental Health Care
Thames Valley District School Board
Western Hub Telepsychiatry Program
Clinics in Community
4
ORIENTATION FOR POSTGRADUATE RESIDENTS
POSTGRADU ATE EDUCATION
PGY 1 General Adult Psychiatry Residents

All postgraduate year one psychiatry residents do one block of child and adolescent psychiatry.
The rotation will occur on the Inpatient Unit (B8200) of the Child and Adolescent Mental Health
Care Program at London Health Sciences Centre (LHSC). You will be notified of what month your
rotation is by the program coordinator, Eva Adams.
PGY 3 General Adult Psychiatry Residents

All residents in postgraduate year three do a mandatory six blocks of training in Child and
Adolescent Psychiatry (CAP). Residents must complete this experience in both
inpatient\residential and outpatient settings. The resident could complete all six blocks in one
placement if they had exposure to inpatient\residential and outpatient\community settings
simultaneously or the resident could spend three of the six blocks in inpatient\residential
programs and three blocks in an outpatient\community setting. Inpatient program refers to a
hospital-based program in an acute care or tertiary care hospital. A residential program refers to a
setting where children and adolescents with mental health problems are assessed and treated
therapeutically under the supervision of a child and adolescent psychiatrist. During the six blocks
of training in Child and Adolescent Psychiatry, a two week rotation in Developmental Disabilities
is required. Residents will meet with the Postgraduate Education Coordinator in the Division of
Child and Adolescent Psychiatry in the Postgraduate year 2 to arrange their rotations. Residents
should also arrange to do one telepsychiatry consultation with the Western Hub. Please see Core
Training Objectives which follow in this section.
PGY 5 and PGY6 Child and Adolescent Psychiatry Residents

Twenty for months of approved residency in Child and Adolescent Psychiatry which must include:




At Least 18 months of clinical training in Child and Adolescent Psychiatry including
Inpatient, Ambulatory (Outpatient clinics, day treatment program, provision of consultation
liaison to pediatric services, provision of direct or indirect patient or program consultation
to schools, correctional programs, and community mental health services), and at least 6
months of this training must occur in the final year of experience.
Clinical selectives up to 6 months within the clinical training period may be comprised of
rotations in approved programs outside of, but related to the practice of Child and
Adolescent Psychiatry. Each of these rotations must be one month in duration and may
include Neurology, Neuroimaging, Pediatrics, Adolescent Medicine, Developmental
Disabilities, Addictions, and Forensic Psychiatry.
Regular opportunity for and experience in emergency/urgent assessment and care of
children and youth in a minimum longitudinal experience equivalent to one month’s
duration.
Up to the equivalent of 6 months of advanced knowledge and skill straining relevant to
Scholar and/or Manager and is undertaken utilizing a horizontal or longitudinal experience
5
in a special area of interest in at least one of the following domains, Health care delivery,
Research, Teaching, Educational Scholarship, Administration.

Please contact Tracy Henebry, Program Coordinator by email Tracy.Henebry@lhsc.on.ca for
more specific information regarding the Child and Adolescent Psychiatry Subspecialty Program.
All residents are to do family therapy during their training in Psychiatry. Please meet with the
Psychotherapy Coordinator of the Department of Psychiatry to discuss meeting your psychotherapy
requirements. The department of psychiatry is actively developing Family Therapy experiences across
the lifespan. The Division of Child and Adolescent Psychiatry offers several modalities of family therapy
training at various locations.
EDUCATIONAL OPPORTUNITIES
Child and Adolescent Psychiatry Teaching Rounds



occur the third Thursday of each of the following months: September, October, November,
December, January, February, April, and May; they occur from 830 to 1000; they are usually held
at LHSC-Victoria Hospital in room# B2-119
residents are to organize the rounds
one month prior to your rounds please send title and three objectives to the administrative
assistant for the University of Western Ontario Division of Child and Adolescent Psychiatry.
PGY3 Module Lecture Series

occur Thursday afternoons during the year.

schedules are provided by the Department of Psychiatry PGME office.
Child and Adolescent Psychiatry Complex Case Rounds and Journal Club

occur on the second Wednesday of every month from 12:15 to 1:15; they are usually held at
LHSC-Victoria Hospital in room# B8-035.
PGY5 and PGY6 Child and Adolescent Psychiatry Subspecialty Curriculum

occur Thursday afternoons during the year.

Schedules are provided by the Child and Adolescent Psychiatry PGME office.
OTHER EDUCATIONAL OPPORTUNITIES FOR RESIDENTS
Continuing Medical Education (CME) Rounds

child\adolescent psychiatry has CME rounds the second Thursday in June- the rounds occur
between 08:30 and 10:30; a resident usually presents a case; a local or invited speaker gives a
one hour talk; and one member of the Division of Child and Adolescent Psychiatry moderates the
session
6
Semi-Annual Division of Child and Adolescent Psychiatry Meeting

consists of a short business meeting followed by an invited guest speaker and dinner.
Annual Division of Child and Adolescent Psychiatry Meeting

consists of a business meeting and is followed by an invited guest speaker and dinner.
Annual UWO Division of Child and Adolescent Psychiatry Conference

Usually occurs on the last Thursday in April of each year; a whole day; usually one or two
speakers
ADMINISTRATIVE ASPECTS OF THE UNIVERSITY OF WESTERN ONTARIO
DIVISION OF CHILD AND ADOLESCENT PSYCHI ATRY
Advisory Committee of the UWO Division of Child and Adolescent Psychiatry


members include the Division Chair, Undergraduate Education Coordinator, Postgraduate
Education Manager, CME Education Director, representative from the Thames Valley District
School Board, representative from the London and District Catholic School Board, Research
Director, Resident Representative, Southwestern Ontario Medical Education Network
(SWOMEN), Community Member, Faculty of Education at Western, Children’s Aid Society
Member
this committee meets four times per year
Undergraduate Education Coordinator

Dr. Ben Loveday, RMHC-London, coordinates the clinical clerkship; he coordinates elective
medical students; he sits on the monthly Undergraduate Education Committee of the Department
of Psychiatry
Postgraduate Education Manager
 Dr. Patricia Hall coordinates the PGY3 psychiatry residents for their child\adolescent psychiatry
rotations
 Coordinates the PGY3 module lecture series
 sits on the Resident Training Committee
Child and Adolescent Psychiatry Subspecialty Program Director

Dr. Patricia Hall is responsible for developing and maintaining the specific standards of
accreditation by the Royal College of Physicians and Surgeons of Canada. The Postgraduate
Director is involved in multiple committees including chairing the RTC.
Family Therapy Program

The psychotherapy coordinator for the Department of Psychiatry coordinates family therapy
experiences for residents
7
Research Director

Dr. Jeff Carter, Vanier Children’s Services, will meet with each career child/adolescent psychiatry
resident to discuss their plans for research to fulfill diploma requirements.
LONDON HE ALTH SCIENCES CENTRE – CHILD AND ADOLESCENT
MENTAL HE ALTH CARE PROGRAM
Outpatient Program
Day Treatment Program
Eating Disorders Program
Inpatient Unit
Intake Department
PSYCHI ATRISTS AT LONDON HE ALTH SCIENCES CENTRE
Outpatient Department

