Department of Psychiatry

Alcohol Recovery Clinic (ARC)

Overview: Provides urgent outpatient services for patients experiencing mild to moderate alcohol withdrawal.

Location: Health Sciences Centre, Winnipeg

Referrals: Typically from the Health Sciences Centre Emergency Department. Physicians outside the Health Sciences Centre must arrange referrals by phone with the triage nurse clinician or the on-call doctor.

Appointments: Patients are usually seen within 24 hours. The outcome may lead to admission to the Addictions Unit or referral to community-based treatment.

Bridging Opioid Agonist Therapy (BOAT) Clinic

Overview: Offers short-term follow-up care for patients who started opioid agonist therapy (buprenorphine/naloxone or methadone) while in hospital.

Location: Health Sciences Centre, Winnipeg

Referrals: Patients are connected to long-term care in the community once they are stable.

Complex Addiction & Recovery Medical Assessment (CARMA) Clinic

Overview: Provides non-urgent consultations for outpatients with problematic substance use, including prescription medications, illicit substances, and alcohol.

Location: Health Sciences Centre, Winnipeg

Referrals: Accepted from the patient’s primary physician or prescriber. Fax referrals to 204-787-3996, including patient contact information, the clinical question, and relevant history.

Appointments: The clinic provides recommendations but does not take over prescribing medications.

Rapid Access to Addiction Medicine (RAAM) Clinic

Overview: A walk-in clinic offering access to addiction physicians, physician assistants, and counselors.

Location: Crisis Response Centre, 817 Bannatyne Avenue, Winnipeg

Services: Includes withdrawal management, medication-assisted treatment, and referrals to addiction treatment programs.

Appointments: No booking needed; no referrals required. Further information is available on the RAAM webpage.

Addiction Consult Service

Overview: The Addiction Consult Service provides diagnosis, treatment planning, and medication recommendations for managing withdrawal, cravings, and relapse prevention for patients admitted to medical, surgical, or obstetrical wards with substance-related concerns.

Location: Health Sciences Centre, with satellite service to St. Boniface Hospital.

Referrals: Consultation requests should be called in to the Addiction Consult Physician on call and faxed to 204-787-3996. New consults are generally seen within 24 hours, Monday to Friday, depending on urgency and volume. Consults received in the evening or on weekends are typically deferred to the next weekday, with interim advice provided to the admitting service over the phone. Peripheral hospitals can receive telephone advice for admitted patients by paging the Addiction Consult Physician seven days a week.

Appointments: New consultations are typically scheduled within 24 hours on weekdays, depending on urgency and volume. Evening and weekend consultations are deferred to the next weekday, with interim advice provided over the phone.

Education: The service plays an active role in teaching and medical education in Manitoba. Trainees, including medical students, residents, nursing students, and community physicians, gain knowledge about addiction and treatment resources. Training may include obtaining prescribing privileges for methadone and/or buprenorphine/naloxone.

Addictions Unit

Overview: The Addictions Unit is an 11-bed hospital unit providing short stays of five to 10 days until patients are medically and psychologically stable. It admits patients with active addiction requiring inpatient treatment for complications related to drug and alcohol use and withdrawal, and provides treatment for co-occurring medical and psychiatric conditions.

Location: Health Sciences Centre.

Referrals: Admission is voluntary; patients must agree to their admission. Those who are actively suicidal or behaviorally disruptive are generally excluded.

Appointments: Services are available for short-term stays of five to 10 days.

Education: The unit provides education and training opportunities for healthcare professionals, focusing on the treatment of addiction and co-occurring conditions.

Overview: The Adult Eating Disorders Program at the Health Sciences Centre offers a comprehensive, multidisciplinary approach to the assessment and treatment of eating disorders.

Services Include:

Inpatient Treatment: Intensive support through dedicated inpatient care.

Outpatient Therapy: Individual therapy for those transitioning from more intensive treatments.

Cognitive-Behavioural Courses: Evening courses focusing on cognitive-behavioural techniques.

