1. Michael Ungar, Ph.D. Killam Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org Breaking the Silos: The Possibilities and Perils of Interagency Collaboration

2. 2008 British Columbia Adolescent Health Survey

3. The Question We Need to Ask: Which services, delivered by whom, to which children, exposed to what amount of risk, nurture the most resilience?

4. Informal supports and formal services facilitate mental health Good News

5. A Three Stage Reciprocal Coping Process Individual Coping Strategies Engagement with Social Supports Engagement with Formal Service Providers Catalyst

6. The better we design services and build bridges to supports, the more resilient children become Good News

7. Contextual Risk Individual Risk Service Use Experience Resilience Functional Outcomes.37* -.30* -.17* -.38*.33*.07 -.03 -.21*.53*.18*-.14.13 Life time Service Use Accumulation

8. Service Use Experience Resilience Functional Outcomes.37*.33*

9. Nationally, we are changing systems to respond better to children’s mental health needs Good News

11. cultural adherence relationships identity power & control social justice access to material resources cohesion Seven Resilience Resources Children Need

12. Our efforts to help children and youth access services and find supports, even when they are available, often fail More workers won’t fix the problem We need to address two gaps: Review files to see what’s really happening Develop evidence-informed practices for collaboration/service integration/continuity/advocacy Bad News

13. Case Study Tony (pp. 191-192)

14. Mental health of youth using multiple services (n=152) Youth (mean age 17) in justice services and youth in mental health services (mean age 16) show the same levels of comorbidity (internalizing and externalizing mental health problems) Youth in justice services show higher levels of externalizing behavior problems

15. Mental health of youth using multiple services But, justice youth accessed mental health services much less often than mental health youth They were also less likely to access school supports, physical health services, and child welfare services Liebenberg, L. & Ungar, M. (2014). A comparison of service use among youth involved with juvenile justice and mental health. Children and Youth Services Review, 39, 117–122.

16. Help children Navigate

17. Help children Negotiate

18. Exposure to Adversity Differential Impact of Protective Factors and Processes LOW - HIGH Help Line + Impact on Development 0

19. Exposure to Adversity Differential Impact of Protective Factors and Processes LOW - HIGH Adoption + Impact on Development 0

20. Exposure to Adversity Differential Impact of Protective Factors and Processes LOW - HIGH + Impact on Development 0 Mental Health Education Programs in Schools? Foster Care for Marginalized Youth?

21. The Question We Need to Ask: Which services, delivered by whom, to which children, exposed to what amount of risk, nurture the most resilience?

22. Proportional universality Tailored interventions that match resources to risk No one agency, or support network has everything a child needs when the child’s exposure to adversity is high Boivin, M., Hertzman, C., Barr, R., Boyce, T. Fleming, A., MacMillan, H.,…& Trocmé, N. (2013). Early childhood development: Adverse experiences and developmental health. Ottawa, ON: Royal Society of Canada-Canadian Academy of Health Sciences Expert Panel.

23. Breaking News There is reason to be cautiously optimistic

24. 1.Be multi-level, ecologically complex in their delivery 2.Be coordinated, challenging the barriers created by service silos 3.Emphasize continuity over time, in both the seamless delivery of multiple services and the engagement of staff with the individuals they serve Six Principles of Service Design for Building Children’s Mental Health

25. 4.Be negotiated, with services matched to children's cultures and contexts 5.Be designed along a continuum from least to most intrusive 6.Be effective, whether that effectiveness is demonstrated based on practice based evidence or rigorous evaluation of manualized interventions Six Principles (cont.)

26. Exercise Assessing your programming

27. 1.Overall, I am satisfied with the services I received 2.I helped choose my services 3.The people helping me stuck with me 4.I felt I had someone within the service to talk to when I was in trouble 5.I had a say in how this service was delivered to me. The PRYM Experience of Service Assessment

28. 6.I could get the service when I needed it 7.The location of the service was convenient 8.Staff respected my religious and spiritual beliefs The PRYM Experience of Service Assessment (cont.)

29. 9.Staff spoke in a way that I understood 10. Staff were sensitive to my cultural and ethnic background 11. I am now better able to cope when things go wrong 12. There was a service I needed, but I couldn’t get The PRYM Experience of Service Assessment (cont.

30. Michael Ungar, Ph.D. Killam Professor, School of Social Work, Dalhousie University Twitter @MichaelUngarPhD www.michaelungar.com www.resilienceresearch.org THANK YOU!