Moving on Mental Health
Introduction
Every child and young person deservces support to reach their full potential - and our communities and our province need them to realize that potential. - Ministry of Children and Youth Services, Nov. 2012.
This is one of many initiatives taking place across Ontario that I am extremely excited to see happening because of the sheer importance of the work. It doesn't take a series of surveys to realize that there are significant gaps in the mental health services and they take a lot of forms. Whether it be a lack of specialized care, poor transitioning, or simply not having any idea who has the service there are hundreds of people who fall through the cracks annually and that needs to stop.
The plan is simple: Create and support pathways to care, define core services (and define who does what work), establishing lead agencies, creating a new funding model for efficacy purposes, and build a new framework to standardize care. Right now we have a lead agency - The Phoenix Centre for Children and Families - which is making sure that we have a structure and statistics to guide us forward. The Phoenix Centre is also our Core Service Agency as defined by the Ministry.
Many sectors were identified for the Planning Table. Community Supports, Children's Services, Military, Health, Addictions, Municipalities/Employment/Recreation/Income Support/Housing, Adult Mental Health, First Nations, Victims of Violence, Faith, Justice, Developmental, Education, Francophone, and Immigration. The reason for identifying sectors is to have a representative, someone to bring this information to these smaller communities and to bring information from these communities back to the table.
From this point forward I will be posting information from meetings.
January 10, 2017
We had the results of three surveys compiled to see where some of the gaps in service are from the points of view of Children & Youth, Parents & Guardians, and Service Providers. All in all there weren't as many respondents as I would personally be comfortable using for this kind of analysis but this is what we received. Most of the sectors were identified as needing better care coordination as well as new supports. Key areas of concern include
Lots of work to do yet and more to come.
March 7, 2017
As I read through what I posted back in January I am even more concerned with where we wound up...
After a few re-considerations about the areas of concern we want to impact our list has come down to (1) Intake/Privacy/Access, (2) Pathways to Care, (3) Crisis System. I will be working within the Pathways to Care and Crisis small groups with the hope of bringing some of the concerns expressed by my clients into the group. Considering what was asked for by the handful of community members who filled out the original surveys I think we could do better but this is where we are at.
April 19, 2017
I am not sure about every group but I have to say that things are looking good from my group. The meeting started off as it always does but after dinner we broke off into small groups - Pathways to Care, Intake, and Crisis. There was an attempt to separate the Pathways group into 2 sections - one for everyday referrals and one having to do with transitions, such as child into adult - but that was shot down because of the many possible transitions available - military to civilian, private to community services, adult to geriatric... list goes on. Last thing I wanted was more groups. The group right now is moving into the information gathering phase where we identify who is doing what in terms of navigating the mental health system for current or prospective clients. Next small group meeting is next week.
June 22, 2017
Planning table got together and compiled all of the ideas from each work group. Not a whole lot of surprises which is both reassuring and disconcerting and those feelings will remain in place until October 28, 2017. Reminds me of Tony Stark (Robert Downey Jr.) talking to Loki (Tom Hiddleston) saying, "Not a great plan." The reason I sound a little off-put is I look at the list from each group and my first thought is, "Let's get together in July or August and implement a handful of these things during the slow season," because our workloads - pretty well across the board - drop by a solid 20%, if not more, during the summer. All the clients are still in the "Active" pile but it's almost impossible to get people into the office.
These are the pieces that each working group believes will improve the current system of care:
Crisis Working Group
Every child and young person deservces support to reach their full potential - and our communities and our province need them to realize that potential. - Ministry of Children and Youth Services, Nov. 2012.
This is one of many initiatives taking place across Ontario that I am extremely excited to see happening because of the sheer importance of the work. It doesn't take a series of surveys to realize that there are significant gaps in the mental health services and they take a lot of forms. Whether it be a lack of specialized care, poor transitioning, or simply not having any idea who has the service there are hundreds of people who fall through the cracks annually and that needs to stop.
The plan is simple: Create and support pathways to care, define core services (and define who does what work), establishing lead agencies, creating a new funding model for efficacy purposes, and build a new framework to standardize care. Right now we have a lead agency - The Phoenix Centre for Children and Families - which is making sure that we have a structure and statistics to guide us forward. The Phoenix Centre is also our Core Service Agency as defined by the Ministry.
Many sectors were identified for the Planning Table. Community Supports, Children's Services, Military, Health, Addictions, Municipalities/Employment/Recreation/Income Support/Housing, Adult Mental Health, First Nations, Victims of Violence, Faith, Justice, Developmental, Education, Francophone, and Immigration. The reason for identifying sectors is to have a representative, someone to bring this information to these smaller communities and to bring information from these communities back to the table.
