East Local Collaborative Priority Area: Oakridge TCH buildings Focus on Mental Health and Addictions. May 15, 2017

Transcription

1 East Local Collaborative Priority Area: Oakridge TCH buildings Focus on Mental Health and Addictions May 15, 217

2 Contents 1. Oakridge map, background and methodology/considerations/limitations for this deep dive analysis 2. Key Highlights and Summary of all Findings 3. Socio-demographic, building characteristics and high level utilization (ED visits and Inpatient discharges) analysis of selected high needs Toronto Community Housing (TCH) buildings in Oakridge 4. Emergency Department use for residents of high needs buildings, focus on mental health and addictions 5. Mental health and addictions discharges for residents of high needs buildings 6. Use of Community Addictions services by TCH residents 7. Health Service Providers serving Oakridge residents 8. Future data EMS, Neighborhood provider profile (from Asset Map) 9. Appendix ICD-1 codes used for mental health and addictions ED visits 2

3 East Toronto Sub-Region - Oakridge Neighbourhood 3

4 Oakridge Background information on high needs buildings identified by Health Link Team in the East and Consultations/Interviews Concentrated group of 5 Toronto Community Housing (TCHC) high needs buildings identified (high rises and townhouse complexes) High density area, with social problems Low continuity of services Lack of grocery stores A need of IDs, clothing and transportation has been observed Estimated that 35-4% of residents have complex seniors Few providers in area; services not coordinated Issue of equity to access of services, including hospitals high use of Michael Garron services 4

5 Methodology and Limitations of Analysis Several Data Sources were used for this analysis: 1. Toronto Community Housing Data Information is presented on socio-demographic characteristics of residents and building characteristics 2. Toronto Central LHIN utilization data on emergency department visits (NACRS) with a focus on mental health and addictions, inpatient discharges (DAD) and mental health and addictions inpatient discharges (OMRHS). This data was based on identifying the number of ED visits and discharges from the postal codes of the individual buildings. It is important to note that the analysis was based on the assumption that the postal codes identified were dedicated to only one building and were not shared with any surrounding buildings. A list of ICD-1 codes used for MHA ED visits can be found in the Appendix. 3. CBI data has been used to identify a small group of top HSPs in a neighbourhood, A list of top HSPs that serve 5% of the clients in a given neighbourhood is provided (this gives the top 4 to 6 CMHA HSPs and the top 1 or 2 CSS HSPs). However, it should be noted that most HSPs are serving small numbers in each neighbourhood, so this is just a fraction of the total HSPs involved in the neighbourhood. 4. DATIS data has been included on residents in both Oakridge and Oakridge TCH buildings who are enrolled in at least one Ministry of Health and Long Term Care (MoHLTC) funded substance abuse or problem gambling program. Data includes individuals with the selected postal codes in Oakridge and Oakridge Toronto Community Housing Building. Substance abuse and problem gambling programs provided by an agency and funded by the Ministry of Health and Long Term Care (MoHLTC) are mapped to one of the Functional Centres to permit the generation of statistics by Functional Centre and Functional Centres have been aggregated to Program Levels. Rates calculated for mental health and addictions discharges may be underestimated as discharges for ages included in the analysis is only a subset of the total discharges and the population used to calculate the rate was the total population for that age group. This is due to using data from only the Ontario Mental Health Reporting System (OMHRS) which predominately has data for the adult population (2+). 5

6 Key Highlights and Summary of all Findings TCH Buildings: There are 5 TCH high needs developments in Oakridge (Warden Woods, Woodland Acres North, Woodland Acres South, Bying Towers & Teesdale Pharmacy) which range in size from 168 units to 556 units and have a resident population ranging from 171 to 1,248 residents Residents in all buildings are multicultural and speak a variety of languages Woodland Acres North has the highest proportion of males and residents aged Byng Towers is a building with 1% seniors aged 59+ Overall and MHA ED Visits: Overall, there were 2,473 ED Visits by residents of high needs TCH Buildings with the top 3 most responsible diagnosis chapters being 1) Symptoms, signs and abnormal clinical and lab findings (23%), 2) Injury and Poisoning (18%) and 3) Diseases of the Respiratory System (8%) There was a total of, 198 MHA ED visits (FY to FY215-16) for patients who had a valid health card number with a total of 93 unique patients. The rate of MHA ED visits was slightly higher for TCH buildings (69.3 per 1,) compared to Oakridge overall (68.1 per 1,) Almost half of the ED visits (46%) were from residents in Woodland Acres North which has only 211 residents Majority of ED visits were for ages (74%) with a higher proportion of males than females overall A large majority of patients who visited the ED for MHA conditions had a family physician (72%) A large proportion (89%) of the visits were for CTAS levels 2 & 3 indicating that residents are presenting to the ED when they are really sick 6

