Presentation to GSSD Oct 20/2012 Lois Okrainec Manager Mental Health and Addiction Services Child and Youth Sunrise Health Region

Mental Health and Addiction Services Child and Youth  Mental Health and Addictions team co-located earlier this year to bridge together services from both program areas under one roof.  The Child and Youth team consists of a multi- disciplinary team, that is better resourced to respond to the needs of families, children and youth.  Recruitment for vacant positions that are essential for effective programming, clinical directions and support is currently underway.

Mental Health and Addictions Framework and Foundation Services should fit the person, not the other way around.  The framework aims to provide the foundational conceptual background and support for current operations, as well as future developments within Mental Health and Addiction Services in Saskatchewan.  The framework aims to provide the principles to guide programs and services and staff in delivery of care. It is also intended to provide background for future developments including detailed clinical and program standards.

Why the changes:  Saskatchewan Mental Health and Addictions is in need of a framework that is person and family focused, that is aligned with other provincial and national strategies, that reflects knowledge enhancements and provides the foundation for the on-going evolution of service delivery.  The focus in the integration of program areas has primarily been on system change.

An integrated response Systematic changes have resulted in the amalgamation of services and the restructuring of the provincial leadership teams to reflect an:  integrated mental health and addictions framework,  standardization of screening and assessment tools,  Processes  Discharge planning.

Outline: The framework focuses on an outline of the following five foundational principles for service delivery: 1. Services are Person and Family Centered 2. Services are Coordinated and Collaborative 3. Services are Integrated 4. Services are supported by Continuous Quality Improvement 5. Services are Engaged with Communities

Foundational Principle #1: Services are Person and Family Centered What this means for MH and AD Services:  Services are accepting – welcoming, non-judgmental, hopeful, culturally sensitive, respectful, flexible and timely.  Services are accessible via various means including reasonable travel demands, tele-health, online supports, mobile services, extended hours and outreach services.  Program and services are aimed at empowering persons/ families with mental health and / or addictions issues to manage their care within their abilities.  Program and service development actively engages the voice of clients, patients and family members of the mental health and addictions community.

Foundational Principle #2: Services are Coordinated and Collaborative What this means for MH and AD Services:  There are standard agreements ( protocols and policies) to support inter-regional client care  Access to integrated and collaborative Mental Health and Addiction Services is assured in urban, rural, and northern sites and across Health regions.  There is a high degree of partnerships across key health and human service sectors within and across the region, in accessing services for shared clients.  Effective partnerships exist with First Nation, Métis and NNADAP.  Standardization of forms and processes, including individual service plans and improve the flow of information between providers  Provincial planning identifies and supports new and emerging directions in the provision of effective and efficient MH and AD Services.

Foundational Principle #3: Services are Integrated What this means for MH and AD Services:  Services are integrated and coordinated. Co-location and co- management become the norm, rather than the exception.  Services are delivered in the right way and at the right time to meet immediate needs. Access is timely, appropriate to the need and effective.  A provincial, electronic mental health and addictions client information system exists to provide timely information for clients and providers in identifying, tracking, sharing and coordinating client care, and supporting regional and provincial data and indictor development.

Foundational Principle #4: Services are supported by Continuous Quality Improvement What this means for MH and AD Services:  Services are evidence informed through the application of evidence and consensus based practice and evaluation of existing programs and service efforts.  Services are accountable through the continuous evaluation and monitoring of outcomes and applying this knowledge to enhance services.  Services are innovative through the continuous exploring of new approaches to be responsive to emerging trends and practices.  Services are evaluated in order to reduce or eliminate activities that are inefficient and add no benefit to the person receiving services.  There are outcome indicators for all MH and AD programs that are identified, tracked and reported on in comparison to provincial / national benchmarks

Foundational Principle #5: Services are engaged with Communities What this means for MH and AD Services:  MH and AD Staff, clients, physicians and community participate in and advise on the design, content and delivery of services.  Peer based supports, community self-help programs and other community initiatives, aimed at the person/ family are actively supported.  Prevention and health promotion services are supported to address the unique needs of communities based on their readiness and capacity for action.  MH and Ad services are aligned with Primary Care initiatives to promote positive life style choices, support behavioral change and secondarily help reduce stigma.

Mental Health and Addictions Services must:  Continue to expand and redirect services to increase its availability to marginalize populations that includes those with significant health and social issues.  Partner with specific services to address the increasing impact of intravenous drug use, HIV, Hep C and other major health issues on the general population that affect the MH and AD population in particular.  Partner with other human service sectors to deliver needed supports/ services to those individuals and families with complex social/emotional/behavioral and psychiatric issues including those who are homeless and/or affected by domestic violence and abuse.

7 core clinical competencies were outlined to build base Provincial Training on and over the next 18 months, training events will be delivered on each core competency area.  CBT Therapies  Motivational Interviewing  Family Systems Assessment/ treatment  Case Management Case Consultation / Community development  Assessment and Intervention for risk of harm  Assessment and Treatment of Trauma  Assessment and Management of Disruptive Behavior Disorder Core Clinical Competencies

 Intakes / referrals  Rural Clinics  Participation and Partnerships with community partners / schools / social services  Communication / Documentation Practices Practices currently being reviewed:

 Incredible Years – Partnerships with C & Y and KidsFirst & Big Brothers Big Sisters  Addictions Programming – Phase 1 and 2  Music Group – partnership with C & Y and Boys and Girls Club of Yorkton Programming

 Maternal Mental Health  Addictions Services multi-media resource  CAFAS – refresher / training / implementation  Suicide Intervention training – building capacity Future Initiatives

 Manager  Mental Health Program Area – 9 staff  Addiction Services – 5 staff  Located at : Yorkton Regional Health Center West Unit Addiction Intake : Mental Health Intake C & Y : Child and Youth Team

 For more information: Lois Okrainec (KF) or (C&Y)