Dr. Sandra Fisman

Dr. Margaret Steele

Dr. Heidi Haensel

Dr. Patricia Hall

Dr. Michelle Ngo

Dr. Javeed Sukhera

Dr. Naveed Rizvi – two full days per week
Eating Disorder Program

Dr. Alexandra Nowicki

Dr. Liga Stare - pediatrician works two days per week
Inpatient Program

Dr. Kamran Kizilbash

Dr. Javeed Sukhera
First Episode Mood and Anxiety Program

Dr. Sarah Armstrong – two days per week

Dr. Michelle Ngo – four days per week
8
Telepsychiatry

Dr. Naveed Rizvi – Physician Lead
Telepsychiatry service is known as the Western Hub. It is situated primarily at CPRI but LHSC, St.
Joseph’s Health Center – Regional Mental Health Care – London (SJHC-RMHC-L), Windsor Regional
Hospital (WRH) and the UWO Division of Child and Adolescent Psychiatry are all partners. You may be
asked to do some telepsychiatry consultations. Rhonda Persichilli is the intake coordinator and is based
at CPRI.
All referrals to the Child and Adolescent Mental Health Care Program (with the exception of child and
adolescent psychiatry emergency consultations) will be directed to the intake department. For those
referrals for inpatients, the referral should be directed to Inpatient Child and Adolescent Psychiatrists Dr.
Javeed Sukhera and Dr. Kamran Kizilbash. For outpatient consultations, intake will work with the
outpatient Child and Adolescent Psychiatrists and their secretaries to book these appointments.
Telepsychiatry consultations go to Rhonda Persichilli at CPRI.
Psychiatrists at CPRI












Dr. Al Brown – full time, psychiatrist for residential unit for patients with Developmental Disabilities
and sees outpatients with emotional disorders
Dr. Rida Mirza – three days a week, sees general outpatients
Dr. Rob Nicolson – Chair of the Developmental Disabilities Division; pervasive developmental
disorders; developmental disabilities; (he also has a research office at LHSC), three days a week
at CPRI, sees children with PDD
Dr. Ajit Ninan – full time, Medical Director for CPRI, psychiatrist for the short-term assessment
unit for 6-12 year olds
Dr. Naveed Rizvi – three days per week, psychiatrist for Mood Disorders Clinic and Physician
Lead for Telepsychiatry
Dr. Sohail Makhdoom – full time, sees outpatients with developmental disabilities and pervasive
developmental disorder
Dr. Nevena Dourova – full time, psychiatrist for the residential unit for adolescent girls and
general outpatients and consults to Selective Mutism Clinic
Dr. Sarah Armstrong – three days a week, sees outpatients through Mood Disorders Clinic and
Brake Shop (Tic Disorders Clinic) and general outpatients
Dr. Simran Ahluwalia- full time, psychiatrist for residential unit for developmentally disabled
patients under 12 and consults to ACES (Attachment disorders clinic) and Telepsychiatry and
Complex Special Needs
Dr. Tim Beal – full time, psychiatrist for residential unit for adolescent boys, telepsychiatry,
forensic work, Psychiatry Discipline Lead
Dr. Jose Mejia – one day a week, psychiatrist with Sexual Behavior’s Team and telepsychiatry
Dr. Linda Plowright – two days a week, Dual Diagnosis Program
9
Psychiatrists at St. Joseph’s Hospital – Regional Mental Health Care Program – London Site –
Adolescent Unit


Dr. Ben Loveday – Inpatient unit
Dr. Sandra Fisman – Physician Lead for the entire program at SJHC-RMHC-London adolescent
unit and outreach program and provides consultation for the outreach program
Children’s Aid Society

Dr. Krystyna Wojakowski
COMMUNITY BAS ED CAP PSYCHI ATRISTS IN SOUTHWESTERN ONTARIO

a list of community based child and adolescent psychiatrists in Southwestern Ontario is available
through the Division Chair’s office.
10
LHSC PROGRAMS
Mandate

The Child and Adolescent Mental Health Care Program is a regional provider of primary,
secondary, and tertiary child and adolescent mental health services with four components:
Inpatient, Outpatient, Eating Disorders, and Day Treatment.

The Child and Adolescent Mental Health Care Program serves children and adolescents who
present with mental health difficulties, such as: Mood Disorders including Depression, Bipolar
Disorder and suicidal behaviours, Anxiety Disorders, Schizophrenia, Psychotic Disorders, Eating
Disorders, Post Traumatic Stress Disorder, Psychosomatic Disorders, as well as acute symptoms
of distress related to family or personal crisis, abusive experiences, and/or experiencing or
witnessing traumatic events and changes within the family.

Please note that the Child and Adolescent Mental Health Care Program does not serve children
and adolescents whose needs are better addressed by other agencies due to such primary
presenting concerns as: behavioural problems, attention deficit hyperactivity disorder, conduct
disorder, oppositional defiant disorder, substance abuse, pervasive developmental disorders,
learning disabilities, marked intellectual impairment and physical illness without an associated
mental health problem. We also do not accept referrals to conduct Custody and Access
Evaluations, Child Welfare Assessments or Young Offender Assessments.
DAY TRE ATMENT PROGRAM
The Child and Adolescent Mental Health Care Day Treatment Program offers a two week assessment of
children and adolescents, between 10 and 17 years of age, who require more intensive services than
available through the Outpatient program, but who do not require hospitalization. The anticipated length
of stay is 2 to 16 weeks.
Assessment and treatment are provided by an interdisciplinary team which includes various disciplines
including psychiatry, psychology, social work, child and youth counseling and nursing, and special
education.
During the first two weeks, a comprehensive interdisciplinary assessment is completed. The program
team works closely with youths and families to identify treatment goals and individualized treatment
plans. According to the needs of the youths and the families, the day treatment program offers individual
psychotherapy, group therapy, family therapy and/or pharmacotherapy in a structured therapeutic
environment.
Children and adolescents also participate in the W.D. Sutton school component of the program. The
program team works in close collaboration with the community care providers and the schools to promote
a timely return of youths to their community. After discharge youths are offered outreach support to
prevent early relapse.
11
Education

The Child and Adolescent Centre offers a workshop on a yearly basis. Some of the topics have
included:












Conduct Disorder
Attention Deficit with Hyperactivity Disorder
Attachment
Self-Harm Behaviours
Treating Child and Adolescent Depression
Children’s Mental Health at School
Understanding and Treating Trauma: Biological, Social, Psychological, and Legal
Perspectives
Psychopharmacology Update
Child Maltreatment: Prevention and Intervention
Eating Disorders in Adolescents
Psychosis: From Childhood to Adulthood
Speakers are available to community agencies and groups on a variety of subjects, such as the
assessment and treatment of children and adolescents presenting with Eating Disorders, Mood
and Anxiety Disorders, Post Traumatic Stress Disorder, and other mental health difficulties.
Presentations can also be provided on child and adolescent development, family therapy,
pharmacotherapy, among other possibilities.
Research

The Child and Adolescent Mental Health Care Program has a commitment to scientific practice in
the broadest sense, with ongoing evaluation of clinical programs and participation in clinical
research related to etiology, epidemiology, assessment and intervention.
How To Reach Us

Referrals for all services are accepted from family members, community physicians, mental
health practitioners, schools, social agencies, and other mental health facilities. For psychiatric
consultation a physician's referral letter is mandatory.
Child and Adolescent Mental Health Care Program
8th Floor, B Zone
Children's Hospital, LHSC
800 Commissioners Road
London, Ontario
Tel: (519) 667-6640
Fax: (519) 667-6814
12
INP ATIENT MENTAL HE ALTH CARE PROGRAM
Who We Serve


We serve children and adolescents under age 18 requiring short term inpatient admissions for
crisis stabilization.
Child and Adolescent Inpatients is a regional provider of children’s mental health services in
Southwestern Ontario. Crisis and urgent assessment and treatment for children, adolescents, and
their families is the dominant focus of service delivery. The program serves children and
adolescents who present with mental health difficulties such as: mood disorders, depression,
suicidal behavior, anxiety disorders, schizophrenia, psychotic disorders, eating disorders, and
acute symptoms of distress related to family or personal crisis, abusive experiences, experiencing
or witnessing traumatic events and changes within the family.
Services Provided