7 Key Highlights and Summary of all Findings Overall and MHA ED Visits (cont d): A large majority of MHA ED visits were discharged home (69%) and less than one quarter (23%) were admitted Majority of ED visits were for alcohol (28%) and Schizophrenia, Schizotypal And Delusional Disorders (18%) and residents presented most at Michael Garron Hospital (44%) and Scarborough Hospital Birchmount Site (23%) 16 patients accounted for more than half (55%) of the total ED visits which ranged from 3 to 31 visits MHA Discharges: There were only 43 MHA inpatient discharges (FY to FY215-16) for patients aged 15+ in all TCH high needs buildings with a total of 27 unique patients, indicating an average of 1.6 discharges/patient Majority of discharges were for schizophrenia and other psychotic disorders (6%) and mood disorders (3%) and patients visited Michael Garron Hospital (42%) and Scarborough Hospital Birchmount Site (4%) the most The average annual rate of discharges for all TCH high needs buildings (745.) was fairly similar to the overall rate for Oakridge (746.1) Given the small number of MHA discharges over 2 years for the high needs TCH buildings and the nearly similar rate compared to Oakridge, it can be concluded that mental health and addictions discharges is not as significant an issue for the selected high needs TCH buildings in Oakridge compared to the ED visits for MHA 7

8 Key Highlights and Summary of all Findings Use of Community Addiction Services, FY215/16 & FY216/17 Majority of residents in Oakridge attended programs for Special Community Services, Special Inpatient Services & Residential Rehab Treatment and Case Management and were in the age group Case Management and Special Community Services had the longest average length of stay Majority of residents in Oakridge attended Pinewood Centre of Lakeridge Health in Central LHIN, followed by Toronto East Health Network and UHN in Toronto Central LHIN In both fiscal years for open and discharged admissions, majority of residents in Oakridge presented with problems related to alcohol, crack, cannabis and tobacco. 8

9 Socio-demographic and building characteristics and high level utilization of selected high needs TCH buildings Toronto Community Housing Data, 216 DAD, FY NACRS, FY

10 Oakridge TCH High Needs Buildings, 216 Development Name Address(es) Units % of Bachelors Warden Woods 68 Warden Ave 1 Cataraqui Cres 1 Cataraqui Cres 12 Cataraqui Cres 1 Firvalley Crt % of 1 Bedroom % Rent Geared to Income 345.% 3.5% 99.1% Woodland Acres North 682 Warden Ave %.% 99.6% Woodland Acres South 4 Firvalley Ct % 5.% 98.2% Byng Towers 333 Danforth Ave % 24.7% 99.5% Teesdale Pharmacy 3 Teesdale Pl 4 Teesdale Pl Total 1, % 5.% 99.% Buildings range in size from168 units in Woodland Acres South to 556 units in Teesdale Pharmacy Woodland Acres North only has bachelor units and has the highest percentage of residents with rent geared to income Byng Towers also has a high percentage of bachelor units and the second highest percentage of residents with rent geared to income Half of the units in both Woodland Acres South and Teesdale Pharmacy are 1 bedroom units Source: Toronto Community Housing Data, 216 1

11 Oakridge TCH High Needs Building Demographics, 216 Development name Total Residents % Male % Female % <13 % % % % 7+ Top 5 languages spoken Warden Woods Woodland Acres North Woodland Acres South 1,248 42% 58% 28% 36% 32% 4% % Arabic, Bengali, French, Tamil, Somali % 23% % % 7% 23% 7% Mandarin, Greek, Arabic, Cantonese % 44% 2% 3% 55% 22% 19% Cantonese, Farsi Byng Towers 197 5% 5% % % % 31% 68% Cantonese, Chinese, Mandarin, Bengali, Tamil Teesdale Pharmacy TOTAL 2,886 1,59 43% 57% 22% 15% 49% 9% 5% Data not ready Warden Woods is a complex of townhomes and has the highest number of residents overall, highest proportion of females and residents aged -24 Woodland Acres North has the highest proportion of males and residents aged Byng Towers is a building with 1% seniors aged 59+ Residents in all buildings are multicultural and speak a variety of languages Source: Toronto Community Housing Data,

12 Oakridge TCH Building Residents with ED Visits Diagnosis - FY215/16 N=136 N=554 N=193 N=253 N=133 Majority of ED visits were for mental and behaviour disorders along with injury and poisoning conditions A physician servicing the area estimates that MHA prevalence at Woodland Acres North is ~5% Data presents overall ED visits for FY for high needs buildings in Oakridge Source: CIHI NACRS IntelliHealth, FY215/16 12

13 Oakridge TCH Building Residents with Acute Inpatient Discharges Diagnosis - FY 215/16 N=45 N=19 N=27 N=32 N=32 Majority of acute inpatient discharges were for diseases of the circulatory system, pregnancy, childbirth and factors influencing health status Data presents overall inpatient discharges for FY for high needs buildings in Oakridge. Does not include adult mental health and addictions discharges as this is included in a separate section using data from OMHRS. Source: CIHI DAD IntelliHealth, FY215/16 13