From this point forward I will be posting information from meetings.
January 10, 2017
We had the results of three surveys compiled to see where some of the gaps in service are from the points of view of Children & Youth, Parents & Guardians, and Service Providers. All in all there weren't as many respondents as I would personally be comfortable using for this kind of analysis but this is what we received. Most of the sectors were identified as needing better care coordination as well as new supports. Key areas of concern include
- Early Intervention/Prevention
- Wait Times/Wait List
- Access Barriers (ie. Travel, Cost, Coverage, Hours)
- Cultural Appropriateness/Sensitivity (incl. Language and Stigma)
- Awareness of Services (decrease service confusion and fatigue)
- Easier sharing of information
- Transition to Adult Services (ie. from Child Services to Adult)
- Respite and Residential Services
- System Navigators and Care Coordination
- Common Intake
- Integrated Crisis System
- Create a Common Database
- Infant Mental Health (parents and infants)
Lots of work to do yet and more to come.
March 7, 2017
As I read through what I posted back in January I am even more concerned with where we wound up...
After a few re-considerations about the areas of concern we want to impact our list has come down to (1) Intake/Privacy/Access, (2) Pathways to Care, (3) Crisis System. I will be working within the Pathways to Care and Crisis small groups with the hope of bringing some of the concerns expressed by my clients into the group. Considering what was asked for by the handful of community members who filled out the original surveys I think we could do better but this is where we are at.
April 19, 2017
I am not sure about every group but I have to say that things are looking good from my group. The meeting started off as it always does but after dinner we broke off into small groups - Pathways to Care, Intake, and Crisis. There was an attempt to separate the Pathways group into 2 sections - one for everyday referrals and one having to do with transitions, such as child into adult - but that was shot down because of the many possible transitions available - military to civilian, private to community services, adult to geriatric... list goes on. Last thing I wanted was more groups. The group right now is moving into the information gathering phase where we identify who is doing what in terms of navigating the mental health system for current or prospective clients. Next small group meeting is next week.
June 22, 2017
Planning table got together and compiled all of the ideas from each work group. Not a whole lot of surprises which is both reassuring and disconcerting and those feelings will remain in place until October 28, 2017. Reminds me of Tony Stark (Robert Downey Jr.) talking to Loki (Tom Hiddleston) saying, "Not a great plan." The reason I sound a little off-put is I look at the list from each group and my first thought is, "Let's get together in July or August and implement a handful of these things during the slow season," because our workloads - pretty well across the board - drop by a solid 20%, if not more, during the summer. All the clients are still in the "Active" pile but it's almost impossible to get people into the office.
These are the pieces that each working group believes will improve the current system of care:
Crisis Working Group
- Supplied definitions of Emergency, Urgent, and non-Urgent. An emergency situation is one where a person is in a life-threatening situation. (Shocker, I know.)
- Development of a common way of rating risk (High-Med-Low, number system)
- Decision making flowchart to help emergency rooms better identify how to work with a patient suffering from psychological distress with a second flowchart to identify best pathway to community services
- Expansion of Age-based services to connect with young adults (moving from a maximum age of 18)
- Identifying a tracking system for emergency cases, suicides, suicide attempts, other mental health crises
- Explore CAPA model across agencies and see how it could work for their agencies. Explore ways to adopt CAPA across service providers (this idea has already been shot down by a rep from an Ottawa hospital... forgetting her name at the moment. CAPA is an all-or-nothing system.)
- Community service map development (Killaloe Resource Centre is already working on two sites: Thrive and County Connections. County Connections is in the process of being updated but that will take some time)
- Service Providers developing a strategy for warm hand-off
- Reiterated need for warm hand-off strategy, adding that there is a need for the referring worker to make sure the service he or she is referring the client to has availability (not sending the prospective client from one waitlist to another)
- Develop a community map for accessibility and services (make sure the service times/days, eligibility criteria, and waitlist length are available)
- Develop strategic partnerships in rural locations for service provision, particularly to make e-counselling available to those in areas that have slow connections
- Agencies need to develop policies that begin transition planning earlier and possibly adopting software to assist (notification when a client is reaching the maximum age for service by that agency, for example)
- Intake workers and service providers should be meeting regularly to discuss common issues, such as waitlists, and new programming in order to assure engagement and improve efficiency of warm hand-off
