(L-R) Dr. Albina Veltman, psychiatrist and Elisabeth Palade, registered nurse

St. Joe’s developmental dual diagnosis program is advancing inclusion for patients with dual diagnoses.  

Dual diagnosis describes a situation where a person has both a developmental disability and a mental health condition. People with dual diagnoses often face stigma alongside physical and systemic barriers to care, compounded by limited specialized services in the community.

Unstoppable compassion in every interaction

St. Joe’s program is designed to provide comprehensive support for patients living with dual diagnoses. Health professionals assess patients’ behaviour and mental health to develop care plans, offer recovery-focused treatment and connect patients, caregivers and families to community supports.  

No two dual diagnosis patients are the same. That means health professionals work with each individual to determine their needs and how best to meet them.

“There is no template that we follow,” said registered nurse Elisabeth Palade. "It changes from patient to patient. Our patients are vulnerable and need more support in the community, so we advocate for them—whether it’s related to mental health or their overall needs. If we can help, we will help.”

This compassionate approach extends beyond patients to those who support them every day. By equipping families and caregivers with tools and guidance, the team helps ensure loved ones can thrive alongside the patient.

“At St. Joe’s, we’re not just invested in the patient or the person coming for the service, but their whole family. A dual diagnosis impacts the entire household, which is why we support patients alongside their loved ones—helping everyone thrive no matter the challenges. When they leave here, they know someone is caring for them and standing in their corner,” said Dr. Randi McCabe, St. Joe’s vice-president of mental health and addictions.

Compassion without limits

St. Joe's developmental dual diagnosis program is one of the only services of its kind in the region. As a regional leader, St. Joe’s cares for patients not only from Hamilton but also Burlington, Norfolk, Brantford and even Niagara. In some of these places, specialized services exist, but waitlists are often longer.

"We are committed to providing care for this unique group of individuals,” said Dr. Albina Veltman, psychiatrist on the developmental dual diagnosis team.

From the beginning, meeting patients in the community was a core part of the program. Despite rising patient volumes, that practice continues for those that need it. “For many patients, it’s extremely challenging to come see us at the hospital,” Dr. Veltman explained. “Anxiety, behavioural issues or other factors can make it difficult, so being able to go see them in the community is extremely important.”  

Championing inclusion

The barriers patients living with dual diagnoses face go beyond access to care. Inequities and exclusion remain everyday realities. “Because of their disability, our patients can face extreme discrimination,” says Palade. "Many have symptoms related to their mental health, as well as physical disabilities.”

In addition to delivering care, the program intentionally works to dismantle systemic barriers patients may face. One of the ways they do this is by educating other healthcare providers on the full potential of their patients and how they can benefit from services they’ve traditionally been excluded from.  

“For example, there may be a program our patient would really benefit from, but an exclusion criterion is that the person cannot have developmental challenges,” explained Dr. Veltman. “However, we know from working with the person that they would be capable of participating and they would benefit from it, so this exclusion criteria is really a barrier that needs to be broken down.”

For the team, inclusion means advocacy as much as treatment.  

“This population deserves to be able to get good care everywhere and it's on us as healthcare providers to learn enough about this population to be able to do that,” Dr. Veltman
said.