14 Emergency Department Visits for Mental Health and Addictions NACRS FY to FY Overall visits for Oakridge residents Visits for TCH building residents 14

15 Emergency Department Visits, FY to FY There were a total of 1,515 ED visits by residents of Oakridge during FY to FY Of those visits, 726 (7%) were for mental health and addictions conditions with a rate of 68.1 per 1, There were a total of 2,473 ED visits by residents of the high needs Toronto Community Housing buildings during FY to FY Of those, 2 (8%) were for mental health and addictions with a rate of 69.3 per 1,. Two fiscal years were combined due to small numbers. Two visits were for patients who did not have a valid health card number The analysis only includes the 198 MHA ED visits for patients who had a valid health card number. There was a total of 93 unique patients indicating an average of approximately 2 visits/resident. Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 15

16 Toronto Community Housing Buildings in Oakridge Demographics of Patients with Mental Health and Addictions ED Visits, FY FY Development Name Address(es) Emergency Department Visits % Female % Male Age Breakdown % -12 % % % 59+ Byng Towers 333 Danforth Ave, M1L4P % 64% 9% 91% Teesdale Pharmacy 3 Teesdale Pl, M1L1L2 4 Teesdale Pl, M1L1L % 79% 78% 21% 7% 6% 36% 72% 46% 22% 11% Warden Woods 68 Warden Ave, M1L4N5 1 Cataraqui Cres, M1L3V5 1 Cataraqui Cres, M1L1N7 12 Cataraqui Cres, M1L1N6 <5 5 <5 1% 1% 1% 2% 1% 1% 4% 4% Woodland Acres North Woodland Acres South 682 Warden Ave, M1L3Z9 4 Firvalley Ct, M1L1P % 81% 93% 7% 43 23% 77% 2% 77% 21% TCH Buildings 198 3% 7% 2% 8% 74% 16% Warden Woods has the highest number of residents (1,248), however has the lowest volume of ED visits for mental health and addictions conditions Almost half of the ED visits (46%) were from residents in Woodland Acres North which has only 211 residents Overall there was a higher proportion of males than females, with variation in each building Majority of ED visits were for ages (74%) Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 16

17 Toronto Community Housing Buildings in Oakridge CTAS Level and Primary Care Provider for MHA ED Visits, All Ages, FY FY Percent of MHA ED Visits with a Primary Care Provider, FY to FY Percent of MHA ED Visits by CTAS Level, FY to FY CTAS Level 5 Other (FHT, Walkin Clinic, etc) % Unknown 16% CTAS Level 4 >5% 1% None 12% CTAS Level 3 58% CTAS Level 2 31% Family Physician 72% CTAS Level 1 >5% N=198 % 1% 2% 3% 4% 5% 6% 7% Percentage (%) N=198 A large majority of patients who visited the ED for MHA conditions had a family physician (72%) More than half (58%) of the MHA ED visits were categorized as CTAS level 3 Urgent and Potentially Serious, followed by CTAS level 2 Emergent and Potentially Life Threatening (31%) indicating that residents are presenting to the ED when they are really sick. Can something be done in the community to support them? Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 17

18 Toronto Community Housing Buildings in Oakridge Day of Week for MHA ED Visits, All Ages, FY FY Day of Week Sunday Monday Tuesday Wednesday Thursday Friday Saturday Grand Total Total Day of Week 28 (14%) 18 (9%) 35 (18%) 29 (15%) 28 (14%) 32 (16%) 28 (14%) 198 (1%) MHA ED visits occurred most on Tuesday (18%) followed by Friday (16%) Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 18

19 Toronto Community Housing Buildings in Oakridge Time of Day for MHA ED Visits, All Ages, FY FY Time of Day Total Time of Day Morning (6:am - 11:59am) 41 (21%) Afternoon (12:pm - 5:59pm) 58 (29%) Evening (6pm - 11:59pm) 44(22%) Late night (12:am - 5:59am) 55 (28%) Grand Total 198 (1%) MHA ED visits occurred most in the afternoon (29%), followed by late night (28%) Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 19

20 Percentage (%) Toronto Community Housing Buildings in Oakridge Ambulance Arrival for MHA ED Visits, All Ages, FY FY Percent of MHA ED Visits by Ambulance Arrival, FY to FY Percent of MHA ED Visits Amublance Arrival by CTAS Level, FY to FY % 9% CTAS Level 5 8% 7% 49% CTAS Level 4 7% 6% 5% CTAS Level 3 62% 4% 3% 2% 51% CTAS Level 2 31% 1% CTAS Level 1 % % 1% 2% 3% 4% 5% 6% 7% Ambulance Arrival Other N=198 Percentage (%) N=11 Half of the MHA ED visits arrived through Ambulance Of the MHA ED visits that arrived through ambulance, majority were for CTAS Level 3 Urgent and Potentially Serious (62%) 2 Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217)