Intensive Ambulatory Treatment: Includes day hospital services, a nutrition clinic, and group therapy sessions.

Readiness Groups: Support for individuals preparing for further treatment or recovery.

Family Education and Transition/Maintenance Groups: Education and support for families and individuals in transition or maintenance phases.

Consultation Services: Additional support as needed.

Treatment Approaches: The program primarily employs behavioral and cognitive-behavioral techniques.

Team Members: The multidisciplinary team consists of:

• Two psychiatrists
• Four nurse-therapists
• One social worker
• Two dietitians
• Two psychologists
• One occupational therapist
• One recreational therapist

Location: Health Sciences Centre.

Referrals: A referral from a physician or nurse practitioner is required to access the program. Ongoing medical involvement by the referring physician is also necessary.

Appointments: The program offers various services, including inpatient treatment for intensive support, outpatient therapy for those transitioning from more intensive treatments, and cognitive-behavioural evening courses. Additional services include intensive ambulatory treatment (day hospital, nutrition clinic, and group therapy), readiness groups, family education, and transition/maintenance groups.

Education: The program is involved in education and research, offering psychiatric training experiences for residents, medical students, and professionals from other health-related disciplines.

Overview
The interdisciplinary team at St. Boniface Hospital supports patients transitioning from inpatient to community care by providing comprehensive follow-up and therapy services. Therapies include:

• Cognitive Behavioural Therapy (CBT) with mindfulness classes
• CBT Groups for depression, anxiety, and co-occurring disorders
• Dialectical Behaviour Therapy (DBT) Groups

Location
Fourth floor of the McEwen Building, St. Boniface Hospital.

Referrals
Referrals are accepted from emergency psychiatrists, other medical specialists at St. Boniface Hospital, and family doctors.

Appointments
Upon discharge from the inpatient ward, patients requiring follow-up care are assigned a primary clinician who meets with them as soon as possible. The intake process includes an initial meeting with the clinician, followed by a session with a psychiatrist. Patients are closely monitored for stabilization over the following months, with community resources activated as needed. Care is eventually transferred to the family physician and appropriate community caregivers. The follow-up process generally lasts up to six months.

Education
The service is involved in training residents, with one resident typically assigned to the service for six months during their PGY-2 year for general adult outpatients. Residents co-facilitate therapy groups and participate in chronic care and elective choices within the residency program. They gain experience in managing a range of psychiatric conditions and contribute to chronic care and elective options within the residency program.

Overview: The Section of Child and Adolescent Psychiatry provides clinical and academic teaching for psychiatry residents during core and elective rotations. The primary clinical sites are the Health Sciences Centre (HSC) and the Manitoba Adolescent Treatment Centre (MATC). The section, with a diverse faculty, employs a biopsychosocial approach to diagnose and treat psychiatric disorders in children and adolescents, working within multidisciplinary teams to support patients, their families, and associated systems.

Location: Primary clinical sites include the Health Sciences Centre and the Manitoba Adolescent Treatment Centre.

Referrals: Child and adolescent mental health services can be accessed through two pathways:

Centralized Intake Service: Manages outpatient referrals, triages, and coordinates patient referrals to both HSC and MATC, and monitors waiting lists.

Acute Care Entry Pathway: Accessible through the emergency department at Children's Hospital, providing direct referrals to inpatient and crisis services.

Appointments: Patients are referred through the centralized intake service or the acute care entry pathway, which helps direct them to the appropriate care setting, whether outpatient, inpatient, or crisis services.

Education: The section offers a comprehensive educational experience for residents and medical students, including:

PGY3 Academic Seminar Series: A formalized series in child and adolescent psychiatry for all psychiatry residents.

Clinical Rotation Activities: Involves section rounds and the child and adolescent residents’ journal club.

Psychotherapeutic Treatment: Residents in their PGY3 year, and upon request in subsequent years, are expected to treat a child or adolescent using a psychotherapeutic modality under the supervision of an attending child and adolescent psychiatrist.

