Integrating Hospital- and Community-Based services
Decreasing visits to Hospital Emergency Departments
Toronto, ON: Many people experiencing a mental health crisis turn to emergency departments (EDs) such as North York General Hospital’s Charlotte & Lewis Steinberg Emergency for help. Treating mental health issues, however, often requires more than a hospital ED visit. Once stabilized in the acute care setting, it can be vital to receive follow-up care for non-life threatening issues in the community.
It’s not unusual that we see people with mental health issues who have been suffering for a while and had no idea where to seek support or were discouraged by long waits to access both community- and hospital-based services
Director of Emergency Services and Mental Health at North York General
Les services des urgences sont souvent la première étape pour les personnes recherchant des mesures de soutien pour une crise de santé mentale, ce qui n’est pas toujours optimal pour les patients qui n’ont pas besoin d’être hospitalisés en raison de l’environnement achalandé, déroutant et bruyant. De plus, il existe un besoin réel de mieux informer aux gens et de leur fournir les mesures de soutien de suivi communautaires afin de s’assurer de réduire le nombre de visites répétées et non nécessaires aux services des urgences.
Une meilleure intégration des services communautaires et hospitaliers est une façon de s’assurer que les patients reçoivent les meilleurs soins. Pour y arriver, l’Hôpital général de North York s’est récemment joint à un partenariat appelé Accès aux ressources et au soutien communautaire (ARSC). Par l’entremise de l’ARSC, les patients qui cherchent initialement à obtenir un traitement en santé mentale aux services des urgences de l’Hôpital général de North York et de l’hôpital Humber River, mais qui ne nécessitent pas une hospitalisation, sont aiguillés vers Cota pour des soins de suivi communautaires, qui sont dispensés en collaboration avec Toronto North Support Services et Bayview Community Services.
One of the key features of the ARCS program is its responsiveness. Within 48 hours of an ED visit for a mental health issue, a patient is contacted by a community-based worker who will offer immediate supports, coordinate community services and provide short-term case management, as may be required.
Our focus in the ED is to treat the immediate crisis at hand. This partnership really helps us ensure that patients receive prompt high quality care, follow-up in their community through a multidisciplinary approach. It also decreases their need to return to the ED
Officially launched in November 2016, ARCS is the revamped version of the Emergency Department Diversion Project, piloted by North York General in 2007. The key differentiation is the addition of Cota, an accredited community-based organization that has been supporting adults with mental health and cognitive challenges for over 40 years, as the lead community-based organization coordinating the ARCs program.
Cota is committed to service level integrations between community and hospital-based services. We believe that, done right, they lead to better coordination and transitions of care and result in improved patient experience and outcomes. We are very pleased to be involved in the ARCS initiative and feel confident that it will continue to have a positive impact in the lives of many patients
These patients include *Li, who required further treatment after her visit to the Charlotte & Lewis Steinberg Emergency. Li initially received short-term case management through the ARCS program but then mental health issues returned so she reached out again to David, her Cota case manager. Through a combination of the right medication and community resources, Li was better able to find balance in her life. “It marked a turning point in the depression I went through,” Li says of her ARCS program experience.
According to Sandy, stories such as Li’s are common. “The ARCS program is all about linking patients with the right care, at the right, in the place,” she says. “By partnering with community agencies such as Cota, we are able to tackle a major health care challenge – mental health – and transition patients seamlessly from the acute care setting to support within the community.”
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