21 Percentage (%) Toronto Community Housing Buildings in Oakridge Disposition Status for MHA ED Visits, All Ages, FY FY % 7% Percent of MHA ED visits by Disposition Status, FY to FY % 6% 5% 4% 3% 2% 23% 1% % Discharged Home/Place Of Residence/Insitution 4% % Admitted Left Death (On And After Arrival) 4% Transfer (intra facility, another acute or nonacute care facility) N=198 A large majority of MHA ED visits were discharged home (69%) and less than one quarter (23%) were admitted Only 2 out of 137 visits discharged home were discharged home with support Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 21

22 Toronto Community Housing Buildings in Oakridge Diagnosis Category and Hospitals visited for MHA ED Visits, All Ages, FY FY Percent of MHA ED visits by Diagnosis Category, FY to FY Percent of MHA ED visits by Top 1 Hospitals Visited, FY to FY Other Mental And Behavioural Disorders 16% Schizophrenia, Schizotypal And Delusional Disorders 18% Alcohol 28% Mood 16% Substance Abuse 12% Anxiety 8% N=198 Dementia 1% Other Poisonings 1% Scarborough Hospital - Birchmount Site 23% Michael Garron Hospital 44% St. Michael's Hospital 8% Other 6% Scarborough St. Joseph's Hospital - Health Centre General Site 4% 6% N=198 Rouge Valley Health System - Centenary CAMH 2% Site 2% Humber River Regional Hospital - Humber Memorial 2% UHN TWH 2% North York General Hospital 1% Majority of ED visits were for alcohol (28%) and Schizophrenia, Schizotypal And Delusional Disorders (18%) Majority of patients visited Michael Garron Hospital (44%) and Scarborough Hospital Birchmount Site (23%) Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 22

23 Unique Patients Toronto Community Housing Buildings in Oakridge Frequency of visits for MHA ED Visits, All Ages, FY FY Frequency of MHA ED visits by Unique Patients, FY to FY (64 visits) 18 ED visits in total (55%) Majority of patients were males (75%) and in the age group (81%) Majority of the ED visits were for diagnosis category alcohol, followed by mood disorders (26 visits) Frequency of MHA ED visits A large majority of patients only visited the ED once for MHA related conditions (69%) Of the 16 patients who had 3 or more MHA ED visits, the number of visits ranged from 3 to Source: National Ambulatory Care Reporting System (NACRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217)

24 Inpatient Discharges for Mental Health and Addictions OMHRS FY to FY Validation to determine if hospitalization was a significant issue 24

25 Inpatient Discharges for Mental Health and Addictions Conditions There were 11,219 Mental Health and Addictions discharges in Toronto Central LHIN for patients aged 15+ during FY to FY Two fiscal years were combined due to small numbers. Of those, 299 discharges were for patients who did not have a valid health card number and 11were for patients who identified as Other in terms of gender The analysis only includes the 1,99 discharges for patients who had a valid health card number and identified as male or female Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 25

26 Rate per 1, population Inpatient Discharges for Mental Health & Addictions Conditions by Sub-Region - Ages 15+, FY to FY Sub-Region Discharges Population (211) 15+ Average annual rate of discharges FY FY Total per 1, North Toronto , , Mid-West Toronto 1,515 1,49 2, , East Toronto 1,24 1,268 2,58 222, West Toronto 1,219 1,59 2, , Mid-East Toronto ,82 125, Toronto Central LHIN 5,654 5,255 1,99 984, Toronto Central LHIN Rate of Discharges for MHA Ages Average annual rate of discharges for mental health and addictions conditions per 1,, Ages 15+, FY to FY Toronto Central LHIN Rate: North Toronto Mid-West Toronto East Toronto West Toronto Mid-East Toronto East Toronto had the third highest rate of discharges for mental health and addictions conditions and is higher than the Toronto Central LHIN rate Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 26

27 Rate per 1, population East Toronto Neighbourhoods - Inpatient Discharges for Mental Health & Addictions Conditions- Ages 15+, FY to FY Average annual rate of discharges for mental health and addictions conditions per 1,, Ages 15+, FY to FY East Toronto Rate: Rates of MHA discharges ranged from 32.3 in Birchcliffe-Cliffside to in Blake- Jones Oakridge had the sixth highest rate of discharges for mental health and addictions conditions in East Toronto sub-region (746.1) which was 1.3 times the rate of East Toronto (564.7) Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217) 27