The Child and Adolescent Centre offers assessment, stabilization and treatment. The inpatient
service offers short-term stabilization admissions, inpatient assessments of urgent mental health
problems presenting in crisis, and coordination with community resources for follow-up treatment
planning.
Inpatient Services are delivered by an interdisciplinary team consisting of psychiatrists, social
workers, family therapists, psychologists, nurses, child and youth counsellors, medical
consultants, teachers, and office support staff.
Education

included:








Perspectives
Eating Disorders in Adolescents
13
THE OUTP ATIENT PROGRAM
Crisis and urgent assessment and treatment for children and adolescents with mental health difficulties of
an internalizing nature, and their families, is a dominant focus of service delivery.
The Outpatient Program of the Child and Adolescent Centre offers assessment and treatment children
and adolescents who are 15 years of age or younger. Recommendations for treatment will be made at
the time of the assessment.
If ongoing services are to be provided at the Outpatient Program, this may include family therapy,
individual therapy, group therapy and/or pharmacotherapy. However, there may not be further
involvement after the initial assessment.
Services are delivered by an interdisciplinary team consisting of psychiatrists, social workers, family
therapists, and psychologists.
Education


included:

Conduct Disorder

Attention Deficit with Hyperactivity Disorder

Attachment

Self-Harm Behaviours



Perspectives



Eating Disorders in the Young

14
E ATING DISORDERS PROGRAM
Who We Serve



For clients up to age 18 who are experiencing eating problems, including restricting, bingeing,
purging, excessive exercising and related preoccupations with food, shape, and weight.
Clients may be experiencing physical symptoms related to low body weight or purging behaviour.
Eating problems must be the primary area of concern but comorbidities are also addressed.
Services Provided








Intake and screening of those up to age 18.
Assessments.
Consultations with physicians and practitioners in the community.
Inpatient stays for those in need of medical stabilization. Four beds available.
Day Treatment for those between age 13 and 18 years with serious eating problems. Eight spots
are available. Day Treatment is for those who require intensive treatment but are medically
stable. Patients and their families must be motivated to participate within the Program. The
Program runs from 8 am to 6 pm, Monday through Thursday. There is also a weekly evening
group for patients and their families. During the school year, a qualified teacher provides an
academic Program in the mornings. Afternoons include a variety of group-oriented treatments.
Patients receive meal support therapy, consisting of meals and snacks, provided within a
supervised setting.
Outpatient psychoeducational groups for clients and their family.
Outreach workers are available in six areas (Chatham, Sarnia, Stratford, Owen Sound, Goderich,
and Woodstock) offering limited services, including screening, psychoeducational groups, and/or
therapy.
A specialized multi-disciplinary team consisting of psychiatry, psychology, nutrition, social work,
child and youth work, and nursing.
Education



Eating Disorders
assessment and treatment of children and adolescents with eating disorder symptoms and
illnesses such as anorexia, bulimia nervosa, and other disorders related to these illnesses.
Opportunities for practicum students and interns in medicine(Psychiatry, Pediatrics and Family
Medicine in particular) and other , psychology, nutrition, and social work.
Research


The Child and Adolescent Mental Health Care Program has a commitment to scientific practice in
the broadest sense, with ongoing evaluation of clinical programs and clinical research related to
etiology, epidemiology, assessment and intervention.
Program evaluation in conjunction with Ontario Community Outreach Program for Eating
Disorders.
15
How to Reach Us




Referrals to the Eating Disorders Program must be made by a physician.
As part of the referral process, documentation of recent medical evaluation must be included (e.g.
physical examination and laboratory investigations within the past two weeks).
Once a physician’s referral has been received a full assessment is conducted with the client and
family and treatment recommendations are made.
If one of the programs can meet the needs of the client s/he will be invited to attend the Program.
Intake Department,
8th Floor, B Zone, Children's Hospital, LHSC
London, Ontario
Tel: (519) 667-6640
Fax: (519) 667-6814
Outpatient Program




Mainly Group Intervention
 Eating Attitudes Group (Why Weight Manual)
 Parent Support Group
 Duration is 8 - 10 weeks
Age range generally is 13 - 18 years of age
Limited Individual/Family Therapy
Designated Outreach Workers - Groups may vary










Least Intrusive Intervention Model
Continuum of Care
Regional Accessibility
Group Process
Age range is between 13 - 18 years of age
Accommodates 8 patients
Average length of stay is 6 months
Program runs Monday to Thursday 8:00 a.m. to 4:00 p.m.
Treatment Goal
 Normalized Eating
 Weight Restoration
Half Day of School (W.D. Sutton)
Inpatient Program


Accommodates 4 patients
Medical stabilization with some weight restoration
16



Average length of stay is 2 - 3 months
Up to age 18
Pediatric consultation available
Outreach Program






6 regions with approximately 2 days per week - Chatham, Goderich, Owen Sound, Sarnia,
Stratford, Woodstock
Each area has individual demands and expertise
Primarily Outpatient Groups
Limited Individual/Family Therapy
Intake Screening
Provide ongoing linkage for full assessment by Treatment Team
Referral Process






Eating Disorder Program's referral form completed by Physician
Documentation of recent medical evaluations within last two weeks including physical exam and
laboratory investigations
Imminent medical complications, Physician to Eating Disorders Program Physician contact
Outreach representatives are main community contact and intake referral process
Upon referral, full assessment by Treatment Team and treatment recommendations will occur
Refer to attached Outpatient Treatment Program and Outpatient Follow Up Protocol
QUICK RESPONSE CLINIC
Please Note: The QRC is a pilot project and information in this document may change.
Who We Serve:
The Child and Adolescent Mental Health QRC clinic accepts referrals from the Paediatric Emergency
Department in cases where the ER physician has deemed the case as urgent but not requiring an
immediate emergency psychiatric referral. Currently only patients that are in Middlesex County can be
referred to this clinic.
Services Provided:
The service provides a telephone assessment by a mental healthcare professional within 2 business
days. After the telephone interview, the patient will be given recommendations about the appropriate
services in the community that would best suit the patient needs. The mental health professional may
feel an additional consultation of a psychiatrist is needed. In this case, the patient will be seen by a
psychiatrist at the Child and Adolescent Mental Healthcare Program, for a one time consultation. The
psychiatrist may ask that the patient receive short term crisis therapy, which would be provided through
the QRC clinic.
Referrals for the QRC clinic are only accepted from the Emergency Department, Children’s Hospital,
London Health Sciences Centre. Please be aware that if the QRC does not offer treatment and is a
17
consultation service only with some very limited follow up capability (3 sessions maximum). For questions
about the QRC please contact:
8th Floor, B Zone
Children's Hospital, LHSC
London, Ontario
Tel: (519) 667-6640
Fax: (519) 667-6814
MATERNAL CHILD MENTAL HE ALTH PROGRAM
Who We Serve
The Perinatal Mental Health Care Program offers services to women with mental health issues who are
contemplating pregnancy, are pregnant, or up to one year post-partum. The attachment relationship of
the mother-child dyad is emphasized in our interdisciplinary clinic. The catchment area is the same as
that of the Women’s Care program at London Health Sciences Centre.
Services Provided
One full day clinic with an interdisciplinary team is offered, as well as a half day clinic which is focused on
diagnosis and medication-based treatment. In the interdisciplinary clinic, assessments are performed by
a team which consists of a psychiatrist, social worker and clinical nurse specialist. Medication
management, psychotherapy, birth planning and connection with community resources are all part of the
treatment modalities offered. A prenatal education workshop on attachment for expectant mothers with
mental health issues is also offered through this clinic. Depending on the needs of the patient, service
can range from one-time consult to ongoing follow-up up to one year post-partum.
Education

