General Info | Staff | Location

Royal Victoria Hospital

The Royal Victoria Hospital (RVH) is a 647-bed general hospital serving the urban community of Montréal. However, its expertise in medical care and research is recognized internationally. Among its many outstanding and innovative programs are clinics for microsurgery, organ transplantation, respirology and the care of the terminally ill patient in the Palliative Care Service. These and other hospital programs performed over 350,000 annual outpatient visits with approximately 21,000 admissions in 1994-95. The annual budget of the hospital, 85& of which derives from the provincial government, is approximately two hundred million dollars. directions

The Allan Memorial Institute

The AMI, the psychiatric wing of the hospital, is located in a complex adjacent to the main general hospital. The AMI has approximately 48 inpatient beds divided into specialized units for adolescents and adults requiring brief hospitalization. Discharge from these inpatient programs into the community is often facilitated by a transition to the Day Hospital program. Numerous outpatient clinics such as the Ambulatory Care Clinic, the Schizophrenia Follow-Up Unit and the Mood Disorders Clinic all provide specialized treatment and follow-up care.

Because the RVH is a major university teaching hospital in the McGill University network, the AMI is able to offer a wide array of seminars, workshops and training courses for students in all health professions.

Research also flourishes at the AMI with a combination of basic science research performed in the adjoining Research and Training Building of McGill's Department of Psychiatry coupled with more clinically-oriented research conducted at the AMI, including the internationally known work of the Psychopharmacology Unit.

Psychologists participate in many of these research endeavors in addition to functioning as independent investigators in many areas of psychosocial research. directions

The Psychology Department

The Psychology Department of the RVH is an autonomous body reporting to the Director of Hospital Services. With respect to staff, we have a relatively largedepartment with a staff of approximately 18 psychologists representing approximately 12 FTE's (full-time equivalents) funded by the hospital's global budget plus another 17 psychologists engaged on a contractual basis. Psychologists perform a variety of assessment and therapeutic services using a wide range of instruments and conceptual models. Although all major orientations from existential to psychoanalytic and cognitive-behavioural are represented, the Department fosters a flexible, problem-solving approach where ideas and their measured utility count more than doctrine.

Organizationally, the Department follows three types of models, two which offer the traditional services provided by psychologists in hospital settings and a third which provides clinics and programs which would not otherwise develop in a hospital without a fee-for-service structure.

In the first of these, the Integrated Model, psychologists are integrated with other mental health professionals in teams led mostly by psychiatrists, while in the second, the Consultative, the psychologists are centralized within the department to act upon consultations from service areas without permanently assigned psychologists. Psychotherapy provided on the inpatient wards or psychological testing in our outpatient clinics are two examples of activity deriving from the Integrated and Consultative models, respectively.

Each of these models has distinct advantages. In the Integrated one, the efforts of psychologists along with members of other professional disciplines are focused by psychiatric service chiefs in areas traditionally addressed by hospitals such as inpatient care and specialized outpatient treatment. In the Consultative model, the advantages stem from the constantly evolving experience of a core group of staff who develop experience in the particular consultation task. Their work is facilitated by the latest in assessment instruments and computerized testing whose central location benefits many remote users.

However, over the last 16 years we have developed another model, the Departmental, in which psychologists create and then manage a variety of treatment programs not only for the traditional outpatient population but for the community at-large. Treatments for sexual problems, obsessive-compulsive disorder, anxiety and depression are just some of the many examples of the programs which are offered under this model. Since the programs are delivered by psychologists, health promotion and risk-factor reduction are heavily emphasized. Group programs to enhance sexuality and communication in couples as well as interventions to educate people at-risk for depression not only about the nature of the condition but about the importance of optimism illustrate the focus on health-maintenance. Often, our programs are conducted in partnership with business, for example, our work-site smoking cessation interventions, or in partnership community groups interested in mental health such as AMI-Québec where we conduct information groups in the areas of depression and obsessive-compulsive disorder. For many other services, we communicate directly to the public using advertisements or information articles in the newspaper.

Since psychologists possess solid grounding in research as well as clinical skills, these programs not only reflect the latest in empirically validated treatments but all interventions are subject to sophisticated measures of outcome and satisfaction. In fact, our quality-assurance measures, all of which are stored and analyzed with a computerized database, are more advanced than any routinely conducted quality-assurance program in mental health which we know of in the province.

All these programs are revenue-generating with a sliding fee progressing to zero for those unable to pay to rates below that offered by unsupervised private practitioners. The revenue not only supports the activity in this third model, but the profits have maintained the activity of the Integrated and Consultative models which would have suffered severe cutbacks with the past years of budget reductions.

We believe that each model has unique advantages with the whole offering more than any one its components. In fact, it is the integrated whole with the flexibility to shift resources from one model to another as new needs or market opportunities arise which we think makes our department especially responsive to the needs of our community. directions

General Info | Royal Victoria Hospital (RVH) | Allan Memorial Institute (AMI) | Psychology Department | Staff | Location

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