Hello, my name is Dr. Tony George, I’m Chief of Addictions and Concurrent Disorders at the Centre for Addiction and Mental Health And I want to tell you a little bit about some of the exciting work that we’re doing here Particularly around patients with concurrent mental health and addictive disorders which are about sixty percent of the people that we serve In fact many of those tough to treat psychiatric disorders like schizophrenia and bipolar disorders the rates of co-morbid substance abuse are through the roof. They’re irtually almost every patient has some sort of problem with an addiction Whether it be tobacco, alcohol, cocaine, methamphetamines, cannabis are all pretty common. The first thing we are starting to change is the way we integrate the services that we deliver. Rather than having clinics that work in silos we are trying to integrate the work we do. For example with the care pathways in alcoholism and depression this actually brought together the staff from both the Moods and Anxiety program with staff in the Addictions program. And those divisions now collaborate to deliver integrated care delivery and services for people with concurrent addictions, specifically alcoholism and depression. Already we have some data that treatment outcomes in the first 200 or so of these patients enrolled in the alcohol and depression care pathway are doing better than if they are enrolled in the depression treatment and alcohol treatment separately which is the spirit of how you do concurrent disorders treatment Once patients get stabilized in the emergency department and get proper assessment and early treatment they can be transferred to our specialized inpatient service for the concurrent disorders addictive, mentally ill folks, known as the CAITS unit and that will allow for further stabilization of their withdrawal state with appropriate medications like methadone and suboxone Benzodiazepine, and then essentially get them to the point that they are ready to go to our specialized outpatient day treatment clinics which is more intensive specialized treatment but in an outpatient recovery model which is really evidence based care If you have a concurrent addiction and mental health problem you really need to have something known as a no wrong door policy The upshot of this no wrong door policy is patients can get treatments anywhere on their own terms We want them, if they go to the schizophrenia clinic, or the child and adolescent clinics We want them to get the addiction treatment right there And so this is really about building capacity for our physicians and staff to assess and treat concurrent disorders here at CAMH everywhere If we can have a model that basically everyone who treats any type of disorder basically acknowledges that addictions is just part of the illness we will have a more ideal and effective way to deal with these complicated patients who are 60 per cent of the people who come through out door

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