Moving on Mental Health: Community Mental Health Planning Meeting York Region

Purpose of the Webinar Introduce Moving on Mental Health (Cathy Paul) - A system that makes sense for children and youth Kinark Child and Family Services (Vicki Mowat) Responsibilities of Lead Agencies (Robert Burkholder) Moving on Mental Health in the York service area (Christine Simmons-Physick)

Moving on Mental Health Moving on Mental Health – A System That Makes Sense for Children and Youth, released on November 19, 2012, builds on A Shared Responsibility, Ontario’s Policy Framework for Child and Youth Mental Health, 2006 (Policy Framework) and on Ontario’s Comprehensive Mental Health and Addiction Strategy (2011)

Moving on Mental Health - a system that makes sense for children and youth Moving on Mental Health is the next step in transformation of the child and youth mental health system. The purpose of the strategy is to transform the experience of children and youth with mental health problems and their families, so that regardless of where they live in Ontario they will know: - what mental health services are available in their communities; and - how to access mental health services and supports that meet their needs

Moving on Mental Health Target Populations Children and youth who are experiencing the most severe, complex, rare or persistent diagnosable mental illnesses that significantly impair their functioning Level 4 Children and youth who are experiencing significant mental health problems that affect their functioning Level 3 Continuum of Needs-based Services Children and youth identified as being at risk for, or are experiencing mental health problems that affect their functioning Level 2 All children, youth and families Level 1

Moving on Mental Health MCYS produced a draft Service Framework that sets out CYMH services and processes to be funded. Eight were identified as core (available in every service area) services and two key processes. MCYS has divided the province into 34 administrative service areas. Boundaries roughly match Statistics Canada Consolidated Municipal Service Manager boundaries. Each service area will have a lead agency. Core Services: Targeted Prevention Brief Services Counselling and Therapy Family Caregiver Skill-Building and Support Crisis Support Services Intensive Treatment Services Specialized Consultation and Assessments Key Processes: Access/Intake Service Coordination/Case Management CMSM: Consolidated Municipal Service Manager (Canada)

Moving on Mental Health Role of Lead Agencies: Create clear and simple to use pathways to care for parents and youth Establish a plan for the delivery of CYMH services across the York service area Deliver or contract for the range of defined core MCYS-funded CYMH services Ensure those services are effective and accountable to parents, youth, and children Lead Agency Identification Process The first 14 Lead Agencies were selected through a competitive Request for Proposals process in the summer of 2014 (Phase 1) - Kinark was identified as the successful lead agency in York In early February the Lead Agency for Toronto selected and announced. Lead Agencies for the remaining service areas will be identified 2015 (Phase 2)

Kinark Child and Family Services Vision A healthy future for Ontario’s children and youth Mission Helping children and youth with complex needs achieve better life outcomes Values Hold children and youth at the centre of all we do Challenge ourselves to be the best Achieve more together Instill hope Lead

Kinark Child and Family Services We serve approximately 9,400 children, youth and families annually across three program streams: – community–based child and youth mental health (CMH) – forensic mental health/youth justice – autism Beginning in 2006, all treatment interventions migrated to evidence-based practices. In 2013 Kinark was accredited by the Canadian Centre for Accreditation and recognized for meeting “all Mandatory and Leading Practice Standards – a remarkable achievement”.

Kinark’s Communities Community-based Child and Youth Mental Health: – currently providing a full range of core services to our clients – programs provided in counties/regions of Northumberland, Peterborough, Durham, York and Simcoe. Local offices in Midland, Barrie, Aurora, Vaughan, Markham, Keswick, Whitby, Peterborough, Cobourg, Campbellford – some programs in Peel, Halton, Wellington Forensic Mental Health/Youth Justice: – Intensive Support and Supervision Program – York, Peel, Halton, Dufferin, Simcoe – Syl Apps Youth Centre (province-wide secure treatment, custody, detention, Ontario Review Board) Autism: – provincial lead agency for former ‘Central East’ region for IBI, Connections for students direct service, sub-contracted direct service and direct funding – respite at the Kinark Outdoor Centre in Haliburton

The Responsibilities of Lead Agencies Core Service  responsibilities Are community-based core services available in my service area? Engage other community based child and youth mental health service providers in planning for the delivery of core service through the development of a Core Services Delivery Plan Local System  responsibilities Are services across the continuum working together to meet the needs of children, youth and their families? Collaborate effectively across the continuum of CYMH services in developing a Community Mental Health Plan -Multi year process -Focus on year 3 – when Kinark moves into the fund holder role

Lead Agency Implementation YEAR 1 YEAR 2 YEAR 3 Assess current state in service area – inventory existing pathways and protocols Develop initial Core Service Delivery Plan and CYMH Community Mental Health Plan Begin implementation of Core Service Delivery Plan and CYMH Community Mental Health Plan Begin fund holder role including beginning of sub-contracting and funding functions, pending MCYS capacity assessment -Multi year process -Focus on year 3 – when Kinark moves into the fund holder role

-2 things that are happening simultaneously -Community mental health partners will hear about the core service delivery plan, are not direct contributors -Relationship with core service providers and other partners is changing, ultimately Kinark will be the fund holder for core service providers and will work with community mental health partners for system planning -