Speakers are available to community agencies and groups on a variety of subjects related to
mental health in pregnancy and postpartum, attachment relationships, and the mental health
needs of the mother-child dyad.
Research

The Perinatal Mental Health Care Program has a commitment to scientific practice in the
broadest sense, with ongoing evaluation of clinical programs and participation in clinical research
related to etiology, epidemiology, assessment and intervention.
18
How To Reach Us

Referrals are accepted from obstetrical and midwifery care providers, community physicians,
mental health practitioners, and public health care providers. For psychiatric consultation a
physician's referral is preferred. A referral form can be made available by contacting the program.
Perinatal Mental Health Care Program
London Health Sciences Centre
London, Ontario
Tel: (519) 667-6673
Fax: (519) 685-8595
TRANSITION AGE PROGRAM
A Transition Age Program is currently in the process of being developed.
CATCHMENT AREAS
Outpatients




London and Middlesex
Wards of the London and Middlesex Children’s Aid Society (CAS) should access psychiatric
consultations within that agency. Some exceptions may apply if crisis situation and there is a
long wait at CAS
Referrals from other counties are deferred to their local Children’s Mental Health agency
Crisis and urgent cases from Oxford and Elgin counties requiring a psychiatric consultation may
be seen on an exceptional basis, however, ongoing services are expected to be completed at the
local community level
Inpatients





Elgin
Oxford
Exceptions may occur involving the admission of patients from other counties on occasion
If patients are from out of the catchment area, referrent should be advised that for youth:
 Ages 13-17 years – they should contact St. Joseph’s Health Care Centre, Regional Mental
Health Care London – Adolescent Unit; and
 For children under 13 years – they should contact CPRI
19
Day Treatment




Elgin
Oxford
Exceptions may apply if transportation to the program can be arranged by the family and/or
guardian
Eating Disorders










Elgin
Oxford
Huron
Perth
Lambton
Kent
Grey
Bruce
Essex
PLEASE SEE ATTACHED REFERRAL FOR
20
REFERRAL FORM
Intake Office
Phone Number: (519) 667-6640
Please Fax Referral to: (519) 667-6814
Total # of pages (including this page):
Age criteria: Outpatients ages 15 and under, Inpatients 8-15 yrs., Day Treatment 10-17 yrs,
Eating Disorders - consultation and treatment for ages 17 yrs and under
For referrals regarding EATING DISORDERS: please contact our office and we will fax an
eating disorders referral form.
Name of child/adolescent:
Date of Birth:
Sex: M
Age:
F
Health Card Number: __________________
*Name of parent/guardian (please provide this information): ______________________________________
Phone number(s)-Home: ________________________ Work: _________________________________
Mailing Address: _____________________________________________________________________
___________________________________________________________________________________
Has the parent/guardian been informed of the referral?
Yes
No
If not, please do so before submitting this referral.
Referral Agent:
Role with child/family: ___________________
Phone Number:
FAX Number: _________________________
Mailing Address: ____________________________________________________________________
__________________________________________________________________________________
Detailed reason for referral: ____________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Intensity of service sought (circle only one):
Inpatient
Outpatient
Day Treatment
Date/Completed by: ________________________________________________________
Child & Adolescent Mental Health Care Program Eating Disorders
Today’s Date: ____________________________ Health Card # ________________________________
Patient’s Name: ___________________________________________
DOB: ______/_______/_______
Day
Month
Year
Address: ______________________________________________ Postal Code: ___________________
Parent/Guardian Names: ________________________________________________________________
Phone #(Res) _______________________ (Bus)_______________________(Cell)__________________
Email Address: ________________________________________________________________________
Who does patient reside with?
Who has custody of patient:
 Both parents
 Joint
 Mother
 Mother
 Father
 Father
 Guardians
 Guardians
 Ward of CAS
Step-Parent(s) Name: __________________________________________________________________
Phone #(Res) _______________________ (Bus)________________________ (Cell)________________
Referring Physician: ____________________________________________ (Specialty)_______________
Address: _____________________________________________________________________________
Phone #____________________________________________ FAX #____________________________
Email Address ___________________________________ Physician Referring #____________________
Family Doctor/Paediatrician: _____________________________________________________________
Please note: Please print or type all information legibly. Please complete all sections. Your referral will not be
processed until all information is received.
************************************************************************************
COMMENTS: _________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Clinical Urgency Please circle one
Please return entire form by fax to:
Crisis
Urgent
Semi-Urgent
Elective
Child & Adolescent Mental Health Care Program
Eating Disorders
Attention: Intake Office
Phone: (519) 667-6640
Fax: (519) 667-6814
22
PRESENTING PROBLEM(S):
DIAGNOSIS:
1.
2.
3.
WEIGHT & HEIGHT: PLEASE PROVIDE A GROWTH CHART OR COMPLETE GROWTH HISTORY IN ADDITION TO
BELOW
Please record Current Weight
Date taken:
Kg
Please record Current Height
Date taken:
Lbs.
Cm
Previous Weights:
Ft/In
Previous Weights:
Lowest
Weight Loss
Date of lowest wt:
kg/lbs
Highest
kg/lbs
Onset
Precipitating Factors
Duration
Date of highest wt:
WEIGHT CONTROL
METHODS
FREQUENCY
No
Yes
Per Day
Per Week
Food Restriction
Binge
Vomiting
Laxatives
Diuretics
Ipecac
Diet Pills
Exercise
MENSES:
Menarche: _____________________________________________________________
Usual Cycle: ____________________________________________________________
Last Menstrual Period: ____________________________________________________
Last Normal Menstrual Period: ______________________________________________
1 amenorrhea: _________________________________________________________
2 amenorrhea / length: __________________________________________________
23
LAB WORK: Please have the following lab work completed and faxed to us at time of referral
Sodium
Potassium
Chloride
Glucose
Urea
Calcium
Phosphate
ALT
Total Protein
AST
CBC, Diff., Platelets
ESR
Electrocardiogram (ECG) completed date: _____________________________________
MEDICAL STABILITY: **VERY IMPORTANT…PLEASE FILL OUT COMPLETELY WITH CURRENT INFORMATION**
Blood Pressure
lying
standing
Date taken
Heart Rate
lying
standing
Date taken
Oral Temperature
Hydration
F
poor
fair
C
good
Date taken
very good
Date taken
MEDICATIONS:
Prescribed: Name(s) & dose(s)
Non-prescribed: Name(s) & dose(s)
PRIOR MEDICAL DIAGNOSES AND/OR TREATMENT FOR THIS CONDITION AND/OR OTHER CONDITIONS
Previous Treatment for an Eating Disorder:

Yes

No
If yes, when & where _________________________________________________________________
___________________________________________________________________________________
Name of healthcare provider and tel. #: ___________________________________________________
Other medical diagnoses: _______________________________________________________________
PRIOR PSYCHIATRIC DIAGNOSES AND/OR TREATMENT:





Suicidal behaviour
Suicidal ideation
OCD
Depression
Anxiety Disorder





Self Harm Behaviours _____________________________
History of CAS involvement
History of Abuse  Sexual
 Physical
 Emotional
History of Legal Trouble (police involvement)
Substance Abuse  ETOH
 Other __________________
Please provide a separate formal referral note.
24
REGIONAL MENTAL HEALTH CARE – LONDON (ST.
JOSEPH’S HEALTH CARE)
The Regional Mental Health Care – London, Adolescent Unit is an inpatient, tertiary care facility for ages
13 to 18 years old, with a psychiatric disorder. The average stay is between 4 and 6 weeks. We have an
interdisciplinary team which includes a psychiatrist, clinical psychologist, two social workers, occupational
therapist, recreational therapist, child and youth workers and nursing staff. The residents can be involved
in numerous therapeutic modalities such as individual therapy, group therapy and family therapy. We
have regular case conferences involving patients, their families and all other parties involved, such as
Children’s Aid Society (CAS), group homes, and schools.
THE CHILD AND PARENT RESOURCE INSTITUTE
(CPRI)
CPRI provides a range of highly specialized, interdisciplinary consultation, treatment, research and
education services to children and youth from 0 to 18 years of age and their families across our 17
county catchment area.
CPRI has staff with a wide range of clinical expertise, including the following:

