Finding treatment can mean a cruel choice for those who need help with both mental illness and addiction.
“We put them in a bind,” says Dr. Raj Bhatla, chief of psychiatry at The Royal Ottawa Hospital. “They have to make a choice. Do they get treatment for, say, their anxiety disorder, then for their addiction, or do they treat the addiction first and leave their mental illness?
“It’s completely unfair.”
Improving treatment for such patients is the goal of a major revamp of addiction treatment at The Royal. Its new Substance Use and Concurrent Disorder Program will treat alcohol and substance abuse problems and at the same time offer clinical treatment and other therapies for mental disorders. It includes a 12-bed inpatient unit for the most severe cases.
“It does fill a gap in our system,” Bhatla said.
Planning for the new program began nearly three years ago, when the Royal started to review its patients’ charts to see exactly who it was treating and what services they were using. The hospital interviewed frontline workers and did an extensive literature review to go over the latest research on concurrent disorders. Doctors visited concurrent disorder programs in British Columbia, Alberta and other Ontario jurisdictions and held focus groups with more than two dozen other agencies within the Champlain Local Health Integration Network.
“The concurrent disorder population is one group that we really need to help, given The Royal’s expertise in that area,” he said.
One casualty of the program, however, is the Royal’s longstanding Meadow Creek Residential Treatment Program for addiction. It will close this fall after 30 years, first at a rural property on Carp Road and, since 2008, at The Royal’s Carling Avenue campus. The Royal will ensure that patients in Meadow Creek will receive support for as long as to a year after they leave the 28-day residence program.
Closing Meadow Creek does eliminate some jobs, but those affected will either be incorporated elsewhere at the hospital or be given early retirement or exit packages, said Royal spokeswoman Roxanne Beaubien.
Meadow Creek overlapped with existing addiction treatment programs in the city, whereas the concurrent disorder program will treat a unique, underserviced population.
Studies show that roughly 30 to 40 per cent of mental health inpatients also struggle with addiction to alcohol or drugs, Bhatla said.
The Royal’s service revamp also includes a new opioid-intervention service and a program to ease the transition of children with concurrent disorders at the Children’s Hospital of Eastern Ontario into the adult health-care system.