28 Mental Health and Addictions Inpatient Discharges for Patients Residing in Oakridge, FY to FY Development Name Byng Towers Teesdale Pharmacy Warden Woods Woodland Acres North Woodland Acres South TCH Buildings All other postal codes in Oakridge Oakridge Total Address(es) Discharges Unique Patients 333 Danforth Ave, M1L4P9 3 Teesdale Pl, M1L1L2 4 Teesdale Pl, M1L1L3 68 Warden Ave, M1L4N5 1 Cataraqui Cres, M1L3V5 1 Cataraqui Cres, M1L1N7 12 Cataraqui Cres, M1L1N6 682 Warden Ave, M1L3Z9 4 Firvalley Ct, M1L1P1 <5 <5 13 <5 <5 9 <5 < Population* 197 1,59 1, Average annual rate of discharges per 1, , N/A , N/A , There were only 43 mental health and addictions inpatient discharges for patients aged 15+ in all TCH high needs buildings. This accounted for 27 unique patients. The average annual rate of discharges per 1, for all TCH high needs buildings (745.) was fairly similar to the overall rate for Oakridge (746.1) Note*: Population for buildings is based on data provided by Toronto Community Housing and includes ages 13+, Population of Oakridge is based on Census 211 for ages 15+, Population for all other postal codes is an estimation based on the difference between the total population of Oakridge and the population in Toronto Community Housing buildings Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217), Toronto Community Housing Data 28

29 Toronto Community Housing Buildings in Oakridge Demographics of Patients with Mental Health and Addictions Discharges, FY FY Development Name Byng Towers Teesdale Pharmacy Warden Woods Woodland Acres North Woodland Acres South Address(es) Hospitalizations % Female % Male Age Breakdown Average LOS % % Danforth Ave, M1L4P9 3 Teesdale Pl, M1L1L2 4 Teesdale Pl, M1L1L3 68 Warden Ave, M1L4N5 1 Cataraqui Cres, M1L3V5 1 Cataraqui Cres, M1L1N7 12 Cataraqui Cres, M1L1N6 682 Warden Ave, M1L3Z9 4 Firvalley Ct, M1L1P1 <5 67% 33% 1% <5 <5 38% 5% 62% 5% 1% 77% 1% 1% 23% % 69% 1% % 33% 56% 44% 37.1 TCH Buildings 43 44% 56% 77% 23% Overall there was a higher proportion of males than females, with variation in each building Majority of discharges were for ages (77%) Residents from 4 Teesdale Place had a higher Average LOS compared to the other buildings and all buildings overall Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217), Toronto Community Housing Data 29

30 Toronto Community Housing Buildings in Oakridge Diagnosis Category and Hospitals visited for MHA Discharges, Ages 15+, FY FY Percent of MHA Discharges by Diagnosis Category, FY to FY Percent of MHA Discharges by Hospitals Visited, FY to FY Mood Disorders 3% Schizophrenia and Other Psychotic Disorders 6% N=43 Delirium, Dementia, and Amnestic and Other Cognitive Disorders 5% Substance- Related Disorders 5% Scarborough Hospital - Birchmount Site 4% Michael Garron Hospital 42% N=43 Centre for Addiction & Mental Health 9% Sunnybrook Health Sciences Centre 5% Waypoint Centre for Mental Health Care 2% Rouge Valley Health System - Centenery 2% Majority of discharges were for schizophrenia and other psychotic disorders (6%) and mood disorders (3%) Majority of patients visited Michael Garron Hospital (42%) and Scarborough Hospital Birchmount Site (4%) Source: Ontario Mental Health Reporting System (OMHRS), FY214/15-FY215-16, MOHLTC, IntelliHealth (Extracted: 217), Toronto Community Housing Data 3

31 Summary of Findings for Mental Health and Addictions Discharges Oakridge has a higher rate of mental health and addictions discharges (746.1 per 1,) compared to East Toronto subregion (564.7 per 1,) and Toronto Central LHIN overall (553.9 per 1,). The rate for the high needs buildings (745 per 1,) was nearly similar to the Sub-region rate. The number of mental health and addictions discharges from the high needs buildings in Oakridge only accounted for 27% of the total discharges, which was a relatively small number over two fiscal years (43). Residents from those buildings account for 27% of the total Oakridge population. From the analysis shown, it can be concluded that mental health and addictions discharges is not as significant an issue for the selected high needs TCH buildings in Oakridge compared to the ED visits for MHA. 31

32 Use of Community Addictions services by Oakridge and TCH residents DATIS FY215/16 & FY216/17 32

33 Number of Open Individuals in Oakridge by Program Level, Gender and Age Group, FY15/16-FY16/17 Program Level FY15/16 Gender Age Group Males Females Other Total < Total CMH/A Centralized Access Case Management Special Community Services Special Inpatient Services & Residential Rehab Treatment Program Level FY16/17 Gender Age Group Males Females Other Total < Total CMH/A Centralized Access Case Management Outreach, Counselling & Treatment Special Community Services Special Inpatient Services & Residential Rehab Treatment In both fiscal years, majority of residents in Oakridge attended Special Community Services, followed by Special Inpatient Services & Residential Rehab Treatment and Case Management In FY15/16, overall there were more females than males and majority of residents were in the age group. In FY16/17, overall there were more males than females and majority of residents were in the age group again. Note: To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". masked to prevent another masked value from being calculated from a column total. Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 '---' indicates a value equal to or greater than 6 that was 33

