Serious mental illness has been a primary focus of Ontario mental health care in past years. Typically included in this designation has been schizophrenia, mood disorders, psychoses and severe personality disorder.
While recognizing the possible co-occurrence of serious mental illness and other issues (including addictions), the Ontario Ministry of Health has treated such needs – called “complex” – as requiring a possibly greater level (rather than specifically different type) of care.
In general, the level of need of a person in distress has been said to determine the level of service required, so that:
- First line referred to the assessment and treatment provided by front line health care workers including community-based social, medical and mental health services as well as hospital-based primary care and emergency services.
- Intensive referred to the mental health assessment, treatment and support services provided in community and hospital settings focused on serious mental illness.
- Specialized referred to highly specialized programs in the community and hospitals that served issues of serious mental illness together with complex, rare or unstable disorders.
Services that are intended for complex needs have included:
- Mobile outreach teams that provide first line and intensive service to clients, families and community agencies through a team of multi-disciplinary personnel. Services have included crisis intervention, clinical consultation, case management and access to specialized services, if warranted.
- Provincial psychiatric hospitals that provide in-patient and out-patient service treatment, rehabilitation and specialized programs for persons with a serious mental illness.
- Shared models of care to ensure that persons with complex issues receive coordinated services across a variety of service jurisdictions.
These definitions of service have tended to shape (or possibly been shaped by) the types of positions open to workers in the mental health field.