New program tackles soaring overdoses and deaths from substances

A conversation with Shane Tabobondung, the Program Director of B’saanibamaadsiwin Aboriginal Mental Health Program CMHA Muskoka-Parry Sound and Meredith Fryia, Manager of Addiction Services CMHA Simcoe County about the launch of a collaborative vision

After years of soaring death and overdose rates from opioids, our region will soon add new services to its continuum of care, two programs that deliver service to where it’s needed most.  The Barrie Area Native Advisory Circle – Mamaway Wiidokdaadwin, CMHA Muskoka Parry Sound Branch and CMHA Simcoe County Branch have come together to collaboratively build and deliver these new services: Day/Evening Care for Substance Use Program and Home Care Withdrawal Management Services.

The Home Care Mobile Withdrawal Management Services – Where I Live Loved (WMS WILL), will help people who want to withdraw from the use of opioids, alcohol and other substances to do so from the comfort of their home, the home of a family member or friend, a shelter or a CMHA safe bed. Individuals can access this service for up to thirty (30) days and following stabilization; they will be supported to access other relevant services and supports, including day/evening care.

The Day/Evening Care for Substance Use Program uses structured therapeutic modalities: (1) group intervention, (2) life skills and socialization, and (3) individual counselling and monitoring for individuals. These services will be provided 4-5 days or evenings per week for up to 3-5 hours per day.  Both programs are underpinned by a holistic framework that guides the staff ‘to see and to care’ for the whole person and to recognize the impact that all aspects of our lives and experience have on our health and wellbeing. In addition, these programs will use trauma-informed approaches and harm reduction strategies that are evidence-informed and culturally sensitive.

While Simcoe County has an excellent residential withdrawal management centre in a 17-bed facility operated by Royal Victoria Regional Health Centre, this level of service is required for only a portion of those in need (according to a 2017 review of literature conducted by the health ministry in British Columbia). The evidence revealed that a residential setting such as a withdrawal management centre or hospital unit is necessary for about 20 to 40% of individuals, but the balance, 60 to 80% of people can benefit from a home or mobile service.

“Some people who want to stop using a substance may not wish to go to a hospital or other in-patient setting. Others simply can’t leave behind responsibilities at home or work,” said Meredith Fryia, who manages the Addiction services for the Canadian Mental Health Association, Simcoe County Branch (CMHA SCB).  “Some are working. Some have children to care for. Some don’t want to go into a congregate setting, especially during the COVID-19 pandemic,” Fryia said.

The new services, expected to launch on May 31^st, 2021, are being actively planned by the newly established teams at CMHA SCB, neighbouring CMHA Muskoka Parry Sound and Mamaway Wiidokdaadwin, which means “Everybody Helps”. We are working together to build the key components of the integrated model of care, such as central intake which will be led by Mamaway Wiidokdaadwin.  Each agency has a local team but the agencies have come together to provide these services as one integrated team.

“I am excited to provide Mobile Withdrawal Management and Day Treatment to a diverse population in an underserviced region with unique geographic and rural needs,” said Shane Tabobondung, the program director of B’saanibamaadsiwin Aboriginal Mental Health Program for the Canadian Mental Health Association, Muskoka-Parry Sound. “Indigenous and Non-Indigenous organizations working collaboratively is a brilliant example of reconciliation.  The vision of all the partners has aligned as an innovative program and I look forward to working together.”

The pressing need for the new services has been made clear by grim and worsening outcomes for people who use substance in the Barrie region:

• Opioid-related ER visits in Simcoe Muskoka have tripled since 2017, according to Public Health Ontario.
• In the first six months of 2020, 107 people were rushed to the ER in Barrie after an opioid overdose, the seventh highest rate per capita among 28 Ontario municipalities on a per capita basis, according to the Simcoe Muskoka District Health Unit. Monthly visits continued to increase the balance of 2020: Of the seven months with the highest monthly visits, six were between July and December.
• Preliminary data shows that there were 133 confirmed and probable opioid-related deaths in Simcoe Muskoka in 2020, which was more than 60% higher than the average of 81 deaths from the previous three years.
• Significantly more Simcoe Muskoka adults drink in excess compared with Ontario as a whole. About one-in-four Simcoe Muskoka adults engage in heavy drinking at least once per month. Alcohol may play a role each year in 60 deaths and 600 hospitalizations, Simcoe Muskoka District Health Unit estimates. 

Dr. Valerie Grdisa, CEO, CMHA SCB stated, “This tri-agency collaboration was built on a shared vision for collectively achieving shared goals and establishing a program that responds to the unique needs of each individual.  We hope for each individual that:

• They will face less stigma and labelling for entering the programs;
• They will have increased privacy and ability to plan their care based on their individual needs;
• They will complete the program and will have ‘easy’ access to other services and supports that they need; and
• They will achieve their desired outcomes such as improved overall functioning, harm reduction, mental health and wellbeing, social relationships, employment etc.”

Grdisa says, “We are so appreciative of the Ministry of Health and Ontario Health (Central Region) for funding this tri-agency model of care to respond to the critical needs made even more urgent by the pandemic.”

The new WMS-WILL and Day/Eve Care will offer services through a multidisciplinary team including a nurse practitioner, nurses, social workers, addiction and mental health counsellors, and peer specialists.  Clients will be supported to access other available mental health and addictions programs within each partner agency.  Clients from both programs will have access to after hour supports through the CMHA crisis lines, which is available 24/7/365. The integrated team will work closely with the referring primary care providers, partners, clients, and their support systems, to support a successful recovery.

By providing services to clients where they reside, the new program reduces barriers, and as a result, may prompt those in need to seek treatment sooner. There are benefits to the system as a whole too, because the cost of home/mobile services is about 48% of the cost of in-patient withdrawal management services.  “It will address a gap in services within our region” Fryia said of the new programs. “It’s really exciting.”

Written by Jonathan Sher