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Division of Adult Psychiatry

Division Co-Chairs: Dr. Simon O'Brien, MD, LMCC, CCFP, FRCP (PCH) and Dr. Claudio Soares, MD, PhD, FRCPC, MBA (Acting - HDH)
Administrative Support: Carol Burtch (PCH) and Claire Chow (HDH) 

The Division of Adult Psychiatry is comprised of an energetic multidisciplinary group of psychiatrists, psychologists, social workers, nurses, occupational therapists and pastoral care workers. Faculty members are engaged in a wide range of activities including providing clinical services, teaching, research and administrative duties.

Our services are provided at Hotel Dieu Hospital and Providence Care Hospital.

The Division of Adult Psychiatry out of Hotel Dieu Hospital offers acute psychiatric assessment and treatment to adults over the age of 18 through the following services: Inpatient Services, Outpatient Services and Emergency Psychiatry and Community Liaison. We have also two specialised regional programs: Heads Up! - Early Psychosis Intervention Program and Eating Disorders Program

The Division of Adult Psychiatry at Providence Care provides a wide array of specialized services through three program areas - Adult Treatment and Rehabilitation, Geriatric Psychiatry and Forensic Services.  Each of the three services offers a continuum of care - inpatient, outpatient and community - with an emphasis on reintegrating clients into the community at the earliest possible opportunity.  As we move forward with restructuring, Providence Care will take on a clearly defined role as a regional provider of specialized services to people with serious mental illness and a regional resource to community agencies.  In its role as a teaching facility, Providence Care participates in the training of students and a number of clinical staff conduct clinical research to contribute to the understanding of mental illness and treatment.

The Community Mental Health Services at Providence Care are described here

The Adult Division also has comprehensive Psychotherapy Services and more information can be found on the Academic page under the Postgraduate tab.

Clincal Services 

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 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.

The Emergency Psychiatry at Queen’s University is a team of clinicians and psychiatrist who assess and treat individuals with acute mental health problems who have presented to the Emergency Department at Kingston Health Sciences Centre (Kingston General Hospital site).

We work closely with the Emergency Medicine team at KHSC. After our team gets consulted to see an individual, we will meet with them as a team or individually. As part of the assessment, we will ask questions to understand the problems and concerns of the patient. Once all the information has been gathered, the team will meet to make a decision about the best care we can provide. We work with our patients to develop the best plan for them.

We also work closely with inpatient, outpatient and community mental health services to assist individuals in finding the right level of care. People experiencing a psychiatric crisis arrive in the Emergency Department in many different ways.  Our goal is to provide the best support to individuals in crisis in our community.

Members:
The Emergency Psychiatry attendings each have varied interest expertise.

·     Clinical Lead: Dr. Nazanin Alavi has interest in improving suicide risk assessment in the emergency settings.
·     Dr. Eric Prost has expertise in women’s reproductive psychiatry.
·     Dr. Taras Reshetukha has extensive clinical practice in addiction and concurrent disorders.
·     Dr. Dijana Oliver has interest in psychopharmacology.
·     Dr. Megan Yang has expertise in transitional age youth.

Teamwork and collaboration are our main goals. We work as part of a multidisciplinary team including mental health social workers, nurse coordinators, psychiatry nursing staff, psychiatry residents, students and psychiatrist.

Education

During the Emergency Psychiatry rotation residents do not cover other services. Usually, the team consists of a senior psychiatry resident, 1-2 junior psychiatry residents, and 1-2 off-service residents from family medicine or emergency medicine services.

Residents work as a team. Junior residents are involved in assessment of the patients under supervision of the senior psychiatry resident and the staff psychiatrist. This encourages all junior residents to get involved in the care of the patients and also helps the senior residents with leadership role.

ER psychiatry rotation lets the students and residents learn a different set of skills with a different patient population and supervisor, providing unique perspectives daily. It also allows for the knowledge acquisition and practice of acute care psychotherapy interventions that can be done in the ER setting.

