Division of Adult Psychiatry | Psychiatry | School of Medicine

Division Chairs:
Dr. Simon O'Brien, MD, FRCP (Chair PCH)
Dr. Naz Alavi, MD, FRCPC (Chair KHSC)
Dr. Taras Reshetukha, MD, FRCPC (Deputy Chair KHSC)
Administrative Support: Susan Beck (PCH) Claire Chow (KHSC)

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 Kingston Health Sciences Centre (Acute care) and Providence Care Hospital.

The Division of Adult Psychiatry out of Kingston Health Science Centre offers acute psychiatric assessment and treatment to adults over the age of 18 through the following services: Inpatient Services, Outpatient Services, Emergency Psychiatry, and Consultation 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 Mental Health, Seniors Mental Health, and Forensic Mental Health. 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. Providence Care is 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

Mood Disorders Service / Interventional Psychiatry

The Mood Disorders Service at Providence Care provides both inpatient and outpatient care to patients with treatment resistant mood disorders. It is leading regional provider of interventional treatment options such as Ketamine and TMS (Transcranial Magnetic Stimulation) , and a national leader in research in these areas.

Adult Inpatient Services (PCH)

Providence Care Hospital Site has 60 inpatient beds for the treatment of patients with complex and refractory mental illness who require hospitalization beyond an acute care stay. Staff have specialized expertise in the treatment and management of treatment resistant Bipolar Disorder, Depression and Schizophrenia.

Inpatient Services

Interim Clinical Lead: Dr. Daniela Volochniouk

Our inpatient unit is situated at Kingston General Hospital (KGH) on Burr 4. We provide 41 general psychiatry beds, including:

7 IOA (Intensive Observation Area) beds for patients requiring a higher level of supervision and 2 short-stay beds (admission up to 72 hours) in the A unit
32 regular beds in the “B unit”.

We receive admissions from the Emergency Department and transfers from medical/surgical units at KGH. The inpatient team collaborates with the Emergency Psychiatry team, Consultation Liaison Team, Providence Care Hospital, and various outpatient teams to ensure comprehensive care.

Our Treatment Team

Our treatment team is composed of highly skilled professionals, including psychiatrists, psychiatry residents, nurses, social workers, occupational therapists, and psychotherapists.

Education and Training

We are committed to fostering the growth and development of healthcare professionals. Our inpatient unit plays a vital role in training various healthcare trainees. Here's an overview of our educational opportunities:

Psychiatric Residents: Our program accommodates residents at PGY 1 and 2 levels, as well as PGY 4-5 (senior) residents during their electives. Residents have extensive opportunities to complete EPA’s, and actively participate in both group and individual psychotherapy sessions under the guidance of our psychotherapist and psychiatrists.
Medical Students and Other Disciplines: We welcome medical students and students from other disciplines, including registered nurses (RNs), occupational therapists (OTs), and physical therapists (PTs) to participate in our educational endeavors. All trainees collaborate as integral members of our multi-disciplinary team.

At our Inpatient Services, we are dedicated to providing exceptional patient care while nurturing the next generation of healthcare professionals.

Emergency Psychiatry

Clinical Lead: Dr. Nazanin Alavi

The Emergency Psychiatry team 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 the Kingston General Hospital site.

We work closely with the Emergency Medicine team at KGH. After our team gets consulted to see an individual, we will meet with them as a team or individually.

We work closely with inpatient, outpatient and community mental health services to assist individuals in finding the right level of care.

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 the 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.

The 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 practice of acute care psychotherapy interventions that can be done in the ER setting.

Consultation Liaison

Clinical Lead: Dr Rafael Friere

Consultation-liaison psychiatry is the branch of psychiatry specializing at the interface of general medicine and psychiatry. CL psychiatrists provide consultations to inpatient medical or surgical patients at the request of the treating team, giving diagnostic assessments and management recommendations.

This service is situated in the Kingston General Hospital (KGH) site.

The CL psychiatry team collaborates with the medical and surgical teams in multiple ways and plays a crucial role in diagnostic clarification, helping to distinguish between psychiatric and medical conditions, ensuring accurate diagnosis and appropriate treatment.

The CL psychiatry team is composed of medical students, off-service residents, psychiatry residents, clinical fellows and attendings. The attending is the staff psychiatrist covering the service.

Outpatient Services

Clinical Lead: Dr. Taras Reshetukha

Outpatient Psychiatry is divided into two streams, named urgent and general. The Urgent Stream is designed to provide swift intake, assessments, and brief transitional mental health and addiction care (up to 6 months) for patients who have been discharged from the Emergency Room or Inpatient Psychiatric Unit. Additionally, the Urgent Stream offers group therapy rooted in Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT).

The General Stream offers non-urgent psychiatric assessment, consultation services, pharmacological treatment, group psychotherapy, and follow-up care (up to 12 months) for adult patients with complex psychiatric conditions.

There are 3 specialist programs within general outpatient psychiatry:

Early Psychosis Intervention (EIP) Program

The Early Psychosis Intervention (EIP) program is a specialized interdisciplinary team focused on assisting individuals experiencing their first episode of psychosis. This program provides barrier-free assessment, treatment, and education for individuals with psychosis aged 16 years and older, recognizing the critical importance of early detection for successful recovery.

Adult Eating Disorders Program

The Adult Eating Disorders Program offers client-centered, evidence-based treatment to individuals dealing with Anorexia Nervosa, Bulimia Nervosa, or other specified feeding or eating disorders. Services are offered through intensive Day Treatment and outpatient programs. This program provides diagnostic assessment, consultation, and interdisciplinary treatment services to both females and males aged 18 years and older.

Detoxification Centre

The Detoxification Centre provides short-term residential withdrawal management services to offer individuals the support they need to take their first step towards recovery. In addition to residential services, the Centre offers access to self-help groups, 24-hour drop-in supportive counselling, and telephone support.

Education:

Our current educational approach is rooted in competency-based medical training. This means that the complexity of the tasks undertaken by our trainees evolves as they progress through their training. Junior psychiatry residents independently assess and provide follow-up care to patients with lower psychiatric complexity within our Clinical Teaching Unit (CTU). As our senior trainees advance, they gradually assume responsibility for delivering complex mental health and addiction care, with supervision tailored to their evolving competencies. We actively encourage and support residents to participate in various specialty clinics within our Outpatient Psychiatry.

Research:

We champion innovation in this field. Within Outpatient Psychiatry, we serve as the home base for the Online Psychotherapy Lab, known as QUOPL (Queen's University Online Psychotherapy Lab). QUOPL specializes in integrating virtual psychotherapy guided by artificial intelligence (AI), harnessing technology to improve patient outcomes.

Faculty members based in Outpatient Psychiatry conduct research studies that explore complex questions surrounding mood and anxiety disorders, ADHD, neuropsychiatry, and the enhancement of psychiatric care quality.

Online Psychotherapy Lab

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.