Mental Health & Addictions Child and Adolescent Services

In 2018-19 we standardized the way we collect and report wait-times for Community Mental Health and Addictions out-patient clinic appointments. Wait time standards were developed and waits will be publicly reported online by triage level.

A person’s triage level is determined by their condition as assessed by clinicians working in intake or referral. In providing care and treatment based on clinical assessment, people triaged as urgent receive care before people triaged as non-urgent.

• Triage 1: Emergency, no wait--patients immediate access to care through emergency or crisis services
• Triage 2: Urgent, target is within seven days
• Triage 3: Non-Urgent, target is within 28 days

Wait times for triage 2 are shown by zone. The four health zones are below.

People who require emergency care are not placed on wait lists. They receive immediate access to care through emergency or crisis services. Emergency mental health care needs should be directed to emergency departments, crisis response services, Mental Health Crisis Line (toll free at 1-888-429-8167), and First Responders (911).

Regular monitoring and reporting on wait times provides:

• patients with information on wait times in their communities and across the province;
• health care providers with information to compare wait times across communities and between provinces;
• identification of problems that create delays in accessing care and solutions.

Definitions and standards

Wait 1:  Number of calendar days from the date of initial referral to the date of the first attended appointment.

Wait 2:  Number of calendar days between the date of the first attended appointment to the date of the scheduled first treatment appointment. 

Referral
A referral is the contact made to a mental health and addictions intake or referral team by someone (or on behalf of someone) requesting to be seen by a professional mental health and addictions clinician for consultation, assessment, diagnosis, and/or treatment.

What the numbers mean:

50th percentile: For example, the maximum wait-time for five out of 10 cases says 20 days, it means that 50 per cent of people have been seen (or are expected to be) within 20 calendar days or less;
90th percentile: For example, the maximum wait-time for nine out of 10 cases says 30 days, it means that 90 per cent of people have been seen (or are expected to be) within 30 calendar days or less.

Population(s)
Adults 19 years and older with confirmed or suspected moderate to severe mental disorders, including addictions, who are experiencing difficulties in daily functioning as a result of the mental disorder. The severity of the individual’s condition can be most appropriately and safely managed in an outpatient setting. There is a reasonable expectation of someone responding positively or will experience ongoing benefit from the care interventions in this care setting.

Children and adolescents between 0-18 years (up to their 19th birthday) who present with moderate to severe symptoms of mental disorder and/or harmful substance use that significantly impact day to day functioning (i.e., moderate to severe impact).  Specifically: the presence of mental disorder and/or harmful substance use; the severity of illness results in moderate to severe functional impact on their lives; and risk level which can be addressed safely in an outpatient setting.

Community Mental Health and Addictions clinics (Outpatient Services)
Community Mental Health and Addictions clinics are outpatient services and are the largest service area within the Mental Health and Addictions program of care. Services are delivered in a variety of settings including schools, hospitals, and community and are matched to the person’s presentation and need.

Services are evidence informed, time limited and delivered collaboratively by the mental health and addictions team, which usually includes the patient, caregiver, and clinician (which could include social workers, psychologist, psychiatrists, occupational therapists, and nurses amongst others). Services may include: screening and assessment, goal directed group and/or individual therapy, consultation, care planning, etc. Services are voluntary and require consent for treatment. If the patient is not ready to actively engage in treatment, parents, family and/or other caregivers may be given strategies and treatment interventions to support the person who is experiencing challenges due to their mental disorder, including addiction.

NSHA provides community mental health and addictions services for adults (19 years and older) across Nova Scotia and for children and adolescents living in Eastern, Western, and Northern Zone(s). The IWK provides community mental health and addictions services for children and adolescents between 0-18 years (up to their 19 birthday) who live within the Halifax Regional Municipality.

The Choice and Partnership Approach (CAPA; http://www.capa.co.uk/) is the mental health and addictions outpatient service delivery model for children and adolescents in Nova Scotia. CAPA is a mental health care service delivery model for children and adolescents. CAPA considers the child, adolescent, and family as experts in their lives. Through shared clinical decision making with mental health practitioners, children, adolescents, and their families become stewards of their own mental health. CAPA places the child and adolescent along with their family at the centre of service organisation.