The two-year child and adolescent psychiatry subspecialty residency training program is accredited by the Royal College of Physicians and Surgeons of Canada.

Research Opportunities: Available in various areas of child and adolescent psychiatry, including:

• Acute Assessment Service - HSC
• ADHD Clinic - MATC
• Anxiety Disorder Service - HSC
• Community Child and Adolescent Treatment Service - MATC
• Consult Liaison Service - HSC
• Consultation to Provincial Child and Adolescent Community Mental Health Programs - MATC
• Early Childhood Clinic - MATC
• Eating Disorders - HSC
• Emergency/Rural and Remote Emergency Telehealth - HSC and MATC
• Gender Dysphoria Assessment and Action for Youth - MATC
• Inpatient Service - HSC
• Intensive Child and Adolescent Treatment Service - HSC
• Intensive Community Reintegration Service (Day Hospital) - MATC
• Intensive Treatment Service (Inpatient) - MATC
• Neurodevelopmental Disorders Service - MATC
• Outpatient Mental Health Services - HSC
• Rapid Assessment Clinic - HSC
• Rural and Northern Telehealth Service - MATC
• Youth Forensics Service - MATC

Overview: The Community Psychiatry Program offers a diverse range of psychiatric services, focusing on child psychiatry, forensic psychiatry, Northern and rural Manitoba clinics, and psycho-geriatrics. The program aims to broaden residents' knowledge of community psychiatry through practical experiences.

Location: Various locations across Manitoba, including clinics in Northern and rural areas.

Referrals: Referrals for the Community Psychiatry Program come from various sources, targeting different patient populations, including those requiring specialized services like child and forensic psychiatry.

Education:
The program emphasizes innovative approaches to mental health, providing residents with opportunities to work within diverse community settings.

Residents in their PGY2, PGY3, and PGY5 years are required to make eight visits per year, engaging with community psychiatry practices and developing a systems perspective on mental health challenges.

Crisis Services

Overview: Crisis services provide immediate mental health support through various channels, including walk-in services, mobile crisis units, and crisis stabilization units.

Locations:

• Crisis Response Centre: Offers 24/7/365 walk-in services.
• Mobile Crisis Service: Provides phone and direct crisis assistance (Phone: 204-940-1781).
• Crisis Stabilization Unit: Offers short stays for crisis management (Phone: 204-940-3633).

Referrals: Open to individuals in crisis seeking immediate mental health support.

Appointments: Services include brief counseling/treatment and access to the Urgent Follow-up Intensive Treatment Team, which provides group therapy and psychiatric consultations.

Early Psychosis Prevention and Intervention Service (EPPIS)

Overview: EPPIS focuses on clients experiencing their first episode of psychosis, providing early treatment and supporting recovery over a two-year period. A multidisciplinary team, including allied health, psychology, and psychiatry staff, provides comprehensive support.

Location: Community-based services are provided across the region.

Referrals:
Targeted at individuals experiencing a first episode of psychosis.

Health Outreach and Community Support

Overview: Provides consultation services to improve access to primary care and behavioral health services for vulnerable populations, including the homeless. Supports collaboration between community agencies, the Winnipeg Regional Health Authority, and government programs.

Location: Community settings and partner agencies.

Referrals: Works with partner agencies and community organizations to identify and support clients.

Program of Assertive Community Treatment (PACT)

Overview: The PACT program provides recovery-oriented treatment, support, rehabilitation, and crisis services for individuals with severe and persistent mental illnesses.

Locations:

• PACT – Hargrave
• PACT – Leila
• PACT – Logan
• PACT – Winnipeg West

Referrals: Patients with severe and persistent mental illnesses, including those requiring specialized treatments like clozapine.

Appointments: Approximately 400 participants receive comprehensive care based on the PACT model developed at the University of Wisconsin.

Shared Care Mental Health

Overview: Shared Care operates within primary care settings, integrating mental health services with primary healthcare. Teams include psychiatrists, psychologists, and counselors working alongside primary care providers.

Location: 25 clinics, including private fee-for-service clinics and Access Centres in Winnipeg.