34 Number of Open Individuals in Oakridge TCH buildings by Program Level, Gender and Age Group, FY15/16-FY16/17 Program Level FY15/16 Gender Age Group Males Females Other Total < Total CMH/A Centralized Access Case Management Special Community Services Special Inpatient Services & Residential Rehab Treatment Program Level FY16/17 Gender Age Group Males Females Other Total < Total Case Management Special Community Services Special Inpatient Services & Residential Rehab Treatment In FY15/16, majority of residents in Oakridge TCH buildings attended Special Community Services. In FY16/17, majority of residents in Oakridge TCH buildings attended Special Community Services, followed by Special Inpatient Services & Residential Rehab Treatment Note: To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". masked to prevent another masked value from being calculated from a column total. Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 '---' indicates a value equal to or greater than 6 that was 34

35 Length of Stay (LOS) for Clients in Addiction Treatment Programs in Oakridge by Program Level, FY15/16-FY16/17 Average LOS Median LOS Terminated Program Individuals with Terminated Program Level FY215/16 (Days) (Days) Registrations Program Registrations CMH/A Centralized Access Case Management Special Community Services Special Inpatient Services & Residential Rehab Treatment Average LOS Median LOS Terminated Program Individuals with Terminated Program Level FY216/17 (Days) (Days) Registrations Program Registrations CMH/A Centralized Access Case Management Outreach, Counselling & Treatment Special Community Services Special Inpatient Services & Residential Rehab Treatment In both fiscal years, Case Management had the longest average length of stay, followed by Special Community Services. In FY216/17, Outreach, Counselling & Treatment also had a long length of stay. Majority of individuals with terminated program registrations were enrolled in Special Community Services and Special Inpatient Services & Residential Rehab Treatment Notes: LOS calculations are based on program registrations that were terminated during the fiscal year. Length of Stay (LOS) = (Program Registration End Date - Program Registration Start Date) + 1 Terminated Program Registrations: Includes all program registrations terminated during the fiscal year. If an individual had two or more terminated program registrations, all registrations are counted under the Program Level. Individuals with Terminated Program Registrations: If an individual had two or more terminated program registrations during the fiscal year, the individual is counted once only under the Program Level. Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 35

36 Length of Stay (LOS) for Clients in Addiction Treatment Programs in Oakridge TCH Buildings by Program Level, FY15/16-FY16/17 Average LOS Median LOS Terminated Program Individuals with Terminated Program Level FY215/16 (Days) (Days) Registrations Program Registrations CMH/A Centralized Access Case Management Special Community Services Special Inpatient Services & Residential Rehab Treatment Average LOS Median LOS Terminated Program Individuals with Terminated Program Level FY216/17 (Days) (Days) Registrations Program Registrations Special Community Services Special Inpatient Services & Residential Rehab Treatment In FY215/16, Case Management had the longest average length of stay, followed by Special Community Services. In FY216/17, Special Community Services had a longer average length of stay compared to the previous year. Majority of individuals with terminated program registrations were enrolled in Special Community Services and Special Inpatient Services & Residential Rehab Treatment Notes: LOS calculations are based on program registrations that were terminated during the fiscal year. Length of Stay (LOS) = (Program Registration End Date - Program Registration Start Date) + 1 Terminated Program Registrations: Includes all program registrations terminated during the fiscal year. If an individual had two or more terminated program registrations, all registrations are counted under the Program Level. Individuals with Terminated Program Registrations: If an individual had two or more terminated program registrations during the fiscal year, the individual is counted once only under the Program Level. Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 36

37 Number of Open Individuals in Oakridge by LHIN and Addiction Treatment Agency, FY15/16 LHIN CONNEX # Agency Name Open Individuals Central 1733 Vitanova Foundation Central 516 Black Creek Community Health Centre Central East 197 Pinewood Centre of Lakeridge Health 14 Central East 1386A Salvation Army Homestead Central East 1386B Salvation Army Harbour Light Centre Erie St. Clair 51A Hotel-Dieu Grace Healthcare Hamilton Niagara Haldimand Brant 1183 New Port Centre Hamilton Niagara Haldimand Brant 1196 Community Addiction Services of Niagara Toronto Central 1116 St. Joseph's Health Centre Withdrawal Management Services - Toronto Toronto Central 112 Toronto East Health Network 8 Toronto Central 1124 Street Haven at the Crossroads Toronto Central 1128 St. Michael's Withdrawal Management Services Toronto Central 1182 Breakaway Addiction Services Toronto Central 127 St. Michael's Homes Toronto Central 1319 Jean Tweed Treatment Centre Toronto Central 1576 Centre for Addiction & Mental Health (CAMH) - Problem Gambling Service Toronto Central 1576A Centre for Addiction & Mental Health (CAMH) - Substance Abuse Programs (Including MAARS) Toronto Central 1184 Corner, A Community Drop-In Centre (The) Toronto Central Renascent Centres (The) Toronto Central University Health Network / Toronto Western Hospital, Mental Health and Addictions 7 Toronto Central 571 Reconnect Community Health Services Total 65 In FY15/16, majority of residents in Oakridge attended Pinewood Centre of Lakeridge Health in Central LHIN, followed by Toronto East Health Network and UHN in Toronto Central LHIN Notes: Open Individual counts are calculated as follows: If an individual had two or more admissions to the same agency during the fiscal year, the individual is counted once only under the agency. If an individual had at least one admission to more than one agency during the fiscal year, the individual is counted once under each agency. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 37

