Ontario
Types of Drug and Alcohol Services in Ontario
Case Management

A process that includes the designation of a worker whose primary responsibilities include the ongoing assessment of the client and his/her problems, ongoing adjustment of the treatment plan, linking to and coordination of required services, monitoring and support, developing and implementing the discharge plan, and advocating for the client.

Centralized/Coordination Access

This functional centre pertains to the provision of a centralized function within a geographic community (or large treatment centre) for clients to access the appropriate mental health and/or addiction services based on their needs. This functional centre is used only when there is dedicated staff that solely provides centralized access and referral services.

Central access collects information sufficient to determine linkage to appropriate services. The client would be registered and the demographics and information about the presenting concerns recorded in order to follow the client to service delivery in referred agencies. The registration information may also be accessible with client permission to other mental health and addictions agencies, thereby reducing information duplication and streamlining service provision.

This service may also include managing waitlists for other agencies that are part of the referral service.

Centralized/coordination access service does not include:

Community Day/Evening Treatment

A structured, scheduled program of treatment activities typically provided five days or evenings per week (e.g., three to four hours per day) while the client resides at home or in another setting, including residential supportive treatment services, to assist the individual in developing skills to manage substance abuse/gambling and related problems.

Community Medical/Psychiatric Treatment

This is a specific, non-residential service to meet the needs of individuals with concurrent disorders. This service may be offered either through a structured Community Day/Evening Treatment, or Community Treatment program. These services are usually part of broader hospital services and employ physicians, nurses, and staff specializing in the treatment of concurrent disorders.

Community Treatment

Community Treatment is the provision of community counseling/treatment that includes initial and ongoing assessment and treatment planning, case management activities, brief intervention, and lifestyle and personal counseling to assist the individual to develop skills to manage substance abuse and related problems, and/or maintain and enhance treatment goals. Sessions are individual, family, and group formats with the frequency and length of sessions varying, depending on client need and program format while the client resides in the community. Such activities as relapse prevention, family intervention, follow-up and aftercare are included. Services may be offered in a variety of settings, including outreach to the client's home, school, an addiction agency or other service setting. Outreach includes activities such as early intervention, but not prevention, education, or public relations activities.

Community Withdrawal Management

Community Withdrawal Management programs provide assistance with voluntary withdrawal from alcohol and/or other drugs to clients who are under the influence of these substances and/or in withdrawal, or otherwise in crisis directly related to these substances. Clients may be simultaneously accessing residential support services, or they may be residing in their home, the home of a significant other, or in another community setting– supervised or unsupervised. Care may be provided with or without the aid of drug therapy and/or other medical interventions. Additional support such as discharge planning and early recovery education is provided.

Residential Medical/Psychiatric Treatment

A structured, scheduled program of addictions treatment and/or rehabilitation activities provided for clients whose biomedical, emotional and/or behavioral problems are severe enough to require individualized medical/ psychiatric care, while the client resides in-house. The treatment and/or rehabilitation is intended to assist the individual in stabilizing and managing his/her medical/ psychiatric problems, while also addressing the addiction problem per se, or to allow for referral to appropriate substance abuse/gambling treatment. In addition to the scheduled program of addictions treatment and rehabilitation activities, clients have 24- hour-per-day access to support and the Residential Treatment milieu.

Residential Medical Withdrawal Management Inpatient Short-Term

Includes:

Residential Supportive Treatment

Supportive residential programs provide safe, substance-free accommodation with low to moderate intensity of services and a level of support appropriate for longer-term treatment of problematic substance use. Suitable for individuals who do not require intensive residential treatment, but who need a safe, supportive environment, away from their usual living situation, in which to manage their substance use. Supportive residential services may also meet the needs of individuals who require additional stabilization and support to integrate into the community.

Support is generally provided through a combination of peer mentoring, group work, education, and life-skills training, and may also include individual counseling that will help the participant to integrate successfully with the community

Residential Treatment

Residential addiction treatment facilities provide intensive time-limited treatment in structured, substance-free, in-house environment. Individuals accessing these services are most likely to be those with more complex and/or chronic substance use. Residential treatment programs provide daily programming that supports participants to examine and process issues related to their substance use. Treatment includes counseling/therapy, as well as psycho-social education and life-skills training. In addition to the scheduled program activities, service recipients have 24-hour-per-day on-site access to support and the residential treatment. Some programs may also provide medical, nursing, or psychiatric support.

Residential Withdrawal Management

Residential withdrawal management programs provide assistance with voluntary withdrawal from alcohol and/or other drugs to clients who are under the influence of these substances and/or in withdrawal or otherwise in crisis directly related to these substances. This care is provided in a Withdrawal Management (detox) Centre, or on an inpatient basis in a hospital. Care may be provided with or without the aid of drug therapy and/or other medical interventions. Additional support such as discharge planning and early recovery education is provided.

Services are provided by staff who are not medically training but who can safely monitor client symptoms. The intensity/severity of symptoms can be managed, as required, with medical consultation being provided by a physician, after-hours clinic, health centre, or hospital emergency department.

Routine medical consultation and sufficient staff resources are available to consider management of the following medication situations:

Support within Housing

Support within Housing programs provide services by staff with a primary designation of a case management role. Responsibilities include the ongoing assessment of substance use clients and his/her problems, ongoing adjustment of the treatment plan, linking to and the coordination of required services, monitoring and support, developing and implementing the discharge plan, and advocating for the service recipient.