Moving on Mental Health Plans   Core Services Delivery Plan Community Mental Health Plan What is the outcome expected from the plan? Children, youth and their families have: Access to a clearly defined basket of core services; and, Confidence in the quality of care and treatment. Sectors (MOHLTC, EDU, and MCYS) work together – across the continuum – to plan and deliver child and youth mental health care. As a result: Families know how services connect and how systems work together; Professionals, such teachers and family doctors, are clear about pathways. Questions that must be addressed by the plan Can we demonstrate that core services are being delivered, and minimum service expectations are being met? Can we show how our services are getting better at meeting the mental health needs of children and youth? Are we making the best possible use of limited resources to deliver the range of core services? Are all those who serve children and youth working together systematically to address mental health needs? Are the roles and responsibilities of everyone across the continuum clear to parents and youth? How will the lead agency work with community partners to address service gaps and expand on opportunities? Process expectations The lead agency and core service providers have engaged respectfully on development of the planning template The lead agency, core service providers and all partners from across the continuum, including: LHIN(s), district school boards, public health units, child welfare agencies, and hospital pediatric psychiatry services have engaged respectfully on development of the planning template Content expectations Service landscape Service priorities Budget planning Understanding current needs and services Collaborative Planning Pathways to, through, and from care

Community Mental Health Plan Section A: Community Engagement, including the engagement process, who and how Section B: Current Service Provision and Pathways to Care, including targeted prevention activities and CYMH services delivered by the broader community, as well as formalized processes/protocols that support pathways to and out of care Section C1: Local CYMH Community Planning Mechanisms, identify purpose of mechanism, who is at the table, roles, outcome/status Section C2: Local CYMH Community Planning Mechanisms, undertake an analysis of the appropriateness and effectiveness of existing mechanisms to support community mental health planning and recommendations for improvements, including changes to existing mechanisms and/or new approaches, where needed

Transformed Child & Youth Mental Health Services LOOKING AHEAD Transformed Child & Youth Mental Health Services What It will look like CURRENT STATE FUTURE STATE Parents, children and youth know how to access services, what is available to them, and what to expect at each point along transparent service pathways Regardless of where they live, families have access to a consistent set of easy to identify supports and services through an identifiable lead agency that is accountable to government Parents, children and youth have confidence in the people and agencies providing services Wait times for service are timely, predictable, and matched to severity of need Parents and funders know whether the services received have made a difference Fragmented, inefficient, hard to access, provider centric Child & youth centered, responsive, flexible, seamless, equitable, evidence-informed & matched to needs Services not consistently matched to needs Acceptable Valid tools, evidence- informed practice Many providers; uneven access to equitable service Accessible Defined communities, lead agencies and core services Lengthy wait times Efficient Pathways/needs and timeliness at centre of service delivery Duplication and silos Coordinated Collaborative Coordination between providers and across sectors Cannot demonstrate results Effective Linked standards, contracting, performance and results Historical funding distribution Sustainable Funding tied to population, needs, and performance

Moving on Mental Health York Region Activities to Date We have begun initial engagement activities with the (7) Core Service providers together and individually in order to gather information and inventory; - services they are currently delivering - populations served - service targets - pathways and protocols - priorities for service improvement   In January we provided them a summary of this information which helped to raise questions regarding whether each organization is interpreting the core services in the same way and if service targets are accurate. We have also been meeting with community partners from education, health, child welfare etc. that are important to connect with to understand service pathways . In March we will be hosting a number of engagement opportunities with families and youth to solicit their perceptions about the CYMH system and gain their advice  on ways to meaningfully involve them.

Community Mental Health Survey In order to gain a better understanding of child and youth mental health services provided in York Region, Kinark will be sending organizations a survey to complete following this webinar. Purpose of the survey: Gather information regarding current community partners including descriptions and details of services (i.e. geographic coverage, age range) Identify: targeted prevention activities and CYMH services delivered by the broader community partners formalized processes/protocols that support pathways to, through and out of care current planning mechanisms including who is at the table, roles, outcome/status gaps and priorities

2015-2016 Plan of Activities Further development of effective engagement mechanisms Understanding who is currently being served and their needs Understanding of who might not be being served Further develop planning priorities into the future including timeframes, indicators of success, targets and desired results Contribute to an enhanced provincial understanding of the child and youth mental health system through analysis and identification of common themes and priorities    Begin to define the service pathways

Questions & Discussion

York Region Population Information Appendix A York Region Population Information Source Total Population (2013) (1) 1,106,096 0-18 Population (2013) 258,016 0-18 Population (Projected 2018) (2) 267,806 Total Aboriginal Population (2011) (3) 4,560 0-18 Aboriginal Population (2011) 1,455 0-19 Francophone Population (2011) 2,760 0-18 Recent & Very Recent Immigration Population (2011) 22,290 Population Density (4) 528.4 Lone-Parent Families (5) 33,120 Low Income Families (6) 74,300 Sources: (1) 2012 Annual population estimates by Census Division, Statistics Canada, (2) Ministry of Finance population projections, Spring 2013, (3) National Household Survey 2011, (4) Population density based on 2006 Census geography, (5) Statistics Canada – 2011 Census, (6) Low Income Families (based on after-tax low income measures, Statistics Canada, Small Area Administrative Data Census Family Data, 2010

York Service Area – Core Mental Health Service Providers (MCYS Funded) Appendix B York Service Area – Core Mental Health Service Providers (MCYS Funded) Abuse Program of York Region Blue Hills Child and Family Centre Family Services of York Region Kinark Child and Family Services MacKenzie Health Southlake Regional Health Centre The York Centre for Children, Youth and Families Youthdale Treatment Centres