10 YEARS LATER: A decade of transformational care for Mental Health and Addictions Program

Barb Evans, Director of Patient Care for the Mental Health and Addictions Program, stands with Robin Crown, Clinical Supervisor of Outpatient Mental Health and Addictions outside of the Outpatient Mental Health and Addictions wing at the St. Catharines Site. With 20 services and programs, Mental Health and Addictions is Niagara Health's largest program of care. 

Renee Rice has a passion for writing short stories.

Romance, horror, joyful tales about everyday life – Rice has about 80 fictional works to her name and the hope of one day publishing the collection.

It’s a hobby she was encouraged to take up by a social worker in Niagara Health’s Wellness Recovery Integrated Complex Care (ICC) Program. It’s one of 20 programs and services part of a broad Mental Health and Addictions Program that grew to serve all of Niagara when the St. Catharines Site (SCS) opened 10 years ago.

“It gives me a sense of accomplishment to do something, and to give them to people and have them keep them,” Rice says about her stories.

The Niagara Falls resident didn’t feel that same sense of purpose when she started her journey with the Wellness Recovery ICC Program in 2019. Rice says she had been sexually assaulted and was experiencing suicidal thoughts. A friend encouraged her to seek help.

She arrived at the St. Catharines Site, which offers 24/7 emergency psychiatric assessment, via the Emergency Department (ED) in Niagara Falls. Over the next few years, Rice would return four times for care, receiving it through the Wellness Recovery ICC Program, which was launched in 2018 with a multidisciplinary team including a psychiatrist, social worker, occupational therapist, psychotherapist and registered nurses. Together, they work with individuals who have complex mental health needs and experience repeat ED visits and hospital re-admissions.

In addition to helping clients while in hospital, the Wellness Recovery team follows up with patients after they are discharged to continue support and connect them with other necessary resources. In Rice’s case, that included finding her a grief counsellor, being present and supporting her during those counselling sessions, and booking medical appointments.

“As long as I need her, she’ll be there,” Rice says about her social worker from the program. “She’s like a big sister for me.”

The program had 85 clients when it launched. That number is down to about 40, which speaks to its success in helping patients heal and avoid further ED visits or readmissions, says Barb Evans, Director of Patient Care for the Mental Health and Addictions Program.

Before the St. Catharines Site opened in 2013, Niagara Health offered inpatient services and some outpatient care at the different sites, she says. Since opening the St. Catharines Site, nine programs and services have been added, including the Wellness Recovery ICC Program helping Rice.

Dedicated psychiatric emergency services, additional acute inpatient beds, the Day Hospital program, evidenced-based group therapy, a Psychiatric Intensive Care Unit and Seniors Mental Health have been introduced, enabling treatment for patients ages five and up.

The Mental Health and Addictions Program, which has 500 physicians and staff, and the largest footprint at SCS, also grew its adult outpatient programming and evidenced-based treatments, including expanding the Rapid Access Addiction Medicine clinic, which has been recognized as a leader in the province. Adding Electro-Convulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) programs provides care closer to home, when at one time patients had to travel outside the region for these treatments.

And by switching to a primarily group therapy model, including offering virtual services that existed even when SCS opened, waitlists for help have been reduced.

“With virtual care options we are not limited by geography as we continue to build a regional model of care and service for patients and families,” Evans says.

The changes brought about since opening SCS have been transformational for Niagara, she explains.

“When you look at our continuum of services, we offer everything that large, academic hospitals offer, which is amazing” she says. “From where we were to where we are now, we have that full continuum and are able to provide services that people previously had to access out-of-area, like ECT and TMS.”

The care model created when SCS opened has also helped with recruitment of psychiatrists and other staff. People are attracted by the large hospital and program, Evans says.

Looking ahead, plans include expanding seniors' mental health services at the South Niagara Site, which will be a centre of excellence for older persons care when it opens in 2028.

As for Rice, she knows she has care and support when she needs it.

“My social worker comes every week, just to talk, just to see how I’m doing and see what support I need,” Rice says. “And she puts it in place for me.”