A System of Care for Children's Mental health: Expanding the ...

A System of Care for Children's Mental health: Expanding the ...

A System of Care for Childrens Mental Health: Expanding the Research Base Using the System of Care Practice Review (SOCPR) to Facilitate System Transformation Efforts in Canada Using the System of Care Practice Review (SOCPR) to Natasha TatartcheffMichael Hone Francine Gravelle Facilitate System Transformation Efforts

in Canada Director of Clinical Services Director of Clinical Services Quesnel Manager Ottawa Childrens Crossroads Childrens CentreYouth Services Bureau of Ottawa 22nd Annual Access Research Conference Coordinated of the Research and Training Center for Childrens Mental Health, Tampa, FL March and Referral to Services

1-4, 2009 SOC:OTTAWA Area Map Quick facts at a glance Population: 877,300 Area: 2,796 kilometers or 1,080 square miles, 90 kilometers east to west Ottawa's area is almost 80 per cent rural SOC:OTTAWA History of the Project

Mandate of the Children & Youth Mental Health Network (CYMHN) Investigation of models/tools for system transformation University of South Florida (USF) Dr. Friedman System of Care (SOC) SOC:OTTAWA History of the Project System of Care (cont)

Centre of Excellence USF & Success 4 Kids and Families present SOCPR CYMHN unanimously approves the SOCPR project Ottawa Childrens Coordinated Access & Referral to Services (OCCARS) is assigned the lead responsibility to coordinate the project in partnership with: Crossroads Childrens Centre (CCC) Ottawa Childrens Aid Society (CAS) Youth Services Bureau of Ottawa (YSB) SOC:OTTAWA SOCPR

Qualitative research tool Case study methodology Principles operationalized at the level of practice Meet the needs of children & families SOC:OTTAWA SOCPR (cont) Primary applications: Identify system/wide strengths and challenges to inform quality improvement and system transformation efforts Staff training recommendations

SOC:OTTAWA SOCPR-R Domains & Subdomains Domain 1 Child-Centered & Family Focused Domain 2 CommunityBased Individualization Early Intervention Full Participation Access to Services

Case Management Minimal Restrictiveness Integration & Coordination Domain 3 Culturally Competent Awareness Sensitivity & Responsiveness Domain 4 Impact Improvement

Appropriatene ss Agency Culture Informal Supports SOC:OTTAWA Highlights of Ottawas Data SOC:OTTAWA Ottawas Preliminary Points of Interests Demographics: 32 case studies conducted (27 cases used) Children

Ages 9 to 18 Mean age 13 70% males 30% females Language 68% English, 26% French SOC:OTTAWA SOCPR Outcomes Strengths:

Identification of strengths Restrictiveness Service delivery is accessible Language Location Times Setting SOC:OTTAWA SOCPR Outcomes (cont) Challenges: Early identification & intervention Integration of service plan across agencies Smooth and seamless transition SOC:OTTAWA

SOCPR Outcomes (cont) Training needs: Cultural competence Strengths based planning & goal setting SOC:OTTAWA Area Needing Further Exploration Case Management There is one person who successfully coordinates services while ensuring that the treatment/service plan is responsive.

No mandate or funding for the delivery of case management The high rating is a direct result of the dedication of the service providers and programs. Cost to intended service delivery. Difficulties experienced by families when attempting to access services or move between services within the system SOC:OTTAWA Areas Needing Further Exploration (cont) Cultural Awareness & Competence Refers to the ability to not only be aware of cultural differences, but also be sensitive and responsive to those needs.

Further, there are additional barriers that prevent our systems ability to deliver culturally competent services such as: Recruitment Outreach, Evidence based programs that are considered culturally competent. SOC:OTTAWA Community Strategy Community training (strength based

treatment planning and goal setting). Development of a cultural Brokerage team Commitment to on-going use of the SOCPR (3 years) Train additional SOCPR reviewers Commitment to address larger system issues SOC:OTTAWA A Shared Responsibility and the Development of a Community of Practice SOC:OTTAWA Development of a Community of Practice Communities of practice are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly (Etienne Wenger).

The strengthening of trust & collaboration Common language, priorities and a shared ownership in the transformation process Development of a committee structure Linked policy to practice Adoption of System of Care Values and Guiding Principles SOC:OTTAWA System of Care Ottawa Project SOC Project Logistics and Operations SOCPR Training Team

Coordinated Access & Referral Project Management Task Committees SOC:OTTAWA The Policy Framework & SOCPR Ontarios Policy Framework Child, youth and family centered. SOC Principles Services are individualized. Families are included as full participants in service planning and delivery. Community driven services and supports should Services are received within the least

be provided as close to home as possible. restrictive environment. Children have access to a comprehensive Accessible. Coordinated and collaborative. array of services. Services are received within the least restrictive environment. Children with SED receive services regardless of race, religion, national origin, sex, physical disability or other characteristics. The rights of children with SED are protected. Services are integrated and coordinated.

Case management is provided to ensure service coordination and system navigation. Children with SED are ensured a smooth transition to adult services when they reach maturity. By using the SOCPR an organization/ Evidence-based and accountable. system is taking steps to ensure that they are accountable. All of the SOC principles help an agency and system deliver evidence-based and accountable services. SOC:OTTAWA SOC Values & Principles

Core values: Child centered & family focused Community-based Culturally competent SOC:OTTAWA SOC Guiding Principles Children have access to a comprehensive array of services. Services are individualized. Services are received within the least restrictive environment.

Families are included as full participants. Services are integrated and coordinated. SOC:OTTAWA SOC Guiding Principles (cont) Case management is provided to ensure service coordination and system navigation. The system promotes early identification and intervention. Children with SED are ensured a smooth transitions to adult services when they reach

maturity. The rights of children with SED are protected. Children with SED receive services regardless of race, religion, national origin, sex, physical disability, or other characteristics. SOC:OTTAWA Next Steps Articulate vision and theory of change Develop logic model System level Organization level Practice level SOC:OTTAWA Contact Us Natasha Tatartcheff-Quesnel

Francine Gravelle Manager Director of Clinical Services Ottawa Childrens Coordinated Access and Referral to Services. Youth Services Bureau of Ottawa Address: 2675 Queensview Dr. Ottawa, ON K2B 8K2 Telephone: (613) 720-0577 ext. 1256 Fax: (613) 288-0426 Email: [email protected] Address: 2675 Queensview Dr. Ottawa, ON K2B 8K2 Telephone: (613) 729-0577 ext. 1242 Fax: (613) 729-1918

Email: [email protected] Michael Hone Director of Clinical Services Crossroads Childrens Centre. Address: 1755 Courtwood Cr. Ottawa, ON K2C3J2 Telephone: (613) 723-1623 ext. 228 Fax: (613) 723-7393 Email: [email protected] SOC:OTTAWA

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