Download - Windsor Regional Hospital

The Case for a Wellness Program for Extended
Psychosis (W-PEP)
• State of Psychiatric Resources in the
Community:
– Ontario College of Physician and
Surgeons estimates that the Windsor
area requires 48 psychiatrists
– Current staffing in Windsor-Essex is 12
full-time psychiatrists.
• Even though the area is under-serviced and
resources scarce, we believe that effective
intervention in schizophrenia and related
disorders can be achieved through community
collaboration.

W-PEP Solves Wait-Time Referral Dilemma
Referral without W-PEP
• Hospital or physician makes
referral to psychiatrist
• Wait time for first appointment is
approximately nine (9) months
• Patients discharged from hospital
without proper follow-up plan,
resulting in re-admission
Referral with W-PEP
• GP’s, Psychiatrists, Hospital
Psychiatric Units may make referral
to W-PEP
• Call to patient within 72 hours to
schedule assessment
• Patient seen for full assessment
within 30 days
• Patient notified of assessment
outcome within 7 days after
assessment
• Patients do not leave hospital
without W-PEP psychiatrist
assigned to their case

There are holes in the mental health system
W-PEP fills in the service gap...
Service Canadian
Mental Health
Association:
• Community based
• Patients with a first
episode of psychosis
• Age < 35 yrs
• Typically clients are of
high school age
• Service is time limited
W-PEP Program:
• Hospital and community
based wellness program
• Age 16 – 65 yrs. (average
age is 26 yrs.)
• Persons diagnosed
with schizophrenia,
schizoaffective or
delusional disorders
• Service is NOT time limited
Service ACT Team:
• Community based
• Patients requiring
more intensive
supportive services for
severe symptoms of
their illness
• Typically patients with
a long history of
lengthy psychiatric
admissions to hospital
• Some require daily
home visits to
administer medication

Model of Care
• Clinical intensity of treatment based on
client’s needs.
• Primary outcome to assist individual in
attaining highest quality of life and personal
growth.
• Improvement through:
– Education (Patient & Family),
– Role reintegration,
– Relapse prevention,
– Reduction of family burden.

3 Levels of Treatment Modalities
Comprehensive
(most intense)
• Specialized
Psychiatrist
• Nurse Case
Manager (Ongoing
Support)
• Access to all patient
groups
• Neuropsychologist
(as needed)
Intermediate
• Specialized
Psychiatrist
• Nurse Case
Manager (Periodic
Support)
• Access to all patient
groups
Medical Management
(least intense)
• Specialized
Psychiatrist
• Patient’s s illness is
stable and only
requires continued
follow-up with a
W-PEP psychiatrist
• If the need arises,
the patient is
transferred into a
more appropriate
level of care

W-PEP Program Measured Effectiveness
• 30% improvement in patient quality of life.
• 65% and 38% improvement in positive and negative
symptoms of schizophrenia, respectively.
• Decrease average length of stay in hospital
from 14.14 days to 10.39 days per admission
(27% reduction).
“The W-PEP program has given me
my son back.”
P.C.
“Before I joined the W-PEP program I
secluded myself. Now I have hope
and I enjoy my life.”
F.Q.

Contact Information
Dr. Leonardo Cortese
Associate Professor,
Faculty of Medicine
University of Western Ontario
Chief and Clinical Director,
Specialized Mental Health Programs,
Windsor Regional Hospital
TEL: 519-257-5111 ext. 76970
FAX: 519-257-5190
Jeffrey Geml
Research Coordinator
Wellness Program for Extended
Psychosis (W-PEP)
Windsor Regional Hospital –
Western Campus
TEL: 519-257-5111 ext. 76972
FAX: 519-257-5190