FAQ: Integrated mental health

Answers to your questions about our Integrated Mental Health service

About Nurse Practitioners in Ontario

Health-care professionals who treat the whole person

Nurse Practitioners (NPs) are Registered Nurses (RNs) who have additional education and experience which enables them to:

  • autonomously diagnose and treat illnesses,
  • order and interpret tests,
  • prescribe medications, and
  • perform medical procedures.

 Their approach includes:

  • addressing needs relating to a person’s physical, mental, emotional, spiritual health,
  • seeing the client/provider relationship as a team based relationship,
  • focusing on how an illness affects a person’s life and family, and
  • offering information on ways for a person to lead a healthy life, interpretation of tests and results, explanation of disease processes, how medications and treatments work to benefit you.

Improving access to primary health care

What value do NPs bring to Canadians and our healthcare system?

Ontario Nurse Practitioners By the Numbers, image courtesy of NPAO.

The biggest difference between NPs and RNs is the level of autonomy granted to Nurse Practitioners. They can see patients on their own or refer to a physician or specialist as a case requires. Unlike RNs, the additional education and experience allow nurse practitioners to diagnose and treat illnesses, and prescribe medications.

Studies tell us that NPs involve patients in decisions about their care, improve access to primary health care, and reduce pressures on the health-care system. Nurse Practitioners are valued and trusted by patients and provide high-quality care.

Both NPs and physicians are able to provide many of the similar care for their patients, and both NPs and physicians will need to collaborate with more experienced providers for some of the care needed by their patients. NP’s and physicians will refer patients on to specialists or other doctors when a patient’s care needs can not be met by the NP or physician’s skills, knowledge or current scope of employment.

 

Meet our nurse practitioners

Julie Bisson
NP-PHC., MHA
Virtually across ONBolton, ON
Adults
Carole Gionet
BSc., BScN., NP-PHC., CPMHN(C)., MN
Virtually across ONBolton, ON
Preteens (10-12)Early Teens (13-15)Late Teens (16-17)Adults
Start self-assessment

2023 Nurse practitioner rates

Psychiatric Assessment (including ADHD assessment):
Comprehensive mental health assessment, diagnosis or diagnostic clarification, and initial treatment.

  • Adults (17 and up) $600.00 (90 minutes)
  • Pediatric (age 10+) $ 800.00 (120 minutes, includes family interviews)

Medication Assessment: (If you have a confirmed psychiatric diagnosis and would like to review and adjust your treatment plan only for medication).

  • You must submit a recent psychological or psychiatric report confirming your diagnosis to receive this type of appointment.
  • The NP will review the report prior to meeting with you. If you have more than one mental health diagnosis and the NP requires a more thorough assessment to confirm diagnosis, you may require a psychiatric re-evaluation.
  • ​​​Rate will range depending on level of complexity, per half hour of assessment $200.00 / One hour $ 375.00

Follow up to monitor treatment (medications/prescription refills):

  • $100.00 (20 minutes)

Routine repeat prescriptions

  • $25.00​

Missed appointments:

  • $60.00
Payment: 50% of your session payment is due upon booking, and 50% is due on the day of your session. 
We accept credit cards, debit and e-transfer. A detailed receipt/invoice will be provided for your records. DALD is not responsible for the cost of sessions that are later found to be not covered by an insurance plan.
​Please ensure you investigate your coverage details prior to booking your appointment if you are relying on insurance benefits to use this service.

You will be able to claim Dig a Little Deeper’s diagnosis & treatment costs if your private insurance plan offers a health spending account. However, the cost is not covered by private insurance plans that do not have a specific health spending account.

Other Rates

Letters & Forms

Consultation letters to family physicians – No charge

​Driver’s medical Examination $75.00
Completion of Work and School related Forms/Notes
Back to work/school notes $20.00
Letter for academic/work accommodations $20.00
University/School/Work Forms requesting accommodations $30.00

Insurance Certificates

Disability Form (OCF-3) $100.00
Long-term Care Insurance $100.00

Government Forms

CPP Disability Medical Report $60.00
CPP narrative medical report $100.00
Revenue Canada, Federal Disability Tax Credit $50.00
Employment Insurance Medical Certificate $50.00

FAQ

No! We opened the service to the general public in the spring of 2023, after piloting the program internally since the fall of 2022. We carefully created processes and systems that will allow for the ethical and practical care of patients, and facilitating faster access to the care we know Ontarians want and need. Anyone in Ontario can sign up through our new NP Clinic Intake Form.  

Yes. Diagnosing ADHD is complex. No two people with ADHD are alike.  ADHD affects functional, structural and neurochemical pathways in the brain, and presentations will vary based on individual peoples life circumstances, experience of other co-existing conditions and the level of external support they may or may not organically have. To complicate matters further, symptoms that look like ADHD might not signal an attention disorder. Figuring out what’s going on takes time, detailed investigation, and expert knowledge. Bottom line: Diagnosing ADHD can’t be done with a simple checklist. It can’t be done in 15 minutes.