38 Number of Open Individuals in Oakridge by LHIN and Addiction Treatment Agency, FY16/17 LHIN CONNEX # Agency Name Open Individuals Central 1733 Vitanova Foundation Central 516 Black Creek Community Health Centre Central East 197 Pinewood Centre of Lakeridge Health 19 Central East 1386A Salvation Army Homestead Central East 1386B Salvation Army Harbour Light Centre Central East 5114 St Paul's L'amoreaux Centre Toronto Central 1116 St. Joseph's Health Centre Withdrawal Management Services - Toronto 6 Toronto Central 112 Toronto East Health Network 12 Toronto Central 1128 St. Michael's Withdrawal Management Services Toronto Central 1182 Breakaway Addiction Services Toronto Central 127 St. Michael's Homes Toronto Central 1319 Jean Tweed Treatment Centre Toronto Central 1576 Centre for Addiction & Mental Health (CAMH) - Problem Gambling Service Toronto Central 1576A Centre for Addiction & Mental Health (CAMH) - Substance Abuse Programs (Including MAARS) Toronto Central 1755 Ozanam House Toronto Central 1184 Corner, A Community Drop-In Centre (The) Toronto Central Renascent Centres (The) Toronto Central University Health Network / Toronto Western Hospital, Mental Health and Addictions 12 Toronto Central 571 Reconnect Community Health Services Total 77 In FY16/17, majority of residents in Oakridge attended Pinewood Centre of Lakeridge Health in Central LHIN, followed by Toronto East Health Network and UHN in Toronto Central LHIN Notes: Open Individual counts are calculated as follows: If an individual had two or more admissions to the same agency during the fiscal year, the individual is counted once only under the agency. If an individual had at least one admission to more than one agency during the fiscal year, the individual is counted once under each agency. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 38

39 Number of Open Individuals in Oakridge in TCH Buildings by LHIN and Addiction Treatment Agency, FY15/16 LHIN CONNEX # Agency Name Open Individuals Central East 197 Pinewood Centre of Lakeridge Health 6 Central East 1386A Salvation Army Homestead Central East 1386B Salvation Army Harbour Light Centre Hamilton Niagara Haldimand Brant 1183 New Port Centre Toronto Central 1116 St. Joseph's Health Centre Withdrawal Management Services - Toronto Toronto Central 112 Toronto East Health Network Toronto Central 1128 St. Michael's Withdrawal Management Services Toronto Central 1182 Breakaway Addiction Services Toronto Central 1319 Jean Tweed Treatment Centre Toronto Central 1576A Centre for Addiction & Mental Health (CAMH) - Substance Abuse Programs (Including MAARS) Toronto Central 1184 Corner, A Community Drop-In Centre (The) Toronto Central Renascent Centres (The) Toronto Central University Health Network / Toronto Western Hospital, Mental Health and Addictions Total 24 In FY15/16, majority of residents in Oakridge TCH buildings attended Pinewood Centre of Lakeridge Health in Central LHIN Notes: Open Individual counts are calculated as follows: If an individual had two or more admissions to the same agency during the fiscal year, the individual is counted once only under the agency. If an individual had at least one admission to more than one agency during the fiscal year, the individual is counted once under each agency. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 39

40 Number of Open Individuals in Oakridge in TCH Buildings by LHIN and Addiction Treatment Agency, FY16/17 LHIN CONNEX # Agency Name Open Individuals Central East 197 Pinewood Centre of Lakeridge Health 7 Central East 5114 St Paul's L'amoreaux Centre Toronto Central 1116 St. Joseph's Health Centre Withdrawal Management Services - Toronto Toronto Central 112 Toronto East Health Network Toronto Central 1128 St. Michael's Withdrawal Management Services Toronto Central 1182 Breakaway Addiction Services Toronto Central 127 St. Michael's Homes Toronto Central 1755 Ozanam House Toronto Central 1184 Corner, A Community Drop-In Centre (The) Toronto Central Renascent Centres (The) Toronto Central University Health Network / Toronto Western Hospital, Mental Health and Addictions Total 26 In FY16/17, majority of residents in Oakridge TCH buildings attended Pinewood Centre of Lakeridge Health in Central LHIN. Notes: Open Individual counts are calculated as follows: If an individual had two or more admissions to the same agency during the fiscal year, the individual is counted once only under the agency. If an individual had at least one admission to more than one agency during the fiscal year, the individual is counted once under each agency. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 4

