System s Im provem ent through Service Collaboratives Cham plain Youth Justice Collaborative June 19, 20 13
Welcome! Bienvenue! Marcia Gibson, Manager, East Region, CAMH Chantal Wade, Health Promotion Lead, East Region, CAMH
Today’s Agenda 1. Welcome and Introductions 2. SISC Overview 3. Overview of Justice Collaboratives 4. Youth Justice & Health System Overview 5. Needs Validation Update 6. System Gaps Identified by the HSJCC 7. Discussion on Key Themes and Issues 8. Process Moving Forward 9. Closing Remarks
SISC Overview Marcia Gibson, Manager, East Region, CAMH
Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy • Commits to the transformation of mental health and addiction services for all Ontarians • Begins with a three-year-plan that focuses on children and youth • 22 initiatives have been rolled out to support this strategy, including 18 Service Collaboratives 5
Ontario’s Comprehensive Mental Health and Addictions Strategy OVERVIEW OF THE THREE YEAR PLAN Starting with Child and Youth Mental Health Our Vision: An Ontario in which children and youth mental health is recognized as a key determinant of overall health and well-being, and where children and youth reach their full potential. Identify and intervene in kids’ mental Close critical service gaps for vulnerable Provide fast access to high quality health needs early kids, kids in key transitions, and those in THEMES service remote communities Professionals in community-based child and youth Kids and families will know where to go to get what mental health agencies and teachers will learn how to they need and services will be available to respond Kids will receive the type of specialized service they need identify and respond to the mental health needs of kids. in a timely way. and it will be culturally appropriate • Fewer hospital (ER) admissions and • Reduced child and youth suicides/suicide • Higher graduation rates • Decrease in severity of mental health INDICATORS attempts issues through treatment readmissions for child and youth • More professionals trained to identify kids’ mental health • Educational progress (EQAO) • Decrease in inpatient admission rates mental health needs for child and youth mental health • Fewer school suspensions and/or • Higher parent satisfaction in services • Reduced Wait Times expulsions received Pilot Family Support Implement Working Implement standardized Enhance and expand Improve public access to Provide support at key Navigator model Together for Kids’ Mental tools for outcomes and Telepsychiatry model and service information transition points Y1 pilot Health needs assessment services Amend education curriculum Develop K-12 resource Funding to increase supply Hire new Aboriginal workers Improve service to cover mental health Increase Youth Mental guide for educators of child and youth mental Implement Aboriginal Mental coordination for high needs promotion and address INITIATIVES Health Court Workers health professionals Health Worker Training Program kids, youth and families stigma Implement school mental Expand inpatient/outpatient Reduce wait times for service, Provide designated mental Outcomes, indicators and health ASSIST program and Hire Nurse Practitioners for services for child and youth revise service contracting, health workers in schools development of scorecard mental health literacy eating disorders program eating disorders standards, and reporting provincially Implement Mental Health Create 18 service Provide nurses in schools to Strategy Evaluation collaboratives Leaders in selected School support mental health services Boards
Advisory & Accountability Structures Provincial Government Oversight Committee Advice, Communication and Approvals System Improvement Accountability through Ministry of Health and Long-Term Care Communication Service Collaboratives (SISC) Service User Expert Panel Provincial Project Advice and Collaborative Sponsor: Scientific Expert Panel Communication Advisory CAMH Group Other Expert Panels Communication Related Services and Stakeholders 7
Who is Participating? Children & youth services Mental Educational health and institutions addictions Community- Community-led Justice based Service Programs Collaboratives services Culture- Clients & specific Families services Hospital services 8
Implementation Frameworks Implementation Science • A specified set of purposeful activities at the practice, program, and system level designed to put into place a program or intervention of known dimensions with fidelity. It is the science of bringing evidence- based research into practice to improve client outcomes. Quality Improvement • System atically im proving system processes . The SISC initiative has incorporated QI tools within our Implementation Science framework to support collaborative partnership development and the implementation of evidence-informed interventions. Quality Improvement Cycle
Implementation Frameworks Use of evidence • Evidence is defined as the integration of the best available findings from the external research world with clinical practice judgment/ expertise and client preferences/ lived experience. Health Equity • The Health Equity Impact Assessment (HEIA) tool is being used at different phases of the Collaborative’s process, including while engaging members and during the selection of interventions, to ensure data on health inequities informs decisions and inclusive representation of high priority populations. Developmental and ongoing evaluation • Developmental evaluation is not one specific method, but rather an approach that can be used to select the most suitable methods, types of data, or focuses. SISC’s evaluation methods include traditional logic models, performance measurement and also qualitative methods, like case studies. 10
Service Collaborative Rollout The Strategy’s First 3 Years – Children & Youth 2013-2014 2012-2013 2014-2015 7 Service Collaboratives 4 developmental sites 7 Service Collaboratives (5 geographic and 2 have been ( 5 geographic and justice + health) will be established created in the final phase 2 justice + health) are being rolled out in the second phase 11
Service Collaborative Update 12
Provincial System Support Program (PSSP) The Provincial System Support Program is a CAMH program focused on supporting the province CAMH’s by: Provincial Offices • Identifying, implementing and monitoring evidence-based mental health and addictions related programs Ontario • Using research expertise to develop an evaluation framework and monitor outcomes to improve system evaluation and performance monitoring 13
CAMH’s Provincial System Support Role Knowledge Performance Health Promotion Exchange Measurement and and Prevention Implementation Using KE resources Providing expertise and Research and expertise (such as access to research, best Evidence Exchange Bringing expertise and practices and programs Network) to increase in health promotion and capacity to support the the system’s capacity to prevention field in measurement access and apply the and data integration best evidence Regional Implementation Structure Four regional implementation teams distributed across the province will support the Collaboratives and ensure dissemination of the identified evidence-based practices across the province through training in implementation and evaluation System partners and stakeholders across Ontario 14
Overview of Justice Collaboratives Uppala Chandrasekera, Project Leader, Justice Collaboratives, CAMH
Justice Collaborative Framework The Justice Collaboratives will: • Focus on improved connections and co- ordination of services at key transitions points between the health + justice system The 6 Ministries • Target a key transition or focal point for have created a action, with consideration to the unique Framework that needs of each community will inform the • Assist police, mental health workers, youth work of the and adult provincial courts, etc., to know Justice when, where and how to assist persons with Collaboratives . mental illness and addictions • Im prove integration and collaboration between justice + health + other human services 16
Role of the HSJCC • Hum an Services and Justice Coordinating Com m ittees (HSJCCs) were established based on It is important the Provincial Strategy to Coordinate Human that the Services and Criminal Justice Systems in Ontario Service (1997), in response to a need to coordinate Collaboratives resources and services, and plan more effectively for are closely people in conflict with the law. • The HSJCC has established networks to aligned with coordinate service delivery among human, health the work of the and criminal justice service organizations. HSJCC . • Mem bership includes hospitals, mental health and addictions, community services, policymakers, government, police, corrections, attorneys, service users, etc. 17
Minimum Specifications for Collaboratives • Focus on improving transitions • Multi-sector partnerships • Use of implementation science & quality improvement approaches • Focus on equity • Evaluation
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