Referrals: Collaborative care with family physicians and nurse practitioners.

Education: PGY4 residents rotate through Shared Care from September to June, gaining exposure to collaborative clinical interventions. Family Medicine residents also receive training in mental health through Shared Care.

Specialized Programs

Community Living Psychiatric Service:
Provides services to dual-diagnosed clients with intellectual challenges and mental health disorders at ACCESS Fort Garry/ACCESS Norwest. Supported by part-time psychiatrists and a team of nurses.

Co-occurring Disorders Initiative:
Focuses on treating clients with both addiction and mental health disorders, offering treatments like suboxone and methadone, as well as dialectical behavioral therapy. Provides educational opportunities on these treatments.

Overview: Consult-Liaison Psychiatry Services provide psychiatric consultation and follow-up care for inpatients across various units. The services are offered at St. Boniface Hospital and the Health Sciences Centre.

Location: St. Boniface Hospital and Health Sciences Centre.

Referrals: Referrals for psychiatric consultation are made for patients in various units, including medical and surgical wards, intensive care units, geriatric-rehabilitation units, obstetrics/gynecology units, dialysis units, and palliative care.

Appointments: Consultations and follow-up care are provided for inpatients referred from various hospital units. The service addresses the psychiatric needs of patients across different medical specialties.

Education: The Consult-Liaison Psychiatry Services offer valuable learning experiences for medical learners under the supervision of experienced psychiatrists. Educational opportunities include:

• Psychiatry Residents: Both senior and junior psychiatry residents participate in part-time or full-time rotations.
• Medical Students: The services serve as training sites for core clerkship and elective rotations.
• Residents in Other Medical Specialties: Elective opportunities are available for residents specializing in areas such as family medicine, internal medicine, neurology, geriatrics, and obstetrics-gynecology.

Additionally, the services are involved in the MLP-IMG training program, providing rotation opportunities for residents in this program.

Overview: The adult forensic psychiatry program, based at the Health Sciences Centre, is a multidisciplinary initiative offering both inpatient and outpatient assessment and treatment. The program operates in affiliation with:

• Shared Health Manitoba Community Forensic Mental Health Service
• The Rehabilitation Forensic Program operated by the Selkirk Mental Health Centre

Services: The program provides:

• Court-ordered assessments of fitness to stand trial and criminal responsibility
• Disposition assessments for the Criminal Code Board of Review
• Treatment services for accused and convicted offenders, individuals found not criminally responsible, and those unfit to stand trial
• Forensic Assertive Community Treatment (FACT) team services, which include mental health and psychiatric care as part of a mental health court diversion program

Location: The inpatient and outpatient components of the program are located at:

• The PsycHealth Centre on the PX3 wing, which houses a 15-bed inpatient unit
• The Crisis Response Centre, where the FACT team offices are situated on the second floor

Referrals: The program accepts referrals from various sources including legal entities and healthcare professionals for court-ordered assessments and treatment services.

Appointments: Appointments for both inpatient and outpatient services are coordinated through the program's administrative offices at the Health Sciences Centre.

Education: The program provides educational experiences for several disciplines, including:

• Medical students
• Psychiatric residents
• Nursing students
• Psychology students
• Social work students
• Occupational therapy students

Research activity is encouraged among faculty and students involved in this program.

Overview: Given the changing demographics of our population, expertise in the care of older adults is becoming increasingly important across most branches of medicine and surgery. This population’s needs are particularly challenging due to conditions such as delirium, neurocognitive disorders, frailty, and the interplay between physical illness and mental disorders.

