Homewood Health — recognizing addiction as a mental health issue

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National network of mental health and addiction treatment clinics Homewood Health has acquired another facility, this time in Montreal, called Homewood du Plateau. Homewood Health acquired half of the facility in 2014, and the 16-bed residence is now a fully-functional, bilingual treatment centre for people struggling with addiction and related mental health issues.

Dr. Ronald Fraser is an addictions psychiatrist who specializes in personality disorders. He runs an inpatient detoxification service at the McGill University Health Centre and is the co-medical director for Homewood du Plateau in Montreal, a 16-bed residential treatment program for addiction and co-occurring mental health conditions. The program was originally developed by himself and Dr. Warren Steiner to provide people the opportunity to access evidence-based treatments.

“There’s no one treatment that works for everybody,” explains Dr. Fraser, which is why it’s an intensive, six-week program that incorporates a number of those treatments. A combination of motivational enhancement therapy, CBT, structured relapse prevention, a blend of general therapeutic activities and health programs, and pharmacological treatments for both addiction and other mental disorders. For example, many patients use opiate replacement therapy with methadone or suboxone as a way of coming off their medications.

Dr. Carlos Lalonde, the chief of psychiatry at The Residence at Homewood in Guelph, Ontario, told Ottawa Life via email that The Residence encourages an abstinence-based model, but recognizes that opiate replacement therapy is the most effective option for some patients. Dr. Lalonde calls The Residence’s model a “bio-psycho-social-spiritual model” committed to working towards abstinence via a variety of methods.

Dr. Fraser says many of Homewood du Plateau’s patients were originally introduced to opioids via prescription by their doctors, and often substitution therapies with methadone or suboxone are the most effective for those patients. Patients also have the option of an abstinence-based model, and occasionally of an opioid blocker.

Between the addictions treatment and the full days of programming, Dr. Fraser says patients are treated for all of their needs, including any co-occurring mental health problems.

“All of these disorders are being treated in order to optimize peoples’ chances of success,” he says. Treatment is individualized with each patient, and often their family is involved as well to ensure continuum of care past the end of the intensive program.

Once patients have completed their six weeks, they can still attend day programs or weekly meetings at Homewood du Plateau in order to stay accountable to their recovery program. As Dr. Fraser explains, the six weeks are meant to build a foundation for what will be a lifetime of work. The same continuum of care is used at The Residence at Homewood, which Dr. Lalonde says encourages attendance at 12-step programs or relapse prevention groups.

Dr. Fraser says it’s important to recognize addiction as a mental health issue, which is why Homewood Health treats not just physical addiction, but also the mental condition of addiction and mental disorders that can stem from or contribute to opioid addiction.

“If you treat one disorder but ignore or neglect the other disorders, you’re probably not going to have an optimal outcome,” he says. “The reality is, addiction is a mental health condition. It is a psychiatric condition.”

Dr. Lalonde agrees, adding that the stigma surrounding addiction can often prevent people from reaching the help they need. This is why, in addition to treating the addiction itself, Homewood Health programs offer a variety of therapies, including mindfulness, behavioural, and grief therapies, to try and address the range of issues someone struggling with addiction might be dealing with.

“The more we do to address other underlying conditions in addition the core addiction itself, the better the outcomes will be,” Dr. Lalonde says. “We want to assist Canadians in letting go of the stigma that is attached to getting help for mental health conditions and addictions while at the same introducing them to the many options available to them that allow access to appropriate, professional treatment that meets their clinical and lifestyle needs.”