Child and Adolescent Psychiatrists

Developmental Paediatricians

General Paediatrician

Psychologists

Psychometrists

Occupational Therapists

Speech Pathologists

Developmental Service Workers

Dietician

Child Care Workers

Behaviour Consultants

Social Workers

Nurses (RPN’s and RN’s)

Pharmacist
25

Library Technician

Child Life Specialist

Recreation Therapist
We provide residential and outpatient services

Residential clients and their families are provided intensive services in a residential unit at CPRI
where they receive services required. There are 5 residential inpatient units at CPRI. Referral to
these units is through Single Point Access Agencies. Children and youth who are most complex
and have tried other outpatient mental health services come in to the inpatient units. Short term
assessment and treatment stays and urgent response intervention are available. CPRI has an
interdisciplinary approach to assessment and treatment including psychiatry, paediatrics,
psychology, nursing, social work, speech and language pathologists, occupational therapy and
behaviour consultants.

Outpatient clients are seen by the clinicians on site at CPRI or may by receiving other services
from CPRI in their home community e.g. behaviour consultants.
The following are the programs/services we provide:

Attachment Consultation and Education Service (ACES) - Consultation and assessment for
children and youth (birth to 18 years) with a focus on disturbances of attachment or attachment
disorders and a history of traumatic and/or disruptive life events. The child or youth may also be
experiencing difficulties in relationships, behaviours and emotional well-being, potentially
impacting his or her functioning in home, school, or community contexts. The clinical approach
includes the Circle of Security. Education, in the form of workshops, resources, and system
consultations is also available to the community.

Mood Disorder Clinic- Assessment, treatment, consultation and education for children and youth
(6-18 years) who are suspected of having early onset Bipolar Disorder.

Brake Shop- Specialized assessment, treatment, consultation and community education for
children and youth (6 to 18 years) with severe behavioural concerns or intermittent Explosive
Disorder, with a co-morbid tic disorder.

Dual Diagnosis- Assessment, consultation and treatment of children and youth 2- 18 years with
developmental delays and complex emotional and behavioral difficulties.

Intellectual Disabilities and Emotional disorders: Adaptive Strategies (IDEAS)- Assessment,
diagnosis, consultation, treatment, education for children and youth (2-18 years) with a
developmental delay and mood disorder, anxiety disorder or psychotic disorder.

Home Visiting Program for Infants (HVPI) - Early intervention program (for the counties of
Middlesex, Oxford, Elgin, Perth, and Huron only) for infants (up to 5 years) and their families who
are at risk for or have developmental or physical disabilities. HVPI is staffed with speech
pathologists, occupational therapists, nursing, physiotherapists and a psychologist.
26

Homeshare- Specialized placement program in which children and youth who are
developmentally disabled, medically fragile/technologically dependent and/or dually diagnosed,
are placed with families on a full-time and long-term basis in London and surrounding counties.
Homeshare is staffed with Social Workers and other disciplines.

Autism Spectrum Disorders (ASD ) Program- Assessment, treatment, and consultation for
children and youth up to the age of 18 years with a diagnosis of ASD.

Selective Mutism- Assessment and consultation for children and youth (3 to 18 years) who have
restricted speech in one or more settings for at least two months and have demonstrated capacity
for speech.

Sexual Behaviours- Comprehensive assessment and consultation concerning sexual behaviours
of children and youth (can include trauma assessment).

General Clinical Services – This program provides mental health services to children who present
with significant behavioural concerns that do not fit within the aforementioned specialty programs.
For more information you can visit our website at www.cpri.ca
VANIER CHILDREN’S SERVICES
Vanier Children’s Services (Vanier) is a licensed and accredited children’s mental health centre
recognized as a leader in helping children and youth age 0 to 14 with emotional and behavioural issues,
and their families. For over 40 years, we have served London and surrounding communities in
southwestern Ontario with compassionate, best-practice and innovative programs and services.
(www.vanier.com)
We work with families, professionals and our community to create a caring, emotionally healthy and
supportive environment where all children, including the most vulnerable, reach their full potential to lead
safe, productive and independent lives.
Vanier is an accredited Children's Mental Health Centre primarily funded by the Ontario Ministry of
Children and Youth Services.
Who we help

Parents are our partners. Together, we provide supports to children to increase the likelihood that
they will reach their full potential. Vanier works with the whole family's unique strengths, needs
and culture. Many of the children we help are reacting to overwhelming stresses within their lives
like death, divorce, violence, neglect, or parents with mental health or substance abuse problems.
Some are coping with genetic conditions and problems resulting from parenting.
27
What we do

Vanier serves children age 0 to 14 who have serious emotional, mental illness and behavioural
problems, and their families. Our programs and services are flexible and responsive to the
specific needs of each family.
We offer









Crisis intervention
Residential services
Day treatment
Early years programming and various attachment therapies
Individual, family, and group counseling
Community outreach
Psychiatric and psychological services
Limited francophone intake and counseling services
In home support services
RESIDENCY TRAINING SITES IN WINDSOR
CHILDREN FIRST (www.children-first.ca)
3295 Quality Way, Suite 102, Windsor, On. N8T 3R9
(519) -250-1850
Population Served

0-6
Services



Out-patient services provided to families with children who have special needs, developmental
and/or social-emotional/ behavioral.
Children and families are visited by a child and family consultant in the home and /or community
child care centres. Needs are identified and a service plan is developed which can address
learning, communication, movement, feeding, social-emotional health, and behavior, in those
settings.
Specialty staff include resource teachers, occupational therapist, physiotherapist, social workers,
speech and language pathologists, and psychologist. A consulting psychiatrist is also available.
When deemed appropriate by the child and family consultant and the family, the child can be
referred to these consultants for specific assessment/intervention.
28
SUMMIT CENTRE (www.summitcentre.org)
3735 King Street, Windsor, On.
(519) 255-1195
Population Served

preschoolers diagnosed with autism who would be no older than 48 months of age at the time of
admission to the program
Services


Provision of early intensive behavioral intervention to preschool children with autism. Children
initially receive one-on-one applied behavior analysis treatment (ABA) each week, year round.
Treatment is provided both at home and the Summit Centre. Treatment is aimed at enhancing
language and communication, social skills and play, and independent living skills. When children
turn six, Summit Centre works with schools and other agencies to provide a smooth transition.
Summit Centre also provides parent training groups and promotes research into autism (affiliated
with the University of Windsor, Department of Psychology). Modest user fees are based on a
family’s ability to pay.
GLENG ARDA CHILD AND FAMILY SERVICES (www.glengarda.on.ca)
1453 Prince Rd., Windsor, On. N9C 3Z4
(519) 257-5106
Population

6-14
Services

All programs include a multi-disciplinary team consisting of child and youth workers, special
education teachers, and social workers. Consultants in psychology and Child and Adolescent
Psychiatry are available when appropriate. In addition to the overall therapeutic milieu, the
program offers individual, family, and group counseling for children, siblings, parents, and
families.