Locations:

Deer Lodge Centre

• Behavioral Management Unit
• Geriatric Day Hospital
• Inpatient Consultation-Liaison

Geriatric Mental Health Teams (GMHT)

• Six teams geographically distributed throughout Winnipeg
• Outpatient and nursing home visits

Riverview Health Centre

• Behavioral Management Unit
• Geriatric Day Hospital
• Inpatient Consultation-Liaison

St. Boniface Hospital

• Two Geriatric Psychiatrists
• Geriatric Day Hospital
• Inpatient Consultation-Liaison
• Outpatient Clinic
• Core rotations for General Psychiatry Program and Geriatric Psychiatry Subspecialty Program

Victoria General Hospital

• Four Geriatric Psychiatrists
• Consult Liaison Services
• Core rotations for General Psychiatry Program and Geriatric Psychiatry Subspecialty Program
• Older Adult Psychiatric Inpatient Beds
• Outpatient Clinic

Referrals: Patients are referred to the geriatric psychiatry service based on their needs, including those experiencing delirium, neurocognitive disorders, and other age-related mental health issues.

Appointments: Appointments can be scheduled at any of the listed locations, depending on the specific services required.

Education: The geriatric psychiatry service offers comprehensive training opportunities in late-life mental health care, including:

• Weekly didactic seminars on various mental health topics relevant to older adults
• Journal clubs throughout the year
• Participation in Geriatric Medicine Rounds
• Virtual attendance at Baycrest Rounds

Rotations:

• Core training requirements are available for both the General Psychiatry Program and the Geriatric Psychiatry Subspecialty Program
• Elective rotations are offered for medical students and off-service residents

Overview: The General Psychiatry Program, based at the Health Sciences Centre, is a multidisciplinary clinical program with both inpatient and outpatient sections. It specializes in the comprehensive assessment and treatment of individuals with complex psychiatric disorders.

Locations:

Inpatient Section

• Located at the PsycHealth Centre, ward PY-2
• Consists of 25 beds
• Provides secondary and tertiary psychiatric care for major mental illnesses such as schizophrenia, mood disorders, and anxiety disorders

Outpatient Section

• Situated on the same level at PsycHealth, in the PZ-2 area
• Offers a range of services including consultations, follow-up clinics, and psychotherapy groups

Referrals: Access to the General Psychiatry Program’s clinical services requires a physician referral. Most referrals are received from crisis or inpatient settings.

Appointments: Appointments are coordinated through physician referrals. The outpatient section provides various services, including consultations, follow-up clinics, and psychotherapy groups.

Education: Education is a vital aspect of the program, providing core psychiatric training for residents, medical students, and professionals from other health-related disciplines. Typically, two to four residents are assigned to six-month rotations in both the inpatient and outpatient sections, while three medical students complete six-week rotations in psychiatry.

Overview: The adult inpatient psychiatric units in Winnipeg offer diagnosis and treatment for complex cases requiring inpatient care. The focus is on short-term assessment, stabilization, and preparing individuals for continued recovery in the community.

Locations:

• Health Sciences Centre
• St. Boniface Hospital
• Victoria General Hospital

Referrals: Access to the adult inpatient psychiatric units requires a physician referral. Referrals are typically for complex cases that need inpatient care.

Appointments: Appointments are managed through physician referrals. The units provide short-term assessment and stabilization, with preparation for ongoing recovery in the community.

Education: Clinical teaching is a core function of the service. Students from various disciplines rotate through the units, and inpatient psychiatrists are actively involved in teaching residents and medical students.

Overview: The Mood and Anxiety Disorders Program at the Health Sciences Centre is a multidisciplinary specialty service that provides comprehensive assessment and treatment for individuals with a wide range of mood disorders, including both chronic and acute conditions.

The program offers:

• Cognitive behavioral therapy (CBT) groups
• Electroconvulsive therapy (ECT) service
• Ketamine service
• Outpatient consultations
• Outpatient follow-up clinics
• Consultations to inpatient units

Location: The program is based at the Health Sciences Centre.

Referrals:

• For Cognitive Behavioral Therapy (CBT) Groups and Outpatient Consultations: Requires a referral from a physician or nurse practitioner.
• For Other Services Within the Program: Requires a referral from a psychiatrist.

Appointments: Appointments are managed through referrals. The program offers a range of services including CBT groups, outpatient consultations, and follow-up clinics.

