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3 |
Patients with Mood Disorders |
Accessibility
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Percent of individuals in high risk groups below with documented screening for major depression at least on one occasion : • Substance abuse or substance abuse withdrawal • Other psychiatric illnesses • Own or family history of depression • Major loss/traumatic events or life changes • Multiple (greater than 5/year) medical visits or multiple unexplained symptoms • Work or relationship dysfunction. • Cardiac disease, diabetes or other major physical illnesses
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6 |
Patients with Acute Conditions |
Accessibility, Patients with Mood Disorders
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People presenting with suicidal, assaultive or homicidal thoughts and/or plans, which make the clinician uncertain of safety of the patient or others: Proportion who receive same-day specialized mental health care.
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8 |
Patients with Psychosis |
Accessibility, Family Involvement
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Family interventions should be offered to families of individuals with schizophrenia who have experienced a recent relapse or have persisting symptoms, and are living with or in close contact with their family. Key intervention elements include duration of at least 9 months, illness education, crisis intervention, emotional support, and training in how to cope with illness symptoms and related problems.
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10 |
Emergency Services |
Patients with Acute Conditions, Accessibility
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Urgently required mental health services are received within 24 hours.
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11 |
Psychotherapy |
Accessibility
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Evidence based psychosocial interventions appropriate to a patient’s condition should be available to patients in addition to pharmacological maintenance treatment, especially if complete or continued remission cannot be achieved.
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16 |
Emergency Services |
Accessibility, Patients with Acute Conditions
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A crisis response system (CRS) is available in each district and includes a plan for 24 hours, 7 days per week services.
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19 |
Patients with Comorbid Conditions |
Accessibility, Patients with Substance Abuse
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Access to relapse prevention treatments of established efficacy should be facilitated for alcohol dependent patients.
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25 |
Rehabilitation |
Accessibility, Living and Working Conditions
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Adults with serious mental illness have access to a long term independent living program, including support staff.
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26 |
Accessibility |
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Average access time for urgent, emergent, and routine services.
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31 |
Children |
Psychotherapy, Accessibility
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Primary health care clinicians have access to or can refer for Child-Parent Psychotherapy (CPP) combined with case management for preschool-age children exposed to marital violence to prevent and treat child mental health disorders.
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32 |
Outreach Services |
Accessibility
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Percent of adults with a serious mental illness at risk of repeated relapse, have made high use of inpatient and/or emergency services, have a poor history of engagement with services or are homeless, who are offered treatment via an assertive case treatment (ACT) or intensive case management program.
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36 |
Emergency Services |
Accessibility, Continuity
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Systematic assessment of gaps in service delivery for patients requiring mental health care out of standard office hours.
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37 |
Outreach Services |
Accessibility, Emergency Services
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Response Time for Adult Crisis Intervention teams.
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40 |
Early Detection |
Accessibility, Patients with Mood Disorders
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For individuals affirming one of the two key symptoms of depression (Over the past month, have you been bothered by little interest or pleasure in doing things? By feeling down, depressed or hopeless?), clinicians should consider using a quantitative questionnaire (e.g., Patient Health Questionnaire-9 (PHQ-9)) to further assess whether the patient has sufficient symptoms to warrant a diagnosis of clinical major depression and a full clinical interview.
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42 |
Outreach Services |
Accessibility, Homeless or Itinerant
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Use of a homeless shelter based outreach intervention to improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders.
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45 |
Equity |
Psychotherapy, Accessibility
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There is equity of access to counseling services or psychotherapy treatments regardless of ethnic origin, age, place of residence, socioeconomic status, and sex.
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46 |
Shared Care |
Accessibility
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Availability of service coordination by a case manager for patients of any age with mental health conditions.
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49 |
Equity |
Accessibility, Patient-Centeredness
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Availability of advocacy, support, or ombudsman services for individuals and patient groups with special needs (e.g., language translation, individuals who cannot articulate their own needs).
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53 |
Emergency Services |
Accessibility, Patients with Acute Conditions
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Percent of telephone crisis line calls answered in a timely fashion by telephone crisis line staff.
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55 |
Accessibility |
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For people age 15 or older in local health region households who have had a visit to a specialist for a mental health disorder in the last 12 months: median wait time since patient and doctor decided patient needed to see a specialist (data source: Statistics Canada survey).
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60 |
Patient-Centeredness |
Speakers of English as a Second Language, Accessibility
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All services should provide written material in the language of the service user, and interpreters should be available for people who have difficulty in speaking the majority language.
