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 Centre for Addictionand Mental Health |
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Innovative housing initiative gives long-term CAMH clients new options“Clients want the same things out of life that we all want, and this partnership project really makes it happen.” Recovery—gaining your highest attainable quality of life—is even possible for some of CAMH’s most long-term inpatients, as this story attests.
Five clients of the CAMH Schizophrenia Program’s Integrated Rehabilitation Unit (IRU) —some of whom called CAMH home for over 20 years—are now living in a supportive housing apartment provided by Homes First Society (a charitable organization providing social housing in central Toronto). They have been able to make this life-changing transition to living in the community because of a novel collaboration between CAMH, Pilot Place Society and Toronto’s Homes First Society. One of these clients has also begun part-time supportive employment. “When I saw the list of people the IRU said they were going to move into the apartment I had to take a deep breath, because I thought, ‘this will be a challenge’, said Dr. Kwame McKenzie, CAMH’s Schizophrenia Program Deputy Director, Continuing and Community Care. “What is extraordinary is how people flourish when given a chance. It’s a marvelous, marvelous thing.”
The apartment has full-time 24-hour staff on site provided by Pilot Place Society (which has been running housing for people living with schizophrenia since 1994). The clients have recourse to CAMH resources, including nurses, physicians, occupational therapists and social workers, plus access to the facilities and staff at a nearby Pilot Place Society site. The program will soon be extended to another four bedroom unit. Three months into the program, results have been “fantastic,” according to staff. While most of the clients agree it was a big decision to move, the consensus is that they prefer their apartment. They’ve been getting used to helping prepare some of their meals, cleaning their rooms, getting to know new people and the new location, and enjoying events and activities in the community. “It’s a place where you can slow down a bit, and just do one thing at a time,” says resident Thomas Schultz. “This is just sensible care – there is empty housing in Toronto where, given the right supports, people with long-term mental health problems can thrive,” says Dr. McKenzie. “The question is trying to make sure people have the right support.” “This initiative personifies the recovery model for client care,” Dr. McKenzie states. “The clients I speak to are quite clear: they want to live in the community and get on with their lives. Recovery is about people being able to flourish in society, and it’s difficult to get on, be happy, flourish and be comfortable with your mental health challenges, if you’re still sitting in a hospital bed. The recovery model argues strongly that this is what we should be doing – supporting people in the community rather than in hospital beds.” Last April, an available apartment prompted an application to the Toronto Central LHIN (Local Health Integration Network) that funds CAMH. Renovations to the unit were completed in early summer and the first occupants moved in July.
At CAMH, preparation focused on finding compatible clients likely to succeed in the transition, and then carefully preparing them for the change. The work started at the IRU, where Advanced Practice Clinician Kate Kitchen and IRU Manager Sophia Geddes moved the project forward. “It’s sort of the same as when people go off to university. It’s emancipating, but takes a lot of preparation,” says Kate, and like a person leaving home, clients still remain connected. “Each of the clients remains a CAMH out-patient and they’re encouraged to come back for social events such as barbeques and the Christmas party.” CAMH staff consulted with family members continuously, helping them remain supportive throughout the process. Says Sophia, “We understand this can feel complicated for our clients, and we have been in the middle of it. It’s quite lovely, and a little complicated, which is what life is like. We make sure they have the skills to succeed.” Having clients work together as a group also decreases anxiety and potential problems. “It’s easier to do something scary if you’re all doing it together,” notes Sophia. Key to the success has been the ‘bridging’ efforts by CAMH, including encouraging clients to maintain contact with familiar nurses, social workers, occupational and recreational therapists, and physicians. When clients first moved to their new apartment, IRU staff visited and worked with them every day, slowly reducing visits as the clients familiarized themselves with their new home and routines. A continuing element in the program is the involvement of CAMH Peer Support Worker George Mihalakokos, whose ongoing relationship with the clients helps them gain skills for coping in the outside world. With George’s help, one client has taken a part-time job at a local community centre.
Central Link, a CAMH outpatient program located within walking distance of the clients’ new home, provides a key element in making this transition a success. "Our job is to provide clinical treatment such as medication management, monitoring, crisis intervention, care coordination and advocacy within a strength-based case management model,” says Program Manager Barb Trudell. “Our goal is to encourage and support clients' personal growth, power and purpose. Clients want the same things out of life that we all want, and this partnership project really makes it happen.” “This is a remarkable success story which challenges the old assumptions about the course and outcome of serious mental illness,” adds April Collins, Administrative Director of the Schizophrenia Program. “It’s clear with proper supports in place, our clients can have productive and satisfying lives outside of the hospital.” CAMH and Pilot Place Society are also exploring using web technology to provide two-way sound and picture communication with CAMH staff, providing as-needed contact and counseling opportunities. Programming is also part of the initiative, including outings to shows such as The Jersey Boys, and a camping trip supported by both CAMH and Pilot Place staff.
“We provide a stable and safe home-like, highly supportive environment. Our care and services change in response to our clients' needs, with consideration for all aspects of their lives,” says Pilot Place Society Executive Director Janet Huang. “All services are delivered at our Shuter or Lombard Street sites and clients are welcome at either. We find that the new clients like to visit the Lombard site where they also feel at home and enjoy the company and excellent meals.” Providing the right level of care, in the right setting, at the right time is our goal,” says Bill Manson, Senior Director, Performance, Contracts and Allocations at the Toronto Central LHIN. “We’re very happy to be a partner in this initiative. This project promotes the recovery model of care, creating exactly the environment needed to successfully support clients to make the transition to living in the community.” “The outcome is what really counts,” stresses Dr. McKenzie, “and so far the outcome is that we have a group of clients and their relatives who are very, very happy. We’ve taken people who many thought were ‘stuck’ and who could not do better, and we’ve supported them to get to another level. That’s extraordinary and priceless.” |
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Last updated: Dec 02, 2009 11:50 AM Published: Dec 09, 2009 4:46 PM ID#P47234 |