Mental Health Promotion in Immigrant & Refugee Serving Organizations Sajedeh Zahraei, PhD, MSW, RSW Senior Manager Professional Development & Training OCASI - Ontario Council of Agencies Serving Immigrants February 6th, 2020
Presentation Overview 1. OCASI Mental Health Promotion Project Overview 2. Highlights from Needs Assessment Findings 3. Promising Practices in Cross-sectoral Collaboration 4. Integrated Model of Mental Health Promotion 5. Opportunities, Challenges, & Next Steps 6. Discussion 2
Mental Health Promotion in Immigrant, Refugee Serving Organizations Project ● 3-year project funded by IRCC through the Settlement Program Service Delivery Improvements Funding (SDI) Stream 3
Mental Health Promotion Project Partners Access Alliance Multicultural Health Polycultural Immigrant & Community ● ● and Community Services Services ● Canadian Centre for Victims of ● Parkdale Queen-West Central Torture (CCVT) Toronto Community Health Centre Canadian Mental health Association (CTCHC) ● (CMHA) – Ontario Division Rexdale Women’s Centre ● ● COSTI Immigrant Services ● Toronto South Local Immigration Crossroads Refugee Clinic - Women’s Partnership Project ● College Hospital Women’s Health in Women’s Hands ● Hong Fook Mental Health Association Community Health Centre ● ● Newcomer Centre of Peel 4
Project Goals & Objectives: 1) Enhance engagement of new and existing partners within the immigrant & refugee sector, mental health and primary care 2) Improve organizational capacity to promote mental health and to respond to mental health issues 3) Develop and test an innovative service delivery model of mental health promotion 5
Project Components 1. Needs Assessment and Environmental Scan 2. Capacity Building 3. Service Model Design & Pilot Implementation 4. Scale up and Dissemination of Lessons Learned 6
Capacity Building Conducted over 10 in-person mental health trainings for frontline service providers and managers
Needs Assessment Conducted a Sector-wide Provincial Survey; 234 respondents ● ● Focus Groups with Staff & Clients of Pilot Sites Interviews with Project Advisory & Leadership of Organizations ● 8
Key Survey Findings 9
Prevalence of Mental Health Problems
Mental Health Supports Need - Clients
Types of Mental Health Promotion Programs Needed
Types of Mental Health Concerns Faced by Staff
Types of Existing Collaborations ● Overall respondents reported a high degree of collaboration (>80%) ● Collaborating Agencies: ○ Community-based mental health agencies (65.7%), ○ Public health (48.8%) and Primary health care agencies (43.4%), ○ Relatively less collaboration with Psychiatric hospitals (24.7%), ○ Community-based addiction agencies (23.5%), ○ Faith-based organizations (21.1%), and General Hospitals (18.7%) 14
Types of Existing Collaborations Mental Health Supports: ● Information/system navigation (30.7%) ● Peer Support (27%), ● Relatively less collaboration for case management, counselling & clinical support services. Mental Health Promotion: ● Community Mental Health Awareness (29.7%) ● Online resources on mental health (26.9%) ● Relatively less collaboration for mindfulness programs 15
Environmental Scan ● Literature Review ○ Promising Practices in Collaboration ○ Workplace Mental Health ● Key Informant Interviews 16
Key Findings from Environmental Scan 17
Promising Models of Collaboration ● In-house Mental Health Team Model ● Partnership Model - Mental Health Services ● Partnership Model - Health Services ● Shared-care Model 18
In-house Mental Health Team Model Mental health supports are provided by a staff person or mental health team that is part of ● the agency Preferred model from client perspective ● Mental health teams are not confined to clinical professionals ● Many of the best practice models identified featured service navigators and peer leaders, ○ with specialized knowledge of mental health, cultural considerations and system navigation, to provide the supports needed by a client 19
Partnership Model - Mental Health Services Health or mental health supports are provided in collaboration with an external partner or agency ● Partnerships are typically established through formal partnership agreement ● Most commonly found between settlement agency and health agencies, rather than settlement and ● mental health agencies 20
Partnership Model - Health Services Healthcare is provided to settlement agency clients by a partner agency ● Clients don’t have to go outside to get support; seamlessness between settlement and ● health services 21
Shared-care Model Mental health care is provided to clients, typically at a health or mental health agency in ● collaboration with an external specialist In-house team provides some level of mental health support, external specialists, usually ● psychiatrists, come to provide consultation to team or directly see clients 22
Service Model Design Development 23
Mental Health Promotion Integrated Service Model Built on findings from the environmental scan/needs assessment ● One-day Design Summit ● Onsite Needs Assessment & Consultation with Pilot Sites ● Consultation with Project Advisory Group ● 24
Guiding Principles ● Community context matters Shared information & collaboration ● ● Prevention Focused ● Address and respect both, social determinants of health and clinical care ● Reduced Stigma ● Communication should extend across ● Mental health for everyone silos and to others Individually & culturally responsive care ● Location of collaborators makes a big ● ● Use clear definitions of success from difference multiple perspectives 25
Model Criteria • Using existing resources (with some enhancement e.g. collaboration, coordination) • Easy/Quick implementation • Supported by evidence-base • Sustainability • Scalability • Address key priority/identified gaps Promotes mental health • Trauma-informed • Culturally-linguistically appropriate • 26
27
Mental Health Promotion Integrated Service Model Components 28
Client Mental Health Refers to mental health promotion initiatives provided to clients, it could include: ● Psychoeducation workshops ○ Peer Support ○ Support Groups ○ Social/Recreational Activities ○ Social determinants of health/Settlement Services ○ 29
Staff Mental Health Mental health for all in the care space highlights the importance of staff mental health ● Organizational approach to staff mental health involves: ● Comprehensive EAP programs ○ Management support ○ Wellness initiatives ○ Routine debriefing ○ 30
Organizational Capacity Implementation of the Integrated mental health promotion model requires agencies to: ● Implement mental health promotion policies and protocols o Trauma & violence informed policies and procedures o Leadership buy-in & commitment o Staff training & professional development o 31
Collaboration & Service Coordination Improving the service pathway for clients involves: ● Formal partnerships ○ Comprehensive intake and referral protocols ○ Consultation (i.e. partnering with external mental health specialists to offer mental ○ health services) 32
Piloting the Model ● Target population: women with complex histories ● Peer Support and Staff Wellness Initiatives ● Organizational Capacity Building: Training, Policy & Protocol Development ● Focus on less resource-saturated areas within the GTA ● Enhance collaboration with local primary care and mental health services 33
Lessons Learned Leadership Commitment & Buy-in ● Engagement at all levels: Management, Staff, Clients, Peers ● Systemic, Structural Challenges & Opportunities ● Time & Resource Allocations ● Knowledge Exchange, Connections & Collaboration ● 34
Next Steps Wrapping up First pilots; Lessons Learned Report ● Onboarding Two New Pilot Sites for 2020-2021 ● ● Promoting New Cross-Sectoral Collaborations ● Ongoing Capacity Building & Outreach Keep in Touch: Community of Practice ● 35
Thank you! Discussion/Questions? 36
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