CAMH has been leading the development and implementation of Integrated Care Pathways (ICP) in the Mental Health and Addictions sector since 2013. Accreditation Canada has already recognized two of the CAMH’s ICPs as leading practice and these have been successfully scaled and spread externally. An ICP is defined as a Clinical Pathway with a multidisciplinary outline of anticipated care, placed in an appropriate time-frame (Middleton, Barnett, & Reeves, 2001).
The core principles of ICPs include: Evidence based practice, improving efficiency in processes, building effectiveness in teams, improving inter-professional collaboration, outcome oriented design, measurement-based clinical decision making and ensuring sustainability. All of this is done with a key focus on learning from every patient to improve care.
In 2017, CAMH developed and implemented an ICP related to the diagnosis of Major Depressive Disorder (MDD). Adult clients with this diagnosis receive clear direction on their pharmacological and non-pharmacological interventions in an integrated manner within an outpatient setting. The pathway aligns with CAMH’s strategic direction to “enhance recovery by improving access to integrated care and social support.” The MDD ICP goes beyond a guideline as it lays out the trajectory of the illness, from first episode to treatment resistant depression. It guides the clinical team through evidence-informed and measurement-based protocols, being both innovative and transformative. It has been planned, piloted, and implemented in the Mood and Anxiety Ambulatory Services (MAAS) at CAMH.
The MDD ICP is aligned with the Health Quality Ontario (HQO) Quality Standards for Major Depression.