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62 |
Competence |
Continuity, Accessibility
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The provision of telephone support by appropriately trained members of the primary health care team - informed by clear treatment protocols - should be considered for all patients, in particular for the monitoring of anti depressant medication regimes.
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63 |
Early Detection |
Patients with Comorbid Conditions, Accessibility
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Use of a common, validated screening tool (e.g., a four-item test with questions on Cutting down, Annoyance at criticism, Guilty feelings and use of Eye-openers (CAGE), The Alcohol Use Disorders Identification Test (AUDIT)) for alcohol or other drug problems for all new patients.
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68 |
Early Detection |
Accessibility, Children
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Well child visits: Child visits the doctor six times in the first 15 months of life at 2, 4, 6, 9, 12, and 15 months of age; children from two to six years old have annual checkups.
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69 |
Outreach Services |
Continuity, Accessibility
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Referrals to community supports are accepted from multiple sources including professionals, nonprofit and other service agencies, homeless shelters, employment services and self-referrals. Pro-active outreach/referral finding is part of this process.
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70 |
Emergency Services |
Patients with Acute Conditions, Accessibility
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Proportion of clients with wait times of less than 14 days for initiation of ongoing treatment intervention after initial contact with any crisis intervention service (police, emergency department, crisis line).
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74 |
Early Detection |
Accessibility, Patients with Eating Disorders
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When screening for eating disorders, one or two simple questions should be considered for use with specific target groups (e.g., Do you think you have an eating problem? and Do you worry excessively about your weight?).
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80 |
Community Health Care Centre |
Accessibility
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Presence of single entry systems/processes (e.g., standardized referral and service forms for CHC).
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84 |
Health Conditions |
Accessibility, Quality and Safety
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Routine utilization of questionnaires, (e.g. quality of life questionnaires) are only used in the presence of ongoing collaborative/quality improvement programs.
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94 |
Accessibility |
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For people age 15 or older in local health region households who have had a visit to a specialist for a mental health disorder in the last 12 months: proportion of patients whose health was affected by wait for specialist visit (data source: Statistics Canada survey).
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101 |
Outreach Services |
Accessibility, Ethnic / Cultural Minorities
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Outreach to Special Populations (cultural and linguistic minorities with the number and percentage served).
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102 |
Children |
Competence, Accessibility
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Availability of tele-health technology for training and case consultation for physician assessment of pervasive developmental disorders (e.g., autism) amongst children.
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110 |
Continuity |
Accessibility, Financial Management
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Existence of a fee-item within the fee-for-service schedule that reimburses physicians for case consultation/case management activities.
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117 |
Patients with Psychosis |
Psychotherapy, Accessibility
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All individuals with schizophrenia who are experiencing persisting psychotic symptoms should be offered cognitive behavioural therapy (CBT) for psychosis.
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119 |
Accessibility |
Acceptability, Continuity
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Use of a standardized but brief scale (i.e., the Primary Care Assessment Tool (PCAT) access subscale) to measure access to primary health care.
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127 |
Accessibility |
Continuity, Patients with Chronic Conditions
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Percentage of patients who have received reminders a few days before their next appointment.
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128 |
Patients with Psychosis |
Early Detection, Accessibility
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Mean age at first treatment contact for persons with psychotic disorders.
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129 |
Children |
Accessibility
|
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Use of the Western Canada Waitlist project revised child mental health services priority criteria, a validated 18-item measure to prioritize children’s access to secondary child mental health care services.
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130 |
Equity |
Accessibility
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Access to mental health and addictions specialists reported by level of income (income quintile) (data source: Statistics Canada survey).
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134 |
Equity |
Accessibility
|
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Mean number of physician visits per year for a mental health problem in a local health region, taking into account (i.e., statistically adjusting) the need for these visits.
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138 |
Accessibility |
Acceptability, Physical Health Intervention
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Proportion of persons with serious mental illness who had at least one physician visit for non-psychiatric reasons during the last year.
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140 |
Accessibility |
Rehabilitation, Unemployed
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Percentage of mental health consumers who are able to access nutrition and exercise programs.
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141 |
Outreach Services |
Accessibility, Children
|
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The percent of initial and follow-up contacts made by staff to clients that occurred outside of the office.
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146 |
Continuity |
Accessibility, Information Management
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Percent of services used by patients captured on a common Electronic Health Record.
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154 |
Accessibility |
Acceptability
|
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Percentage of adult patients seen within 15 minutes of their appointment.
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