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Daya Nand (middle) credits the members of the Surrey/North Delta Assertive Community Treatment team, including Coordinator Gina Parhar (left) and Rupa, for aiding his recovery from severe mental illness.

Mental health treatment is not one size fits all

05/09/2017 10:36:25 AM | 0 comments |
There is no one-size-fits-all solution for treating severe mental health conditions.
 
Not for Daya Nand. Not for his fellow clients. Not for his care team.   
 
That’s why the members of the Surrey-North Delta Assertive Community Treatment (ACT) team always start by asking their clients: “What do you want to do?” They know that treatment will be more successful when it’s as unique as the individuals themselves.
 
Daya Nand is one such unique individual. Originally from Fiji, Daya became a Canadian citizen in 1996. 
 
He worked for 10 years at a bottling plant, but along the way developed an alcohol abuse problem that led to a breakup with his family. 
 
Experiencing paranoid delusions related to schizophrenia, and estranged from his wife and children, by 2014, Daya was struggling with substance use, multiple assault charges and deep emotional pain.
 
“I was very upset with life at the time, depressed from the loss of my family and I was drinking every day,” he says. 
 
After a long stay in hospital in 2014, Daya was referred to the Surrey-North Delta ACT team for support, as his previous connections with other types of mental health care had not been successful. 
 
“Clinical environments can be very stressful for some individuals. It can leave people with mental illness and problematic substance use feeling judged, oppressed and hopeless about their situation, so we focus on meeting them where they’re at ,” says Gina Parhar, Surrey/North Delta ACT Coordinator. 
 
Meeting people where they’re at simply means asking the client: “What can we do to help you?”

Daya was angry, but willingly responded. He said he needed a change in his medication because the side effects were bad. He needed someone to listen. He wanted to go to McDonald’s.
 
ACT psychiatrist Dr. Mansoor Anwar switched Daya to a monthly injection medication with lower side effects, and the team worked at slowly building a relationship with him over cups of coffee at McDonald’s. Coffee chats about his recovery plan eventually led to participation in group sessions and finding suitable housing.
 
Now, Daya greets the team -- Dr. Anwar, Gina Parhar, Meghan, Ramona, Rupa, Sue, Nicole, Natalie, Kirsten and others -- with a big smile and generous praise for what he calls “a wonderful group of people.” 
 
Now sober and with his mental health condition managed, Daya has rekindled a good relationship with his mother and sister. He also uses his culinary talent (his specialty is lamb curry) to feed people in need, volunteering twice a week for the community meal program at the Surrey Urban Mission Society in Whalley. 
 
“Our key to success is focused on building relationships with our clients,” says Parhar. “Sometimes it means going slowly, being casual -- not rushing into a four-page assessment form, but rather identifying what it is that we can help them with. Maybe they haven’t eaten. If so, then we go with them to get groceries.”
 
Today, Daya is very excited to share that he is moving into a new apartment this month in Surrey. With some assistance from the team, Daya successfully interviewed for the apartment rental, which has good connections to community services and public transit. “I’m very proud to move there,” he says. 
 
On days when things don’t go so well for him, he has a strategy in place: “When I get upset or I’m feeling lonely at home, I call the (ACT) team and we go for a coffee and they help me sort things out,” he says. “They talk and spend time with me and remind me of all the good things going on in my life.”
 
And on days when things don’t go so well for his fellow clients, he is there to support them: “I help people to make them feel good. ... I tell them to be kind-hearted and helpful because what goes around, comes around, and you don’t want to be sick all of your life.”
 
Providing Assertive Community Treatment team services in the community is part of the Mental Health and Substance Use program’s strategy to help stabilize and support people who experience severe and persistent mental illness who have not benefited from traditional office-based outpatient mental health and rehabilitation services.
 
For more information about Assertive Community Treatment, visit fraserhealth.ca/mentalhealth

Assertive Community Treatment outcomes

A recent Fraser Health evaluation report on all of our Assertive Community Treatment teams showed that teams across the region continue to make a positive impact on the quality of life for adults with severe and persistent mental illness, and reduce hospital utilization. 
 
In Surrey-North Delta, where Daya Nand is a client, outcomes were as follows: 
  • 71 per cent decrease in days of hospital care due to psychiatric reasons
  • 79 per cent decrease in the number of Emergency Department visits
  • 50 per cent reduction in the number of admissions to hospital care
More importantly, the quality of life for our clients has significantly improved:
  • 88 per cent of Assertive Community Treatment clients have gained stable housing
  • Proportion of clients benefiting from improved management of psychological symptoms has significantly increased
  • Proportion of clients gaining a regular doctor, community service connections, personal identification, etc. has increased

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