Day Treatment – including assessment, counseling, service coordination, special education,
behavior management, life skills, and home support
Community Support Program – treatment team consisting of a special education teacher,
social worker, and child and youth worker provide support programs in community school
and/or the home, as well as counseling to the family.
Supervised Access Program
Prevention and Early Intervention Program – treatment team composed of a child and youth
worker and social worker provide classroom social skills programs, group and individual
counseling, and home support services utilizing a team approach with community school
staff.
29
WINDSOR REGIONAL CHILDREN’S CENTRE (www.wrchildrenscentre.org)
3901 Connaught St., Windsor, On. N9C 4H4
(519) 257-5215
Population

6-17
Services

Specialized Services




Autism and Related Disorders – assessment, diagnosis, intervention and training/education
resource services
Developmental Program – developmental disabilities assessment, diagnosis, intervention and
consultation with parents, therapists, and school personnel; assist children and adolescents
with significant long-term limitations in intellectual, sensory, or motor functioning combined
with significant limitations in adaptive functioning.
Neuropsychological Assessment and Consultation- neuropsychological assessment,
diagnosis, and consultation with parents, therapists, and school personnel; referrals accepted
only from children’s mental health program coordinators who are providing service to the child
and family.
Community Services

Outpatient Services – on-site and community-based programs for children aged 6-17 and
their families; social workers and child and youth workers provide the primary intervention
with access to psychology and psychiatry as deemed necessary during the course of
treatment. Services may take place in-centre, in –home, or in the community. Individual,
group, parental, and family therapy are available as well as in-home and specialized parent
training and education. Additional treatment services that may be available include the
activity-based social skills development group for adolescents and other groups designed to
address issues such as depression, anxiety, and bullying.

Youth Mental Health Court Services

Youth Criminal Justice Program – provides an array of multi-disciplinary services for
youth in conflict with the law, including psychological and psychiatric consultation
between the ages of 12-18; referred by the Youth Court or Probation Services.
Interventions provided include individual, group, and family counseling

Adolescent Sexual Offender Outpatient Program – treatment group designed for
adolescents who have sexually offended; referrals accepted from individuals, police
services probation, and Windsor-Essex Children’ Aid Society

Youth Mental Health Court Service – program works with justice system to divert youth
(16+) with mental health needs out of the formal justice system where appropriate.
Diversion services include access to a multi-disciplinary team at WRCC.
30


Crisis Response Services

Walk-in Clinic – targets children and families aged 0-18 with a variety of social, emotional, or
behavioral problem; mental health and/or psychiatric disorders, suicidality, etc. Immediate
assessment, short-term counseling / intervention and referral to appropriate community
resources provided. Clinic hours are 12-6 p.m. Monday, Tuesday, and Thursday

Emergency Crisis Response Service – provides a social worker available to hospital
emergency room M-F, 8 a.m.-11 p.m. Social worker provides assessment of children and
youth, up to age 16, who present in crisis. Emergency Crisis Response Worker will
determine, in consultation with the Director and Psychiatrist on call whether admission to
WRCC’ s crisis bed or to a Child and Adolescent bed at Maryvale, is warranted. If child is
admitted to either bed, social worker is involved in discharge planning. If child is not
admitted, social worker will develop an intervention plan for those families.
Intensive Family Services (Family Learning Place – FLP)

This is a 4-month milieu residential program for children aged 6-12; 5 residential spaces, 8
spaces from 8a.m.- 8 p.m., 1 crisis stabilization bed (30 days) . A wide menu of services are
provided by FLP, including play therapy, family therapy, group therapy, parent counseling, onsite parent training, in-home parent training, parent seminars, in-school consultation,
psychological assessment and consultation, psychiatric assessment and consultation,
recreation therapy, etc.
MARYV ALE ADOLESCENT AND FAMILY SERVICES
3640 Wells St. Windsor, On. N9C 1T9
(519) -258-0484
Population Served

11-17
Services:

Multidisciplinary team includes child and youth workers, special education teachers, social
workers, nurses, psychologist, consulting psychiatrist.

Music, art, and recreational therapy are also available. Various programs offer milieu treatment,
individual, family, and group counseling, recreational activities, and an on-campus school
operated in conjunction with the Greater Essex County District School Board.

Day Treatment Program – Services for adolescents aged 11-17 who are unable to be
maintained in community school and are typically experiencing problems at home and in the
community.
31

Stabilization and Discharge Planning Program – short term stabilization and discharge
planning for those 11-15 who are in crisis. Admission is for up to 21 days. Multi-disciplinary
assessment is conducted and a plan is formulated to address and stabilize the situation and
provide continuing support. Out-patient follow-up is typically provided by Windsor Regional
Children’s Centre.

Child and Adolescent Acute Care Mental Health Program – acute care hospital bed program
for those 11-15 experiencing significant mental health difficulties. Program is administered by
Windsor Regional Hospital and located at Maryvale. Access occurs through the E.R. at
Windsor Regional Hospital. Length of stay normally not exceeding 7 days. A multidisciplinary team provides an in-depth assessment of the adolescent after which a follow-up
plan is developed with community services for ongoing treatment after discharge.

Assessment and Receiving Program – short-term residential and assessment services for
adolescents 11-17 who have come into the care of the Children’s Aid Society. Admission for
up to 90 days to provide assessment and recommendations for longer term treatment and
living arrangements

Intensive Residential Treatment – 24 hour residential treatment as needed for adolescents
age 11-17
McIsaac residence – supervised housing and teaching of life skills for more independent
living for 5 teenage boys, aged 15-18

TEEN HE ALTH CENTRE (www.teenhealthcentre.com)
1585 Ouellette Ave., Windsor, On. N8X 1K5
(519) 253-8481
Population Served

ages 12-24
Services

A wide variety of out-patient programs including Medical and Nursing Services, Counseling
Programs, Street Health program, Self-Esteem Groups, Anger Management, Parent Support,
Nutrition Services, etc.
Coverage
32
EMERGENCY GUIDELINES
Child and Adolescent Psychiatry Consultations are available for children and youth up to the age of 17
with mental health problems (e.g., eating disorders, psychosis, severe depression, suicidality, sudden
and impairing deterioration in functioning, etc.). Referred patients have been triaged by ER staff as
requiring an emergency psychiatric consultation rather than being discharged and referred to resources
in the community or to the Quick Response Clinic. Only one exception may apply:

When the Child and Adolescent Psychiatrist on call has directed a patient to ER following a
phone consultation with specified Ministry of Child and Youth Services (MCYS).
Weekdays from 09:00 to 17:00, consultations occur in conjunction with assessments provided by
clinicians of the Child and Adolescent Mental Health Care Program at CH/LHSC. After hours and on
weekends, the Child and Adolescent Psychiatrist on call will work with the Residents in Psychiatry.
Summary of consultation process
When a consultation is deemed necessary by the ER physician the following occurs:




The Child and Adolescent Psychiatrist on call is contacted first at pager 13385 between 09:00 to
17:00.
The consultant then calls the assigned clinician if the call is received between 09:00 to 16:30.
A decision will be made to either discharge or admit the patient.
For calls received later than 16:30 or on weekends, the (Psychiatrist) ER Physician will contact
the CEPS team via the resident pager.
Phone consultations to MCYS agencies
Ministry of Child and Youth Services (MCYS) designated agencies in London-Middlesex, Elgin, Oxford,
Grey-Bruce, and Huron Perth can access a direct telephone consultation with the Child and Adolescent
Psychiatrist on call, for youth, up to the age of 18, who are their active patients. If the youth requires
assessment in ER they will be directed to CH. It is the responsibility of the Child and Adolescent
Psychiatrist on-call or the delegated resident, to notify the ER Triage Nurse of the patient’s direct referral
to Psychiatry.
Community services to consider when discharging from ER
Child and Adolescent Mental Health Care Program – Outpatients

Children and adolescents, up to the age of 17, with mental health difficulties of an internalizing
nature, such as:



Mood disorders including depression and bipolar disorder
Suicidal behaviours
Anxiety disorders, including obsessive-compulsive disorder
33






