Richmond improves substance-use care

New and expanded Mental Health and Substance Use (MHSU) services in Richmond will better define the care pathway for people challenged by substance use and enable individuals and families to access the care they need more quickly.

“The expansion of home-based withdrawal management services and residential treatment bed access, as well as the enhancement of the substance use treatment model in Richmond Hospital, has strengthened the local continuum of care,” said Natalie McCarthy, director, MHSU and Residential Care, VCH Richmond. “These additional resources, along with service redesign that ensures same-day access to outpatient treatment, have enabled us to significantly reduce, or in some cases eliminate, wait times for care. As demand for service increases, these changes are more important than ever.”

New withdrawal management beds

Earlier this year, VCH-Richmond contracted for five new residential treatment beds to expedite access to care for Richmond residents seeking recovery from substance use. The beds, located in Richmond and Vancouver, have – in some cases – resulted in same-day access to treatment.

At Richmond Hospital this past June, additional supports were added — in partnership with the Emergency Department, Internal Medicine and the Hospitalists’ services — for inpatient withdrawal management (WDM). Withdrawal management (commonly known as detox) provides individuals with medical, psychosocial care and support for the physical and psychological symptoms associated with acute withdrawal from drugs or alcohol.

On any given day, patients requiring WDM are admitted to acute care for stabilization of medical needs. Prior to the implementation of the enhanced model known as “Withdrawal Management Partners in Care,” these patients were spread throughout the hospital.

The new approach will see patients admitted to dedicated beds on 2South and 6North with expanded addiction physician and nurse availability to provide intensive treatment in collaboration with the acute care team, rather than relying solely on a consultation model. This change will allow care providers to better engage patients, match patient need to level of care and make seamless linkages to residential treatment and outpatient community services.

These new community and acute care beds are Richmond’s contribution toward the provincial commitment of 500 additional substance use beds to be implemented province-wide by 2017.

Wait times for ABHT reduced from weeks to days

For people who are able to undergo withdrawal management safely in their own homes, VCH Richmond has doubled the capacity of the Acute Home-Based Treatment Team (AHBT).

AHBT provides acute psychiatric and substance use treatment in the home – with up to three visits per day — to help people stabilize and pursue recovery in the comfort of a familiar environment, avoiding hospitalization where possible. This expansion has seen the wait-times for home-based detoxification decrease to a matter of hours or days, from a high of 4-6 weeks at this time last year.

Walk-ins welcome

When people make the decision to seek help for recovery, it’s urgent that they have timely access to substance use assessment, treatment and counselling. For this reason, walk-in appointment times have been created at both the Anne Vogel Clinic, which offers opioid replacement therapy, and at the Transitions program, which provides general mental health and substance use outpatient treatment.

Strengthening the continuum of care

These service improvements allow VCH Richmond to offer full scope withdrawal management support, in the absence of a detox facility.

“Whether people access care in the community – as an out-patient – or at Richmond Hospital – as an inpatient – clinicians across the Community of Care now have more tools and options to help individuals connect to the treatment they want and need, when they need it,” said McCarthy. “These improvements really speak to VCH’s commitment to meet substance use care needs across the region.”