At Dig a Little Deeper, we offer a full comprehensive adult or paediatric psychiatric assessment,  where specialized and experienced clinicians take an in-depth look at your entire mental health profile and experiences, and make recommendations backed by science to support functioning going forward.  Our team approach involves several sessions.

What to expect:

  1. Intake: You will be asked to complete a series of forms, that include information about your past and current symptom’s, past or current diagnoses, a family history, and if possible, we will ask you to select a loved one to also provide information about their observations of the same symptoms throughout your life. If you see a psychotherapist on our team, they will also provide an internal referral to help supplement this information. Your NP will have reviewed this information in detail before your appointment. 
  2. Medical Assessment: In your assessment appointment,  you’ll meet with a specialized mental health Nurse Practitioner. Your NP will conduct a detailed medical and developmental history, and ask about current and past functioning. If there are still reports or forms outstanding at the time of your assessment, and your NP deems them necessary to continue, you will have a follow up appointment booked at no extra cost, before a final diagnosis (if any) and/or treatment plan can be finalized. Most assessments are finalized with one assessment session.
  3. Results: Either at your first or follow up assessment appointment, your NP will discuss the findings from a medical perspective and if a diagnoisis and treatment plan is indicated, you will review it together then. You will have an opportunity to ask questions, collaborate, share your values and work together to create a plan that works for you. If you require or will benefit from medication, your NP will be able to prescribe and follow up with you for ongoing care.  At your direction, a detailed Consultation report can be sent to your family physician or child’s pediatrician.
​If you have a confirmed psychiatric diagnosis and would like to review and adjust your treatment plan only (medication), you may book a Medication Assessment. You must be able to submit a written report from the clinician who diagnosed you, confirming your diagnosis to receive this type of appointment. 

​Your NP will review the report prior to meeting with you. If you have more than one mental health diagnosis and the NP requires a more thorough assessment to confirm diagnosis, you may still require a psychiatric re-evaluation and need to book a full adult assessment. 
Guide for Parents on psychiatric assessment for children at Dig a Little Deeper, Psychotherapy and Counselling
 

OUR GUIDE FOR PARENTS

Please click the image to download our brief PDF Guide for Parents about what they can expect with a paediatric assessment with Dig a Little Deeper, Psychotherapy & Counselling. 

A note about age of consent, privacy and confidentiality of patients, regardless of who might be paying for a private service:
It is a fundamental responsibility of all Ontario regulated health care providers to maintain client confidentiality at all times. In compliance with PHIPA  (Ontario’s Personal Health Information Protection Act), health care providers must ensure that the professional relationship with the client and the client’s personal information are kept confidential, within legal limitations, which includes children (or adult children for whom you might be paying for an assessment for). ​

In general, parents are involved actively in the information gathering part of any medical assessment for minor children. Once the interview with your child is completed, the parents are asked to rejoin their child for discussion of the diagnosis and treatment planning. Various options for treatment will be discussed. Risks and benefits of each option will be reviewed. We will spend some time letting both parents and child ask questions.

It is important to note, ​in accordance with PHIPA the consent must be signed by the patient if they are 12 years of age or older. Parental consent is accepted if the patient is less than 12 years of age, or is incapable of consenting. If there is a conflict between the child and the parent, the capable child’s decision prevails with respect to consent. 
 
NP services are considered a “non-insured health benefit”, like almost all mental health care, a massage therapist, physiotherapist or dentistry. Patients are required to “pay out of pocket” for non-insured health benefits, or carry additional health insurance. Many insurance companies such as SGI, WSIB, and some employee health benefit plans do cover Nurse Practitioner services.

Please contact your insurance company to inquire about your coverage. ​Much of the work that is required by patients in the community involves other agencies that may not recognize NP practice. This is changing! For example, Worker’s Compensation, SGI and some insurance companies now accept an NP as a primary care provider. They recognize the work from NP’s equal to the same work done by physicians. Most recently Revenue Canada has accepted NPs as providers for documents such as the Disability Tax Credit. The Coroner’s office and Department of Vital statistics also accepts NP signatures on documents. Slowly most agencies are recognizing that for many Canadians, an NP instead of a physician is the primary provider.

If your insurance company would like an assessment quote to see if you can get coverage, please let your therapist or nurse know and they can provide one for you in advance of your appointment. Please note that you should explore your coverage options before you book your appointment
REFERENCES 
Centre for ADHD Awareness, Canada. (n.d.). Creating Equitable Access to ADHD Care in Canada. Centre for ADHD Awareness, Canada. Retrieved April 25, 2023, from https://caddac.ca/wp-content/uploads/Creating-Equitable-Access-to-ADHD-Care-in-Canada.pdf

Centre for ADHD Awareness, Canada. (n.d.). Girls and women with ADHD: Our missed forgotten and most vulnerable. Centre for ADHD Awareness, Canada. Retrieved April 25, 2023, from https://caddac.ca/wp-content/uploads/Girls-and-Women-with-ADHD-FINAL-1.pdf