Child and Youth Mental Health Services in Ontario - A Service Provider’s Viewpoint
What do we know?
We know what works
We know we make a difference
We know the challenges
Adding to the equation is the fact that services in other sectors are experiencing increased pressures as well. Education has seen special services diminish. In youth justice, police and prosecutors are now specifically required to consider community referrals to help address the underlying causes behind crime. Child welfare finds that maltreatment is substantiated more often for children with behavioural and emotional concerns. These trends exacerbate pressures on our already overtaxed mental health system.
Service providers will tell you they are not only seeing the numbers of referrals rising, but the complexity of needs and ensuing crises are escalating as well. It is critical that our skills and knowledge base are of the highest quality and both must be constantly honed and upgraded - another challenge when combined with diminishing resources.
Taken together, these issues have created for us a sense of sadness and frustration: sadness when we see children and youth we know we could help who instead have to wait until their pain is deep and their problems are entrenched; and, frustration when we see our ability to reach those that need us unnecessarily blocked.
A different health issue of this magnitude with these costs in both dollars and human suffering would create a public outcry that would make addressing it a driving goal of our province. Why has it not? The answer, simply put, is that the stigma attached to these problems is as crippling as the problems themselves. Kinark Child and Family Services Centre and Léger Marketing in Ontario just completed a survey that found 38% of Canadians are embarrassed to admit their children suffer from anxiety or depression and 58% said they would not tell anyone their child had attempted suicide.
What do service providers do?
And we do much more: One important fact that has been emphasized in the past decade is that mental health issues do not exist in a vacuum. The children, youth and families that are struggling with them are often also struggling with an array of problems - any one of which has the power to be devastating. Addressing a mental health issue often leads us to help people find housing, flee abuse, deal with crises, and find warm clothing. We “wrap around” the individual with a blanket of treatment and services.
Perhaps the greatest thing we have learned over the past decade has been that we can only lift up those who need us by standing on each other’s shoulders. Across the province you will find coalitions, partnerships, collaborations, networks and cross-sectoral initiatives the likes of which have never before existed.
Where do we stand?
We also stand at the edge of a precipice. Our next steps are precarious without additional investment and support. With such support bridges can be built and the children, youth, and families who so desperately need our help can be reached.
Cherry E. Murray, MSW, RSW
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Measuring the return on investments in child and youth mental health
“Both funders and donors are asking us to demonstrate how the work we do with families is having an economic impact on our community,” says Laura Dunlop Dibbs, a special projects manager at the Merrymount Children’s Centre. “However until recently, no measurement model existed.”
A new approach developed by researchers at McMaster University’s System-Linked Research Unit, coupled with a program evaluation grant from the Centre, has given Merrymount just the opportunity they were looking for. The $10,000 award allowed Merrymount to develop a powerful plan to determine if investments in community-based prevention and early intervention services produce both clinical benefits for families and economic benefits for the communities in which they live. The research project was launched in November 2006.
The System Service Utilization Model lays out a standard method to measure the cost of the full spectrum of Ontario social services a family uses, which may include income supports and emergency or crisis services. The Merrymount project is using the model to compare the overall cost of serving two randomly-assigned groups of at-risk families referred to the centre by the local Children’s Aid Society. The first group is receiving basic services, including one suitable support program and scheduled respite or flexi-care at specific intervals. The second group is receiving intensive interventions, which can include any combination of Merrymount services, but should include at least one from each of the agency’s four service categories: support and wellness, psycho-educational groups, family and child care and groups for school aged children. Recruitment for the three-year study is ongoing - the agency expects between 300 and 400 families to participate.
The goal of the evaluation is to determine if prevention and early intervention services produce positive outcomes for families and a net economic benefit for society as a whole. The cost effectiveness of the basic and intensive treatment approaches are being compared by adding up the total cost of social services used by each family and adjusting for the precise cost of the Merrymount services they received. By presenting the clinical impact of basic and intensive services alongside their economic effects, this approach will determine if bigger investments in more intensive prevention and early intervention services will result in proportionally greater economic benefits for the province.
According to Dunlop Dibbs, the results of the Merrymount study will likely have impact far beyond the London service area.
“We know that the economic impact study will have national benefits,” she said. “Having the clinical data to measure against the economic model will be both helpful and newsworthy for the social service and children’s mental health sectors.”
September means back-to-school and the Centre’s grants and awards program is in-sync with what is an important time of year for many people. The spectrum of education awards offered by the Centre ranges from those geared to all levels of college and university study, to those for the professional development of service providers and others working in the child and youth mental health and related fields.