Schizophrenia and psychotic disorders
Post-traumatic stress disorder
Psychosomatic disorders
Acute symptoms of distress related to family or personal crisis, abusive experiences,
and/or experiencing or witnessing of traumatic events
Referrals for patients with eating disorders (i.e. anorexia nervosa, bulimia or eating disorder not
otherwise specified), up to the age of 17, must be completed by a physician who is prepared to
take on the role of most responsible physician until the case is assessed by the Eating Disorders
team. These referrals are made to Child and Adolescent - Intake using a specific form with
recent lab work and ECG results
Process






Telephone: 519-667-6640
Mail the Emergency Contact Sheet to Child and Adolescent Intake, Victoria Hospital, or fax to
76814. Please ensure copy is legible
The Child and Adolescent Psychiatrist on call or delegate should call Child and Adolescent
Intake advising that a referral is being made to ensure that Intake is able to follow up promptly
in processing the referral
Family will be contacted once the referral is received, but it is recommended that they follow
up if they have not been contacted in 3 working days
As waiting lists can vary widely, families should not be told a specific time for the
appointment.
An intake phone interview will be completed to determine appropriateness and urgency of
service
Crisis-Intake Team (C-IT) – 519-433-0334

Children and youth up to the age of 17 with such mental health difficulties as:





Services offered include





Disruptive behaviors
Substance abuse
Families and youth in conflict
Youth in crisis due to psychosocial stressors
Crisis support
After hours service
Intake and triage to one of three agencies, including Vanier, Craigwood, and Western Area
Youth Services (WAYS)
An intake interview will be completed to determine appropriateness and urgency of service
Process
 Provide families with the C-IT number to refer themselves directly.
34
Children’s Aid Society (CAS) - 519 -455-9000



Children and adolescents in need of protection.
Process
 Consult with ER staff if sexual or physical abuse is suspected so that ER abuse protocol can
be completed.
If no immediate danger anticipated but past abuse suspected, call CAS directly.
Faculty and Residents – On Call Scheduling
The Administrative Assistant for the Division Chair will contact the faculty for on call availability 2 months
in advance.
During the week the Psychiatrist on call provides coverage starting at 9:00 am for 24 hours except on
Fridays when coverage starts at 9:00 am for 8 hours ending at 5:00 pm. Weekend coverage is provided
by one psychiatrist who starts on the Friday at 5:00 pm and provides coverage until the Monday morning
at 9:00 am.
Residents in the Child and Adolescent Psychiatry Subspecialty Program are required to provide coverage
for one weekend day per month. This coverage will start either Saturday or Sunday at 9:00 am for a 24
hour period. The Program Coordinator for the Child and Adolescent Psychiatry Subspecialty Program will
contact the residents to confirm their availability.
*See attached flowcharts for details about ER assessments for children and youth and admission
procedures and EPC Psychiatrists Reporting Form
35
36
Child Psychiatry Day Call ER Assessment Flowchart #1
(Clinician, Resident and Psychiatrist on call)
Referral made to the Child and Adolescent
Psychiatrist On-call
Psychiatrists calls clinician on call to inform
them of the referral
Clinician calls resident on call to discuss referral and will decide with the resident who will
complete the initial assessment based on flow in the Adult ER. If no resident on call please
see flowchart #2.
Clinician or resident (or both if resident is new to service and would
benefit from watching clinician interview patient) proceed to the ER
to assess the patient
Chart and any other notes available reviewed
Assessment process:
o
o
o
o
o
o
o
Inform patient of clinician/resident role in assessment process and others involved (ie. resident
and/or Psychiatrist)
Explain purpose of ER assessment – to explore and understand what has brought the patient to the
ER and to develop a plan for the management of acute needs
Explain the process of the assessment
Explain the boundaries of confidentiality
Complete the history and gather any necessary collateral information
Interview patient and care-giver separately
Complete the child psychiatry ER contact
37
If initial assessment completed
by clinician
If initial assessment completed by
resident or resident and clinician
together
Clinician calls resident to inform
them that the assessment has been
completed
Resident calls the Psychiatrist oncall and reviews the case over the
telephone
Resident proceeds to the Child ER, and
reviews case with the clinician in person
Resident may choose to call clinician
as well to discuss case and gather
more information about community
resources
Resident sees the patient and accompanying
adults to review pertinent points of the history
and ask any additional questions they deem
necessary- the clinician may choose to join the
resident during this process
Psychiatrist, resident, and possibly
clinician collaborate in making the
decision to admit or discharge the
patient
Resident calls the Psychiatrist on-call
and reviews the case over the
telephone
Resident discusses the admission
or discharge plan with the patient
and accompanying adults
Psychiatrist, resident, and clinician collaborate in
making the decision to admit or discharge the
patient
Resident completes the
diagnosis section and adds
information as necessary on the
Child ER contact sheet
Resident and possibly clinician discuss the
admission or discharge plan with the patient
and accompanying adults
Resident completes the diagnosis
section and add information as
necessary on the Child ER contact sheet
38
If patient is to be admitted
If patient is to be discharged
Resident or clinician will call Child
and Adolescent Psychiatry
Inpatients (52091) to inform nursing
staff of the admission. If no bed
available on D6-200 Psychiatrist on
call will assist in obtaining a bed at
RMHC-L, Paediatrics, or Adult
Psychiatry
Resident completes the discharge orders
on the ER patient chart. Resident also
signs the hospital emergency front sheet.
Resident or clinician obtains two
addressograph stickers, the yellow ER
chart copy and the pink copy of the Child
Psychiatry ER contact sheet (if the patient
is being referred to, or is a patient of, the
Child and Adolescent Center) and places
them in the ER consult binder in CEPS
office
Resident performs a physical
exam and records findings on
the physical exam form
If patient has been or needs to be
placed on a Form 1 the resident
completes/checks the forms and
ensures that the Form 42 has been
completed and given to the patient
Resident or clinician will call
admitting to inform them of the
admission
Resident will complete the
admission orders and inform ER
nurses that the patient is being
admitted. Resident completes
the Medication Reconciliation
Form and the Allergy Form.
Resident or clinician obtains two
addressograph stickers and the
yellow ER chart copy and places
them in the ER consult binder in
CEPS office
39
OTHER COMMUNITY AGENCIES
PLEASE NOTE THAT THE NUMBERS CORRESPOND TO THE NUMBERS ON YOUR MAPS OF
LONDON
1. LHSC – VICTORI A HOSPITAL
800 Commissioners Road East (corner of Commissioners and Wellington)





B Tower, 8th Floor
Child & Adolescent Programs
Inpatient Unit
Eating Disorders Program
2. LHSC – UNIVERSITY HOSPITAL
339 Windermere Road (corner of Windermere and Western Road)
3. ST. JOSEPH’S HE ALTH CARE
268 Grosvenor Street (corner of Grosvenor and Richmond Street)
4. ST. JOSEPH’S HE ALTH CARE – REGIONAL MENTAL HE ALTH CARE –
LONDON SITE – ADOLESCENT UNIT
850 Highbury Avenue, between Dundas and Oxford, on Highbury








