Community Psychiatry | Psychiatry | School of Medicine

Division Chair: Dr. Oyedeji Ayonrinde
Administrative Support: Susan Beck

Community psychiatric services are run through Providence Care Hospital and AMHS (Addictions and Mental Health Services). These programs/teams provide the full spectrum of community mental health care at multiple sites throughout the region. The Division of Community Psychiatry serves as a major focus for research innovative client-centered care, and is a major provider of educational opportunities for health care learners and trainees.

Clinical Services

Addiction Mental Health Services - AMHS

Assertive Community Treatment (ACT) is a multi-disciplinary approach that provides a comprehensive, collaborative array of treatment, rehabilitation and support services to individuals requiring intensive support who are living in the community. ACT serves individuals with acute or persistent mental health concerns who may also have co-occurring problems such as substance use disorders, homelessness, or involvement with the legal system. ACT is delivered by a team that includes occupational, behavioural, recreational, and vocational professionals, addictions and peer specialists, nurses, social workers, and psychiatrists. These highly qualified staff provide individual and family support, as well as advocacy and assistance in accessing other community services. The goal is to assist those experiencing serious mental health concerns in reaching their recovery goals.

Two of the ACT teams in Kingston are based at Addictions and Mental Health Services – Kingston, Frontenac, Lennox & Addington (https://amhs-kfla.ca): the North Shore ACT Team (Dr. N. Delva) and the Frontenac ACT Team (Dr. M. Jariani). The teams are mobile and provide services to people in their community, promoting recovery and community integration through a person-centred approach

Assertive Community Treatment (ACT) Teams

Assertive Community Treatment (ACT) Teams

The Assertive Community Treatment program features teams who provide recovery-oriented treatment, rehabilitation and support services (x 365 days) for individuals who experience serious and persistent mental illness, require a higher level of support in order to maintain success in the community and have not benefitted from traditional community mental health supports.

Psychosocial Rehabilitation (PSR) ACT Team
Community Integration Program (CIP) ACT Team

Location: 525 Montreal St., Kingston

Community High Intensity Treatment (CHIT) Team

The Community High Intensity Treatment program features teams who provide recovery-oriented treatment, rehabilitation and support services (x 365 days) for individuals who experience serious and persistent mental illness, require a higher level of support in order to maintain success in the community and have not benefitted from traditional community mental health supports.

Location: 26 Dundas St., Napanee

Case Management (CM) Services

Case Management Services provides recovery-orientated treatment, rehabilitation and support for those who experience serious mental illness symptoms and are living in the community. This program is for individuals who are ready to step down from the more extensive support provided by Assertive Community Treatment teams.

Location: 525 Montreal St., Kingston

Community Treatment Order (CTO)

The Community Treatment Order program coordinates mental health services for individuals having a diagnosis of a serious mental disorder and a pattern of admission to inpatient psychiatric care, a condition that stabilizes with inpatient treatment, and a history of stopping treatment following discharge.

Location: 752 King St. W, Kingston

Regional Outreach/ Regional Specialty Mental Health (RSMH)

The Regional Outreach program strives to improve clinical outcomes for individuals with serious mental illness by engaging in the provision of clinical services and community capacity enhancement activities. The program is responsible for providing expertise to contribute to recovery-oriented, individualized service plans and to augment and develop resources regionally. Treatment and rehabilitation services are provided in individual and group formats on a time-limited basis.

Kingston: 752 King Street West
Kingston: 525 Montreal Street
Napanee: 26 Dundas St., Napanee
Belleville: 470 Dundas St., Unit 63, Belleville
Sharbot Lake: 1109 Garrett St, 2nd Floor, Unit #3

Personality Disorders Service

Personality Disorders Service provides care for non-psychotic adults who have been diagnosed with a personality disorder. These individuals tend to experience intense and distorted thoughts, and engage in self-destructive and socially inappropriate behaviours that are hard to change and impacts aspects of daily life.

Consultation and Education
The program psychiatrist, Dr. Jamey Adirim, provides consultation to family physicians, community psychiatrists, agencies, and other caregivers. Consultations are typically in the area of medication management, treatment, strategies, diagnosis, and issues that arise in psychotherapy. Other members of the Personality Disorders Service team offer assessments and consultations to professionals and community agencies in their area of specialty, as well as education in the understanding and treatment of personality disorders. We assist agencies in starting psycho-educational groups and provide placements for students in psychiatry, nursing, medicine, psychology, social work and nutrition.

Teaching and Reseach
Psychiatrists and psychologists with the Personality Disorders Service hold joint appointments at Queen's University and Providence Care and are active in teaching and research. Research interests include: The Treatment of Personality Disorders, The Biology of Stress, Learning Disabilities, Childhood Trauma, Sexual Orientation, Minfulness, Eating Disorders, Program Effect on Hospitalization, Common Factors in Psychotherapy, Gender Identity, Posttraumatic Dissociation, Attachment, and the Changing Role of Psychiatry at a Student Health Service.

The principal researchers are: Dr. Margo Rivera, Clinical Leader of the Personality Disorders Service and Director of Psychotherapy, Department of Psychiatry, Queen's University, and Dr. Juliet Darke, Psychologist, Personality Disorders Service.