Residents will get the opportunity for doing ER psychiatry at different stages of their training. They will usually do 2-3 blocks as a junior resident, and 1-2 blocks as a senior resident. 

 

Online Psychotherapy Lab aims to improve the lives of all those affected by mental health disorders through the advancement in mental health research. Primarily located at Queen's University, Kingston Health Sciences Centre, Hotel Dieu Hospital site, Kingston, ON.

In our online Psychotherapy Lab, we design, different online psychotherapy modules and courses for various mental illnesses including Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Borderline Personality Disorder and substance use disorder.  

Through online psychotherapy more service at lower cost could be delivered which could potentially double the performance of the healthcare system. This change in wait time and increased coverage could lead to significant financial and societal cost savings, given the debilitating impact of mental health disorders on individuals’ functioning while waiting for proper care. Diagnosis based care delivery through an online clinic provides a new approach to address the barriers of receiving therapy in the multi-cultural and geographically dispersed society.

Check out the QUOPL website for more information here

The QUOPL is led by Dr. Nazanin Alavi, Psychiatrist and Assistant Professor. 

Chrysalis Day Program is for people with severe, persistent symptoms that have not been resolved in other settings.  Participants must be highly motivated to struggle toward responsible, independent functioning in the community.  All Chrysalis participants live in the community and participate as outpatients.  The program is located at 303 Bagot Street, Suite 300, in the LaSalle Mews in downtown Kingston, and its hours are Tuesday through Thursday from 8:30 a.m. to 12:30 p.m.  Before starting the program all applicants will go through an intake screening.  Up to 24 people can attend at one time.  There are no fees.  The program operates on a 15-week semester system.

Chrysalis is a highly structured and intensive treatment program that integrates Dialectical Behaviour Therapy with a psychodynamic approach in group therapy.  The groups are safe communities where people can experience and reflect on the dynamics of interpersonal relationships.  How they respond within the groups can be a source of insight into destructive personal patterns and a powerful catalyst for change.  All Chrysalis participants develop short and long-term goals for persona change, and progress in meeting these goals is monitored in a weekly Goals group.  A wide variety of other groups are also offered within the context of the day program, including: Choices, the core psychodynamic group, Orientation to Therapy, Effective Communication, Managing Powerful Emotions, Values, Art Therapy, Minfulness, GOALS.

At the end of each 15-week semester, participants review their progress with staff.  If they have demonstrated excellent attendance, active participation and significant improvement in symptoms, and they show evidence of continuing need and motivation, they may re-register for a second semester.  Those who are ready to graduate are asked to make goals for the next stage of their journey.

Participant's community health care providers are expected to continue to manage their ongoing care, and the Chrysalis Program is considered an adjunct to their efforts.

Community Groups

Seeking Safety Group:
This group is intended for people who struggle with the combination of substance abuse and emotional/behavioural dysregulation.  This group is designed to teach participants a set of skills to deal adaptively with their emotional suffering, by understanding their emotional and behavioural dysregulation and by making more constructive choices for themselves.  The groundwork of this group includes lessons and homework on self-soothing, symptom management, relapse prevention, and harm reduction.  Each participant makes weekly goals and is accountable to the group for meeting these goals.
To participate in this group, a referral and screening process are mandatory.

Managing Powerful Emotions Group (DBT):
Managing powerful emotions is a 12-week psycho-educational group offered several times a year for individuals who have difficulty with emotion regulation.  Participants learn specific strategies to help tolerate emotional crises and intense emotions and examine the pros and cons of enacting destructive behaviour.  MPE is an educational group that teaches participants to use practical tools to understand their feelings and exercise control over emotional outbursts that create significant difficulties in their lives.  This group is a pre-requisite for participation in the Chrysalis Program.
Individuals may self-refer to this group.

 

 

Mindfulness Group (DBT)
People Skills Group (DBT)