The Ministère de la Santé et des Services sociaux (MSSS) wishes to carry out a pilot project of a mobile mental health clinic in spring 2023 in other CIUSSS and CISSS in the province in order to reduce waiting times for online services.
This model, which will initially be the subject of pilot projects in six other CISSS/CIUSSS, will be inspired in particular by the formula of psychological support in the event of a crisis which has proved its worth at the CIUSSS de l’Est-de-l’Île. -de-Montréal, the Resolution project. Made up of a mobile mental health crisis management team, it offers immediate, intensive, in-home, personalized and, with some exceptions, non-medical intervention support.
According to the MSSS, more than 20,000 people in Quebec currently lack access to care or follow-up from a mental health professional. Many of them therefore find themselves on a waiting list of up to 24 months. “These delays put some people’s lives at risk,” said Kim Simard-Tremblay, head of Resolution’s mobile team. When a person is in a crisis situation, it is not in a week, in months, it is now that action must be taken. The formula of the Resolution Project, which allows you to follow up for several weeks directly at the home of the subject in crisis, is proof of very conclusive results.
In two years, the number of requests for the mobile crisis management service has increased by 30%, reaching 9,414 consultations in 2021, or 1,000 more people per year. Nearly a quarter of its users live with psychosocial issues and 17% have suicidal thoughts. “I will never have the data of everyone who was saved. These are all cases we won’t see in the coroner’s reports. Every day, that’s what we do, make sure these people don’t get caught up in these files,” explains Kim Simard-Tremblay.
Specialist educator Manon Levasseur, who has more than 30 years of experience in the sector, including several in a crisis centre, agrees and believes residential services are not the only solution. “Since working for Resolution, the results are more concrete. I closed two files yesterday and saw real progress among people. Intensive follow-up at home with users makes all the difference. »
The first offering of its kind in Quebec
In a crisis situation, emergency rooms in Quebec have often become the automatic way to try to see a doctor. In my opinionmyself Simard-Tremblay, this option, while important, is sometimes left incomplete for people living with mental health issues or who are in a period of psychological derangement, as most situations will require follow-up more or less a long term. “Going to the ER, coming out with a prescription, is far from solving all your problems,” she says.
Crisis centers operated by various community organizations also exist in Quebec. There are 21 centers that offer services to people in psychological distress, seven days a week, 24 hours a day. Like Resolution’s mobile team, these centers complement psychiatric emergencies, which they often help alleviate. Resolution’s Mobile Team Project is, however, the only service that offers intensive, personalized follow-up for up to 12 consecutive weeks.
I will never have the data of everyone we saved. These are all cases we won’t see in the coroner’s reports.
Since the onset of the COVID-19 pandemic, the mental health clientele has changed. “Two years ago, our patients were mainly people who had already received a mental health diagnosis. Today we talk a lot about psychosocial issues, where many have felt troubled,” he adds. The vast majority of users who have used Team Mobile since the pandemic are people with no history of mental health issues.
The duty he also met a young woman at his home who had been having suicidal thoughts, but who had not been diagnosed with any mental disorder, during a visit from factory worker Manon Levasseur who was trying to restore her confidence in her morning rounds. “I know you have this strength in you, you have to trust yourself,” encourages him Mmyself Levasseur with empathy.
Rethinking psychological help in crisis situations
Two weeks before the Christmas holidays, an often difficult time for many vulnerable people, the phone won’t stop ringing during the visit of the Homeworks. The 22 dedicated mental health specialists who make up the team act independently and without the presence of a doctor or psychiatrist, which significantly reduces waiting times. “This is proof that we can respond to many users in high levels of seizures without a doctor,” says Kim Simard-Tremblay. “We just need the person to call us,” she adds with conviction.
According to the head of the psychiatry department of the CIUSSS de l’Est-de-l’Île-de-Montréal, Dr.r Lionel Cailhol, a project like Resolution “can very well be replicated in other structures and above all allows immediate, human intervention, and indirectly reduces waiting times for psychological support”.
Two years ago, our patients were mostly people who had already received a mental health diagnosis. Today there is much talk of psychosocial problems, where many have felt destabilized.
The service is distributed in three parts on the territory of the CIUSSS de l’Est-de-l’Île-de-Montréal.
The first component, that of the telephone line, is where the person in a crisis situation can call at any time and quickly discuss with a qualified and available operator. The personal meetings are planned later with a member of the team at home, and the third component, this only if necessary, is the accommodation located at the Crisis Center Émile-Nelligan, on the territory of the CIUSSS. -of-Montreal-island.
Targeted regions
According to a written response from the office of the minister in charge of social services, Lionel Carmant, the mental health showcase projects inspired by Resolution, but also other experiences in Quebec and around the world, will first be implemented in the CIUSSS de la Capitale- Nationale, the CIUSSS de la Mauricie-et-du-Centre-du-Québec, the CIUSSS Centre-Ouest-de-l’Île-de-Montréal, the CIUSSS Centre-Sud-de-l’Île-de-Montréal and finally in the Integrated Centers of Health and Social Services (CISSS) of Outaouais and Laval.
As with the team behind this success, it will be necessary, according to Kim Simard-Tremblay, for the new teams to carry out intensive community follow-up, with skilled and multidisciplinary workers to reproduce the winning formula of east Montreal.
