Tertiary Mental Health Services: I. Key Concepts

Author:

Wasylenki Donald1,Goering Paula2,Cochrane Jeanette34,Durbin Janet3,Rogers Joy3,Prendergast Peter5

Affiliation:

1. Psychiatrist-in-Chief, St Michael's Hospital; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario

2. Director, Health Systems Research and Consultation Unit, Centre for Addiction & Mental Health, Clarke Division; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario

3. Mental Health Consultant, Health Systems Research and Consultation Unit, Centre for Addiction & Mental Health, Clarke Division, Toronto, Ontario

4. Lecturer, Department of Psychiatry, University of Toronto, Toronto, Ontario

5. Director of Professional Affairs/Psychiatrist-in-Chief, Whitby Mental Health Centre, Whitby, Ontario; Associate Professor of Psychiatry and Occupational Therapy, University of Toronto; Staff Psychiatrist, Centre for Addiction & Mental Health, Clarke Division, Toronto, Ontario

Abstract

There are some individuals with severe and persistent mental illnesses who cannot be managed by primary and secondary services and who require tertiary care. Such clients are characterized by aggressiveness, noncompliance with medication, and dangerousness. Tertiary care program elements include psychosocial rehabilitation, sophisticated medication management, and behavioural approaches. Tertiary care may be delivered through assertive community treatment and/or specialized outreach teams, community residential programs, or hospital-based services. Increasingly, organized systems have been developed to ensure that individuals meet criteria for tertiary care and receive the most appropriate level of care. Most importantly, the delivery of tertiary care must not be tied to particular settings or timeframes, and level of care must be delinked from model or location of care in order to create flexible, efficient, effective mental health services.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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