Patients discharged after an acute episode of care such as an emergency department visit or inpatient unit stay are at an elevated risk of negative outcomes such as readmission, self-harm and suicide. Many of these patients experience long wait times when trying to connect with outpatient services while others do not attend their first outpatient appointment despite requiring urgent support. With increasing ED visit volumes and in response to the aforementioned findings, it was determined that there is a clear need for accessible post-discharge mental health and addictions services at CAMH. In October 2017, the Bridging Service was established. The service accepts patients from three primary pathways: (1) patients diverted from the ED at the point of triage; (2) patients referred by the ED following an assessment and/or admission; and (3) patients discharged from an acute care inpatient unit. The service provides low-barrier and rapid access to care including: drop-in based assessment and follow-up with a psychiatrist and/or clinician; scheduled urgent care consultations; both individual and group psychotherapy; and community treatment monitoring and case management. The provision of these services has successfully relieved pressures on CAMH’s Emergency Department by supporting a 15% diversion rate during operational hours (Monday to Friday 9 to 5). This diversion rate is anticipated to increase as the servicesfurther expands into evenings and weekends in 2019. The service has also successfully supported patients during the high risk post-acute episode period, effectively providing them with timely access to urgent care and assisting them with their recovery.
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