TDM Implementation
What activities are included in this project?
The TDM can be implemented in a variety of ways, as long as the basic principles of the intervention are kept intact. These principles include:
- Person-centered care. By placing patients at the centre of care; and
- Continuity of therapeutic relationships. By ensuring a continuity of therapeutic relationships (both hospital staff and peer) as patients are discharged or move between settings.
Before the TDM is implemented at each participating hospital, the project team will assess what type(s) of therapeutic support are available at each setting and in the surrounding community. Each hospital will identify an internal SiteLead who is responsible for the local implementation of the TDM and each geographic site will have a Peer Support Coordinator based in the community and working with the hospital to facilitate matching between peer support volunteers and patients after discharge.
Implementing the TDM in tertiary care psychiatric wards involves having a clinical hospital staff member who has a therapeutic relationship with the patient remain involved following hospital discharge, until the patient establishes a therapeutic relationship with a peer support volunteer.
On acute care wards, there might be less time for the patient to develop a therapeutic relationship with a hospital staff member, in which case a transitional team may be more appropriate, an approach that has worked well in several prior TDM implementations.
In all cases, peer support is offered from a consumer of mental health services who is currently living in the community and who has specialized training in peer support. The Ontario Peer Development Initiative (OPDI) has member organizations that provide peer support services across the province.
Each peer support volunteer will receive specialized training from the Peer Support Coordinator. OPDI will provide training to each Peer Support Coordinator so they are able to train the to each Peer Support Coordinator so they are able to train the peer support volunteers who will be supporting patients from the hospital.
OPDI Peer Support Core Essentials™ Program is a training that OPDI developed through a two-year process of consultation and collaboration with its membership, and an independent evaluation, all funded by the Ontario Trillium Foundation. This training involves five full days in class plus several pre-requisite introductory webinars. On the trainer’s recommendation, successful classroom participants may opt to perform an internship in order to become a certified OPDI Peer Supporter. This internship consists of providing a documented 50 hours of individual support to peers in a mental health program or CSI/PSO setting. Participants in training can use the hours that they accumulate from providing peer support with the TDM project towards this internship, hence benefiting both the training participant and the implementation of the project. For more information on the training program, see http://opdi.org/training.html. Please be advised this training program is the intellectual property of OPDI and is copyrighted with trademark pending. Participants or graduates of OPDI Peer Support Core Essentials™ Program are not qualified or permitted to use OPDI materials to train others, nor to copy or alter them by any means. The project team will work with the Site Leads, Ward Champions and local peer support groups to ensure that the TDM is implemented in a way that best suits the needs of each hospital. Appendix A provides a sample of the TDM workflow at a tertiary care psychiatric ward.