In addition, the Dare to Dream Program provides funding for youth projects geared to raising awareness about mental health with their peers or in their communities. Although not exclusively a school-based program, many previously funded projects have taken place in schools. Dare to Dream applicants need mentors - and that could be you.
Upcoming deadlines for the grants and awards program …
For more information on 2007-2008 grants and awards, please visit our Web site at www.excellenceforchildandyouth.ca.
Coalition for Child and Youth Mental Health Information
Nine out of 10 parents of children with a mental health problem say they want more information to help them understand what is happening, and how to provide help and support effectively. Most don’t know where to find it. Many turn to their local library or the Internet, where they face an overwhelming array of information, little of it research-based and much of it conflicting. Information needs to be reliable, up-to-date and based on the best available evidence. A new partnership is looking to pool efforts to make sure resources are available to address these issues.
In early 2007, the Centre was instrumental in bringing together a number of partners, including the Offord Centre for Child Studies, Children’s Mental Health Ontario and ementalhealth.ca, to disseminate high quality information about child and youth mental health. Through this coalition, we look forward to pooling our expertise and minimizing duplication, to ensure that the information available to youth, parents, caregivers, service providers and others is accessible and of the highest quality.
“At Children's Mental Health Ontario, we're committed to ensuring that children and youth with mental health needs receive services and supports that are known to be effective. The shift to an evidence-based child and youth mental health system will require commitment and collaboration by many players, from researchers to frontline clinicians. We're excited to be at the leading edge of this very important transformation, working alongside our partners in the Coalition for Child and Youth Mental Health Information."
"eMentalHealth.ca, an initiative of the Crossroads Children’s Centre, is delighted to be part of the Coalition. Our online mental health resource directory helps connect children and youth to local mental health resources. Through the Coalition, families and professionals anywhere in Ontario will be able to access quality mental health information about issues such as suicide and depression, and also be able to find out where in their local community they can get help."
“The Coalition represents an exciting new framework for driving the process of knowledge mobilization. By partnering and combining our various strengths in knowledge creation, in service delivery and in advocacy, we will be positioned to influence decision-making at every level, from the choices made by consumers to clinical practice to provincial policy. The result will be to shorten the time it takes to turn knowledge into practice for the benefit of all children and youth.”
“The Centre is focused on building partnerships, sharing information and working towards a child and youth mental health system that makes more sense for children, youth, parents and caregivers, as well service providers. This Coalition is an example of how we can work together to put our priorities into action.”
Roots of Empathy’s mission is to build caring, peaceful, and civil societies through the development of empathy in children and adults. The program’s goals are:
The program focuses on a neighbourhood infant and parent who visit the same classroom every three weeks over one school year. Participating classrooms range from kindergarten to grade 8. A trained Roots of Empathy instructor coaches the students to observe the baby’s development and label the baby’s feelings. The instructor also visits the classroom before and after each family visit to prepare and reinforce teachings using a specialized curriculum with a lesson plan for each visit. There is a 639-page curriculum divided into nine themes, with three classroom visits supporting each theme for a total of 27 visits. Each theme is further broken down into four age ranges. The training and curriculum ensure that each classroom receives the same quality learning experience.
The program has reached more than 156,000 students across the country since it began in 1996. During the last school year, Roots of Empathy reached more than 18,000 children in 735 classrooms here in Ontario.
Results of independent research demonstrate the effectiveness of the program:
More information about Roots of Empathy is available on the Web site at www.rootsofempathy.org. The organization recently launched a program for preschool children called Seeds of Empathy. More information about that program is available at www.seedsofempathy.org.
According to Dr. Davidson, “Canada and its children and youth deserve a mental health system that allows them the best possible life trajectory. It must be built on solid evidence and address the full continuum of care, including mental health promotion and prevention, early identification, intervention, recovery, rehabilitation and continued care. The opportunities for improvement to our mental health services abound. Additional funding is required, but not to provide services in the same old way. I look forward to working with the many leaders across Canada to ensure that the mental health needs of our children and youth are given the attention they deserve.”
Tammy is available to answer your questions at 613-737-2297 or by email at firstname.lastname@example.org.
The Centre recently hosted meetings of youth, service providers and parents and advocates from around the world leading up to the International Initiative for Mental Health Leadership (IIMHL) conference in Ottawa. With representatives from the United States, Australia, New Zealand, Scotland, Ireland and Canada, the meetings focused on an exchange of knowledge and best practices in child and youth mental health. This was the first time this group invited youth and parents to be involved and only the second time child and youth mental health issues were explored. Opportunities for partnership and ongoing learning are likely to follow.
This has proven to be a winning partnership for the young artists and the Centre. The artists have a permanent installation of their work and the Centre has a constant image that reflects the vision of and for youth.