41 Number of Open Individuals in Oakridge by Presenting Problem Substances, FY15/16 -FY16/17 Presenting Problem Substances 215/16 216/17 Open Admissions Discharged Admissions Open Admissions Discharged Admissions None Alcohol Cocaine Amphet. & other stimulants exc. methamphetamines Cannabis Benzodiazepines 1 9 Heroin/Opium Prescription opioids Over-the-counter codeine preparations Tobacco Other psychoactive drugs Crack Ecstasy Methamphetamines (crystal meth.) 6 6 Unknown Missing In both fiscal years for open and discharged admissions, majority of residents in Oakridge presented with problems related to alcohol, followed by crack, cannabis and tobacco. Notes: Up to five Presenting Problem Substances can be reported in an admission. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 41

42 Number of Open Individuals in Oakridge TCH Buildings by Presenting Problem Substances, FY15/16 -FY16/17 Presenting Problem Substances 215/16 216/17 Open Admissions Discharged Admissions Open Admissions Discharged Admissions Alcohol Cocaine 7 Amphet. & other stimulants exc. methamphetamines Cannabis Benzodiazepines Heroin/Opium 6 Prescription opioids Over-the-counter codeine preparations Tobacco Crack Methamphetamines (crystal meth.) In both fiscal years for open and discharged admissions, majority of residents in Oakridge presented with problems related to alcohol, followed by crack, cannabis and tobacco. Notes: Up to five Presenting Problem Substances can be reported in an admission. To protect client anonymity, cells with values less than 6 are redacted and replaced with "...". Source: Drug and Alcohol Treatment Information System, FY15/16 FY16/17 42

43 Health Service Providers Serving Oakridge Residents All HSP List CBI 216/17 43

44 East Sub-Region Health Service Providers by Neighbourhood, 217 Neighborhood Community Health Centre Family Health Team Hospitals Long Term Care Community Support Service Community Mental Health and Addiction Shelter Birchcliffe-Cliffside Blake-Jones -East Toronto Family Community Centre -Woodgreen Community Services Broadview North Clairlea-Birchmount -Providence Healthcare -Cardinal Ambrozic Houses of Providence -West Scarborough Neighborhood Community Centre Crescent Town (Taylor Massey) -True Davidson Acres Danforth Village-East York -South East Toronto FHT -Toronto East Health Network -Toronto Intergenerational Partnerships in Community (TIGP) Danforth Village-Toronto East End-Danforth -Revera Long Term Care Inc. - Main Street Terrace -Applause Community Development Corporation -Dixon Hall - Heyworth House Flemingdon Park -Flemingdon Health Centre -Bellwoods Centre for Community Living Inc. Greenwood-Coxwell -East End Community Health Centre -Alternatives, East York Mental Health Counselling Services Agency North Riverdale -Alpha House Note* Some neighbourhoods are split between LHINs Please note that some HSPs provide services to other neighbourhoods as well as provide different services in different neighborhood 44

45 East Sub-Region Health Service Providers by Neighbourhood, 217 Neighborhood Community Health Centre Family Health Team Hospitals Long Term Care Community Support Service Community Mental Health and Addiction Shelter O'Connor-Parkview -St. Clair O'Connor Community Inc. -Call-A-Service Inc Oakridge Old East York Playter Estates- Danforth The Beaches -Chester Village -Nisbet Lodge -Warden Woods Community Centre Thorncliffe Park -St. Joseph's Infirmary -March of Dimes Canada -East York Meals on Wheels Victoria Village* -Fountain View Care Community -Harmony Hills Care Community -Toronto North Support Services Woodbine Corridor Note* Some neighbourhoods are split between LHINs -Tobias House Attendant Care Inc. Please note that some HSPs provide services to other neighbourhoods as well as provide different services in different neighborhood 45

46 Top CMHA and CSS Providers that Serve at least 5% of Clients in Oakridge CMHA Providers Cota Health 12% Progress Place Rehabilitation Centre (Metropolitan Toronto) Inc. 11% Community Resource Connections of Toronto 1% University Health Network 1% Toronto East General Withdrawal Management Services 6% Centre for Addiction and Mental Health 5% + 21 other HSPs CSS Providers Warden Woods Community Centre 68% + 13 other HSPs Oakridge is served by at least 27 CMHA providers and 14 CSS providers Source: Community Business Intelligence, extracted Feb. 22,

47 Appendix 47

48 ICD 1 Codes used for Mental Health and Addictions Conditions Data Inclusions: Ontario residents ED visits unscheduled visits to hospital emergency departments or urgent care centres (AM case type = EMG) ICD1 codes: the following ICD 1 codes reported for the main problem diagnosis (MPDx) for the ED visit: Mental and Behavioral Disorders: F3, F59, F67, F1, F11, F12, F13, F112, F121, F14, F141, F142, F191, F192, F193, F198, F199, F2, F29, F22, F259, F29, F39, F311, F312, F319, F322, F329, F331, F339, F42, F412, F419, F429, F43, F432, F51, F63, F69, F69, F918, F99 Injury and Poisoning and Certain Other Consequences of External Causes: T368, T41, T529 48