12 bed inpatient unit for youth between 13 and 17 years
chronic mental health problems
longer stay admissions
have 4 day treatment spots
outreach program for London\Middlesex area
accept transfers from LHSC
MCYS and MOHLTC funded agency
larger catchment area than LHSC
5. CPRI * - CHILD AND P ARENT RESOURCE INS TITUTE
600 Sanatorium Road, between Boler and Oxford Street
40




provides outpatient and residential treatment for children and adolescents (up to 17 years) with
severe emotional and behavioral problems, major psychiatric disorders with comorbid behavioral
difficulties, bipolar disorders clinic, pervasive developmental disorders, Tourette’s disorder,
attachment disorders clinic and developmental disabilities
urgent response unit and short term assessment unit for 6 to 12 years old (these have to be
accessed through the Children’s Services Coordinating Network (CSCN))
MCYS funded agency
larger catchment area than LHSC
6. MERRYMOUNT CHILDREN’S CENTRE
1064 Colborne Street, corner of Huron and Colborne Street
 an agency that provides a wide array of services for children and their families
 it offers emergency care for children whose parents need some respite
 there are some beds utilized by the Children’s Aid Society
 has parenting groups
7. HARDY GEDDES HOUSE
507 Queens Avenue, corner of Queens and Maitland

group home for boys between the ages of 14 and 18 years
8. WESTERN AREA YOUTH SERVICES (W AYS) *
714 York Street, corner of York and Lyle Street



group homes for male and female youth up to 17 years
provide some groups for youth in the community
MCYS funded agency
9. CRAIGWOOD YOUTH SERVICES *
520 Hamilton Road, corner of Hamilton Road and Chesley




outpatient, residential and in-home family preservation programs for adolescents (13 to 17 years)
who have significant behavior problems
offer parenting groups
offer anger management groups for youth
MCYS funded agency
41
10. V ANIER CHILDREN’S SERVICES
871 Trafalgar Street at Dillabough





provide residential and in-home family preservation treatment
have 0-6 years program
treat children and youth with behavioral difficulties
MCYS funded agency
London\Middlesex catchment area
11. CHILDREN’S AID SOCIETY, LONDON AND MIDDLESEX
1680 Oxford Street East, London
12. CRISIS-INTAKE TE AM (CIT)
714 York Street, London




an excellent Crisis – Intake – Team (CIT), which is a 24 hour a day service, offers up to 3 or 4
sessions for children and youth with behavioral crises
It is a joint service between Madame Vanier Children’s Services, Craigwood and WAYS
They co-lead a discharge planning group with D62 called KITES
Also provides information about community groups
13. CENTRE FOR CHILDREN AND FAMILIES IN THE JUSTICE SYSTEM *
245 Pall Mall Street, Suite 200, corner of Pall Mall and Richmond





they have a Child Witness program
they do court assessments for children and youth
they do custody and access assessments
they have a community based team providing service to youth in detention centers and residential
settings
Dr. Rida Mirza consults to the community-based team two days per week
14. FAMILY SERVICE LONDON
125 Woodward Avenue, between Oxford/Riverside and Woodward St.

provides counseling for children, youth, adults and families
42
15. GENEST DETENTION CENTRE FOR YOUTH (YOUTH 12 -15)
1670 Oxford Street East
16. KING STREET DETENTION CENTRE FOR YOUTH (YOUTH 12-15)
583 King Street
17. GUNN STREET GIRLS HOME
53 Gunn Street

a group home run by the Children’s Aid Society
18. MAITLAND STREET GROUP HOME
372 Maitland Street (near Princess)

a group home for females between the ages of 14 and 18 years
19. OXFORD AND ELGIN CHILD AND YOUTH CENTRE *





outpatient and limited in-home family preservation for children and youth up to 17 years in Oxford
County
offices in Ingersoll, Woodstock , St. Thomas and Tillsonburg
Dr. Ralyea consults to this agency
MCYS funded agency
they receive telepsychiatry from the Western Hub
20. HURON-PERTH CENTRE (HPC) *




outpatients for children and youth up to 17 years
offices in Clinton, Stratford and Listowel
MCYS funded agency
they receive telepsychiatry from the Western Hub
21. GREY BRUCE CHILDREN’S SERVICES *

children and youth mental health agency for youth up to age 18 years
43




office in Kincardine
MCYS funded agency
they can access child\adolescent psychiatry emergency service
they receive telepsychiatry from the Hospital for Sick Children in Toronto
22. ANAGO GROUP HOME *




a group home for adolescent females
located in Parkhill
they also have 4 beds for youth with developmental disabilities
they can access child\adolescent psychiatry emergency service
23. SCIP (SCHOOL COMMUNITY INTERVENTION PROGRAM )






a partnership between MVCS, LHSC, Merrymount, the Thames Valley District School Board, and
the London\District Catholic School Board
has recently expanded to Elgin County schools
for children and youth between 7 and 14 years who have an externalizing behavior problem
the program is accessed through the school boards
it provides pediatric consultation
it provides group therapy for parents and children
24. CHILDREN’S SERVICES COORDINATING NETWORK (CSCN)





an agency which deals with hard to serve children and youth
children and youth for whom you have suggested residential treatment, day treatment at Madame
Vanier Children’s Services, Wraparound services and in-home family preservation must be
referred to CSCN
they are also the agency to arrange for a patient of CPRI to have an urgent bed
members of different community agencies sit on teams to determine if the child and youth need
residential treatment (Tier One)
if it is decided the child needs residential treatment another team meets about 10 days later to
determine where the child will be placed in residential treatment (Tier Two)
PLEASE NOTE: THE CHILDREN’S AID SOCIETY IS NOT PART OF THE CHILD AND ADOLESCENT
PSYCHIATRY EMERGENCY SERVICE; IF THEY CONTACT THE CHILD\ADOLESCENT
PSYCHIATRIST ON CALL THEY SHOULD BE ADVISED TO GO TO THEIR LOCAL EMERGENCY
DEPARTMENT
* designates agencies that can utilize the child and adolescent psychiatry emergency service
44
ONTARIO CHILD AND YOUTH TELEPSYCHIATRY
PROGRAM – WESTERN HUB
Telepsychiatry – Western Hub of the Ontario Child and Youth Telepsychiatry Program.
Dr. Naveed Rizvi – Medical Director

Western Hub (WH) is located at the Child and Parent Resource Institute (CPRI) and operates in
partnership with The Division of Child and Adolescent Psychiatry, Schulich School of Medicine
and Dentistry, Western University, Child and Parent Resource Institute (CPRI), London Health
Sciences Centre (LHSC), St. Joseph’s Health Care London (SJHC), and the Windsor Regional
Hospital (WRH). Using Ontario Telemedicine Network (OTN), Western Hub child and adolescent
psychiatrists can provides Telepsychiatry Clinical consultations, Program consultations and
Professional to Professional consultations from CPRI, LHSC, SJHC-London or WRH to Child and
Adolescent Mental Health Agencies located in the rural communities of South Western Ontario.

As a member of the Division of Child and Adolescent Psychiatry, you may also be requested to
do some Telepsychiatry consultations for Western Hub. Rhonda Persichilli is the WH coordinator
and will contact you to arrange, coordinate and to provide you the relevant information regarding
the consultation.

If you have any questions or want more information about the Telepsychiatry Program at Western
Hub, please contact Dr. Naveed Rizvi, Medical Director, Western Hub at Syed.Rizvi@ontario.ca
(519-858-2774 x 2919) or Rhonda Persichilli at Rhonda.persichilli@ontario.ca (519) 858-9603.
45

Faculty and Resident Orientation Manual Division of Child & Adolescent Psychiatry

Transcription

Similar documents

Adolescent Health Center http://adolescent.ChildrensAL.org

Title Guidance of secondary students: A developmental view Author

Event Flyer - Curtis Culwell Center

Montevista Chemical Dependency Program Brochure

DIRECTORY OF CHILDREN AND ADOLESCENT MENTAL HEALTH SERVICES FOR GREENE COUNTY

The Social Worker as Part of an Interdisciplinary Team

Teenage Issues and Challenges

717-831-0070 Adolescent Intensive Outpatient Program

full presentation - Med-e-Tel

Fraiberg, Selma, Adelson, Edna and Shapiro, Vivian. 1975. “Ghosts

Faculty and Resident Orientation Manual Division of Child &amp; Adolescent Psychiatry

Transcription

Similar documents

Faculty and Resident Orientation Manual Division of Child & Adolescent Psychiatry