Chrysalis Group Treatment Program

The Chrysalis Group Treatment Program offers specialized therapy for adults (16+) who have difficulty managing intense and overwhelming emotions that often result in problematic patterns of thoughts and behaviours that are long-standing, hard to change and impact many aspects of their lives, including relationships, school, and work. Their problems frequently include some or all of the following: intense and unstable interpersonal relationships, often due to a combination of a longing for deep human connection and fear of intimacy, volatile mood swings, self-destructive and self-sabotaging behaviours, suicidal ideation, inability to modulate anger, unstable sense of self, struggles with substance abuse and eating disorders, and a range of other psychological and behavioural difficulties. Individuals who have recently experienced or are currently experiencing ongoing psychosis would not be suitable for the program, but occasionally severe traumatogenic dissociative symptoms are mistaken for psychosis, and assessments for individuals suspected of possibly living with dissociative disorders, including Dissociative Identity Disorder, are a service regularly offered by the Chrysalis Program.

Treatment approaches include Dialectical Behaviour Therapy, Radically Open Dialectical Behaviour Therapy, and psychodynamic psychotherapies (Transference-Focused Therapy and Mentalization-Based Psychotherapy), offered primarily in group-based settings.

The Chrysalis Program (previously referred to as the Personality Disorders Service) also offers specialized psychiatric assessments for those with suspected or confirmed personality disorders. Assessment referrals may be focused on diagnosis, behavioural, therapeutic, and medication management, and/or questions regarding appropriate treatment, including possible inclusion in the Chrysalis Program’s range of in-person and/or virtual Group Psychotherapy programs.

Community Groups

Managing Powerful Emotions (MPE Group)
Managing Powerful Emotions is a 12-week (90-minute) skill-building group offered three times a year for individuals who have significant challenges with tolerating their distress and regulating emotions and behaviour. Participants learn specific strategies to help tolerate emotional crises and intense emotions; including, examining the pros and cons of acting impulsively and engaging in destructive behaviour. MPE teaches participants to use practical tools to understand their feelings and exercise control over emotional outbursts that create significant and ongoing difficulties in their lives.

Weeks 1 to 6 cover the distress tolerance material and include concepts such as accepting reality, willfulness versus willingness, and crisis survival skills. Weeks 7 to 12 teach emotion regulation concepts and tools: participants learn to identify and/or label their emotions, understand the purpose of their emotions, recognize what activates their emotions, and how to use skills to gain control over emotional outbursts.

In order to successfully complete the MPE group, participants must attend at least 9/12 sessions, actively participate in the group, complete worksheets weekly, and use the skills and tools in their day-to-day life. If these requirements are met, they can then be considered for additional DBT-informed skill-building groups: Mindfulness and People Skills. Participants are welcome to repeat the MPE group.

Mindfulness (DBT Group)
Mindfulness is a skill-based group designed to help individuals live in the present moment, build awareness, and allow emotions and physiological reactions to naturally come and go. The goals of the group are to increase awareness of internal and external responses; and to raise the threshold for accepting and enduring painful emotions.

People Skills (DBT Group: Interpersonal Effectiveness)
People Skills is a skill-based group, designed to teach participants more respectful and effective ways of communicating with others; including, expressing thoughts and feelings, making requests of others, refusing unwanted requests, and resolving conflicts.
These two groups are offered weekly for 12-weeks. Each group runs for 60 minutes and they are typically offered back-to-back, on the same day. To successfully complete and benefit from the groups, participants are expected to attend regularly and to complete the weekly worksheets. Homework for these groups is essential for developing the skills being taught. A group member who misses more than three sessions will be encouraged to repeat the groups.

Seeking Safety (Substance Abuse and Emotion Regulation)
The Seeking Safety group focuses on the link between trauma and addictions. This group teaches a specific set of skills to help individuals establish safety in their relationships, thinking, emotions, and behaviour. Participants may be at different stages in their recovery from substance use, but all will be expected to work towards abstinence. Group discussions follow a series of topics focused on building a life free from substances, with participants setting commitments in each group aimed at reducing substance use. This group meets 1.5 hours per week for 25 weeks.

Kaleidoscope Day Program
The Kaleidoscope Day Program runs for 15 weeks, two mornings a week. This program is an intensive group treatment for people with severe, persistent symptoms that have not been resolved in other settings. The program is highly structured and integrates DBT and psychodynamic approaches. Participants must be functioning independently in the community.
Successful completion of the MPE, Mindfulness, and People Skills groups is required inorder to be considered for the Kaleidoscope Program. Individual screening will be requiredfor program suitability.

Dr. Margo Rivera, PH.D., C.Psyh.,
Clinical Leader,
Chrysalis Group
Treatment Program

Dr. Jamey Adirim,
Psychiatrist,
Personality Disorders Service and Chrysalis Group Treatment Program

Referrals

The Program is located at 303 Bagot Street, Suite 300.
A referral is mandatory to be considered for any of our groups.

Referrals to the Chrysalis Group Treatment Program are accepted from family physicians, psychiatrists, community mental health agencies, and medical care providers. Referrals can be better assessed if all collateral information is included (i.e., psychiatric assessments, social histories, discharge summaries, mental health consultation reports, or a detailed note outlining the purpose of the referral). The South Eastern Ontario Addictions & Mental Health Service Access Form can be found online or you may request a copy from our office.
Participants are encouraged to have their family physician or primary care provider continue to manage their ongoing care as our program is considered an adjunct to existing supports.

All referrals and requests for service or consultation are to be directed to the Chrysalis Group Treatment Program at (613) 542-8344 ext. 0; FAX (613) 542-1400