COTA provides innovative approach to community-based mental health case management


Established in 1973, COTA is an accredited not-for-profit community health and social services organization serving the Greater Toronto Area, Southwestern and Eastern Ontario regions. We provide community-based rehabilitation and mental health services to people of all ages – whether in their home, school, or workplace. Last year, we helped over 22,000 individuals achieve greater independence.

COTA is a proven leader in helping individuals living with mental illness; in fact, over 40% of our programs have a mental health focus. We have pioneered innovative and cost-effective health-care solutions that provide continuity of care for “hard-to-serve” populations, such as the homeless and chronically mentally ill.

Our Granby Case Management program, serving individuals living in downtown Toronto, is a prime example. This prevention-oriented program offers mental health treatment and supports to clients with serious mental illness who are at risk of losing their housing or living in a supportive housing environment. In many cases, these individuals are dealing with multiple issues.

Client-centred care is delivered using a highly effective shared care mental health model. The Granby team works collaboratively with clients to foster an environment of shared responsibility and mutual respect. This approach ensures that clients receive the right service from the right person at the right time.

Five mental health case managers as well as a full-time psychiatric nurse and part-time psychiatrist, both on secondment from the Centre for Addiction and Mental Health (CAMH), staff COTA’s Granby Case Management program. The roles and responsibilities for each are clearly defined. The psychiatric nurse conducts a comprehensive intake and assessment for each referral (accompanied by the client’s psychiatrist, if required). Case managers provide ongoing case management and support services, crisis response, and home visits. Finally, a psychiatrist is available one day a week to provide weekly consultations, monitor medications, renew prescriptions, conduct one-on-one assessments with clients and/or family members, and provide phone consultation with family physicians and other psychiatrists.

The average length of service can range anywhere from one (1) to three (3) years per client. Upon discharge, approximately 75 per cent of clients are referred to day programs, 10% are transitioned to more specialized mental health teams focusing on a specific issue or concern, while the remaining clients are referred to hospitals, nursing homes and/or independent living arrangements. Most clients seen through the Granby Case Management program have no other links to the public health care system. By keeping individuals with serious mental illness under the radar of hospital emergency departments, COTA not only prevents costly hospital stays, but helps these individuals maintain their independence within the community.

Dr. Bruce Menchions, psychiatrist of the Granby Case Management program, attributes much of the team’s success to its low staff turnover rate compared with other community programs. “Granby is an excellent example of how a small team of mature and experienced therapists can provide effective health care in a way that cannot be easily ‘packaged’ as a model and replicated elsewhere in the system. Although this means our success is very specific to the personalities in place, it does reinforce the benefits of keeping a low staff turnover rate to enable a more dynamic provision of services.”

Referrals to COTA’s Granby Case Management program come from a wide range of sources. This includes community health agencies, supportive housing organizations, family members, doctors, psychiatrists, health care professionals and Community Care Access Centres (CCACs).

If you would like to make a referral or receive more details about the Granby Case Management program, please call 416.785.9230. One of COTA’s skilled information and referral coordinators will gladly assist you. In addition, you can learn about other innovative mental health programs offered by COTA through its website