Education: Members of the Mood and Anxiety Disorders Program are actively involved in research in collaboration with the Mood and Anxiety Disorders Research Group, contributing to advancements in the field.

Overview: The Neuromodulation and Neuropsychiatry Unit offers two distinct clinical services: Neuromodulation (rTMS Treatment) and Neuropsychiatry Consultation.

Neuromodulation (rTMS):

The rTMS clinic at Saint Boniface Hospital, established in January 2012, is equipped with two TMS machines. The clinic offers full-course treatments to new patients annually and provides maintenance treatments for returning patients.

Neuropsychiatry Clinic

The Neuropsychiatry Clinic provides comprehensive assessment and management for patients with a range of conditions, including brain injuries, neurodegenerative disorders, epilepsy, and functional neurological disorders.

Location: The rTMS clinic and Neuropsychiatry services are located at Saint Boniface Hospital.

Referrals: Consultations for the Neuropsychiatry clinic are accepted through centralized intake as well as direct referrals from family doctors, psychiatrists, and neurologists.

Appointments: For rTMS treatments, new patients are provided full-course treatments annually, with maintenance treatments available for returning patients.

Education: Information regarding the rTMS and Neuropsychiatry services can be found through Saint Boniface Hospital's educational resources.

Overview: The program offers specialized care for individuals with psychosis through both inpatient and outpatient services, emphasizing comprehensive management that includes diagnosis, treatment, and rehabilitation. It also maintains strong connections with community services, programs, and agencies, such as the Manitoba Schizophrenia Society, the Canadian Mental Health Association, and the Clubhouse of Winnipeg.

Locations:

• Inpatient Care: Provided at the Health Sciences Centre by STEP psychiatrists with expertise in managing psychosis.
• Outpatient Care: Also provided at the Health Sciences Centre, with a focus on preparing patients for community-based services.

Referrals

• Inpatient Care: Referrals are managed through HSC psychiatry's centralized intake or direct physician referrals.
• Outpatient Care: Referrals are accepted from psychiatrists and other physicians.

Appointments

• Inpatient Care: Managed by the inpatient team, including psychiatrists, a social worker, nurses, occupational and recreational therapists, and a mental health rehabilitation worker.
• Outpatient Care: Appointments are scheduled with psychiatrists, senior nurse-therapists, and an occupational therapist. The team focuses on "rehabilitation readiness" to connect patients with community services.

Education

Training Opportunities: Provides training for medical students, psychiatric residents, nursing students at various levels, and occupational therapy and social work students.
 

Overview: The STAT Program, located at the Health Sciences Centre, is a multidisciplinary service offering day hospital and outpatient programs for patients requiring acute psychiatric intervention. This includes individuals facing focal crises, destabilization, or needing short-term intensive treatment. Each year, the program handles approximately 350 to 400 referrals for its acute care day hospital and outpatient services. The team consists of:

• Three psychiatrists
• Five psychiatric nurses
• Two occupational therapists
• One social worker

Location: Health Sciences Centre, located in the PX1 area of the PsycHealth Centre

Referrals: The STAT Program accepts referrals from a diverse range of sources, including:

• Emergency room physicians at the Health Sciences Centre
• Other PsycHealth programs
• St. Boniface General Hospital
• Community physicians

Appointments:

Day Hospital Program

• Intensive, five days per week
• Primarily group therapy-based
• Time-limited, lasting five weeks
• Includes individual and group psychotherapies, psychoeducational, and pharmacological therapies

Intermediate to Long-Term Care

• Provides outpatient dialectical behavior therapy (DBT) for patients with personality disorders and ongoing active symptoms

Education:

Residents have the option to train in dialectical behavior therapy (DBT), a specialized treatment for borderline personality disorder. PGY5 residents can pursue senior elective placements, which may be combined with DBT or other electives. The program also provides clinical exposure for students from various disciplines, including psychiatry, psychiatric nursing, occupational therapy, and social work. Additionally, the program includes ongoing literature reviews and case rounds that focus on the assessment and treatment of personality pathology and comorbid psychiatric disorders.