Glossary

Crisis:

Description

The onset of an emotional disturbance or situational distress (which may be cumulative), involving a sudden breakdown of an individual's ability to cope. (Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Crisis Intervention:

Description

Refers to active treatment and support offered as soon as possible after an individual has been identified as in acute distress (Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999).

Individual with multiple or complex needs:

Description

A person who meets the criteria for serious mental illness, has had past episodes of aggressive or violent behaviour and has one or more of the following characteristics:

  • three or more psychiatric hospital admissions within the last two years;
  • has been detained in an inpatient facility for 60 or more days within this period; subject to two or more police complaints/interventions within the last 12 months or has been incarcerated in a correctional facility for 30 or more days within this period;
  • recently evicted from housing, or is homeless, or living in shelters;
  • current problems with drugs and/or alcohol; and/or problems following-up with recommended treatment plans.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Levels of Need:

Description

These levels focus on the range of clients' needs, which then determine the types of services required. The levels: First Line, Intensive and Specialized emphasize a multi-disciplinary, client-centred approach to thedelivery of mental health services.

  • First Line: Refers to prevention, assessment and treatment provided by frontline health care providers including general practitioners, mental health services, social services, hospital emergency services and hospital primary care clinics;
  • Intensive: Refers to mental health assessment, treatment and support services which are provided in community or hospital settings and are focused on people with serious mental illness; and
  • Specialized: Refers to highly specialized mental health programs provided in community or hospital settings and which focus on serving people with serious mental illness who have complex, rare, and unstable mental disorders.

Long term care is not synonymous with specialized care. Treatment, rehabilitation, and support services are integrated within each program/service type and provided through a multidisciplinary team approach.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Mobile Outreach Teams:

Description

Multi-disciplinary, accountable, mobile outreach teams will offer consultation, assessment and treatment planning services to both first line and intensive service providers and to families. Wherever possible, an emphasis will be placed on averting hospitalization hospitalization and allowing the client to remain in an integrated setting in the local community. Where necessary, however, mobile outreach teams will facilitate immediate access to specialized services. The functions provided include assessment, clinical consultation, crisis intervention, case management, education (in-service training), client advocacy and developing linkages with other services.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Provincial Psychiatric Hospitals (PPH):

Description

PPHs are operated by the Government of Ontario and provide inpatient and outpatient treatment and rehabilitation for people with serious mental illness.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Treatment:

Description

Those interventions directed toward assessing, alleviating, reducing or managing the symptoms of an illness or disorder, or symptoms resulting from the trauma of abuse.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Shared Service Models of Care:

Description

This model ensures that clients with multiple problems that cross a variety of service jurisdictions receive coordinated services.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Serious Mental Illness

There are three dimensions used to identify individuals with serious mental illness/serious mental health problems: disability, anticipated duration and/or current duration, and diagnoses. The critical dimension is the extent of disability and serious risk of harm to themselves or others, related to a diagnosable disorder.

  • Disability refers to the fact that difficulties interfere with or severely limit an individual's capacity to function in one or more major life activities. These activities include: basic living skills such as eating, bathing, or dressing; instrumental living skills such as maintaining a household, managing money, getting around the community, appropriate use of medication; and functioning in social, family and vocational-educational contexts. Increasingly, disability has been seen as the most important defining characteristic of this population and instruments have been developed to quantify the extent of disability and measure change over time.
  • Anticipated Duration/Current Duration refers to the acute and ongoing nature of the problems identified which can be determined by empirical evidence and objective experience or through the subjective experience of the individual. It is important to note that this does not necessarily mean continuous, observable evidence of disorder but may include acute or intermittent episodes with periods of full recovery. More recently, duration has been defined and measured in relation to the amount of services being used, which also helps to assess the severity and chronic nature of the problem.
  • Diagnoses of predominant concern are schizophrenia, mood disorders, organic brain syndrome, and paranoid and other psychoses. Other diagnosable disorders such as severe personality disorder, concurrent disorder and dual diagnosis are also included.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Specialized Forensic Services:

Description

One of the specialized clinical programs available in regional hospitals. Functions of the specialized forensic services include the assessment, treatment and clinical management of people with a mental illness who may be accused of or committed violent, dangerous or criminal acts. Clinical programs are directed at treating mental illness and reducing risk of reoffence. The target population is different from other psychiatric programs, i.e. patients who represent a very high risk of violence, or who have complex overlapping needs relating to aggression, legal status, and clinical/risk management.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)

Specialized Services in Hospitals:

Description

Specialized services in hospitals involve the provision of health care by specialized professionals. Specialized services are provided to persons with serious, complex, and/or rare mental disorders whose service requirements cannot be met in the first line or intensive levels of service. Specialized services include special intensive programs and both episodic and long-term rehabilitative care for people with severe and chronic symptoms. It includes outpatient, outreach and consultative services. These specialized hospital programs are almost always affiliated with a university health science centre.

(Source: Making It Happen: Implementation Plan for Mental Health Reform, Ontario Ministry of Health & Long-Term Care: 1999)