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Strongest Families BC

Strongest Families BC. CMHA BC Division. October 4 & 5, 2011. Disruptive Behaviour - Prevalence. 4 to 6 of every 100 children meet clinical severity for a behaviour disorder , including: A ttention-deficit/hyperactivity Oppositional defiant disorder

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Strongest Families BC

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  1. Strongest Families BC CMHA BC Division October 4 & 5, 2011

  2. Disruptive Behaviour - Prevalence • 4 to 6 of every 100 children meet clinical severity for a behaviour disorder, including: • Attention-deficit/hyperactivity • Oppositional defiant disorder • Above are often pre-cursors of Conduct Disorder • Estimated 30,000 to 40,000 children in BC are affected. If milder conditions are included, the number is much larger. • MSP data reveals that 13,698 GP visits were related to behaviour problems in children aged 0 to 14 years in the 2009/10 year

  3. Disruptive Behaviour – The Impact • Without intervention, there is an increased likelihood of: • academic difficulties, • developmental delays, • rejection by peers, • delinquency and justice system involvement, • harmful substance use • Early intervention can mitigate problems that otherwise persist into adolescence and adulthood • Access to evidence-based interventions is limited and there are barriers to treatment (specialist shortage, stigma, travel)

  4. Strongest Families BC – Support for Physicians • Family doctors first point of contact for parents and caregivers • GPs now have referral access to Strongest Families which offers an effective, home-based intervention program for their patients • Priority access given to GPs participating in the PSP CYMH training • Strongest Families is delivered via telephone and hence, available to families in rural and remote locations • Delivered in partnership with Strongest Families Institute in Nova Scotia

  5. The ProgramDeveloped by Dr. Patrick McGrath, IWK Centre, Nova Scotia

  6. Strongest Families BC – The Model • Parenting the Active Child is a 12-session parent-mediated program for disruptive behaviour in children aged 3 to 12 • Parents are supported by a telephone coach to apply effective behaviour management strategies in the home • Outcome data from Nova Scotia show very strong improvement in child and family functioning • Results for the telephone delivered intervention are comparable to face-to-face parent training programs for behavior disorders • The delivery model shares characteristics with Bounce Back, although offers a more intensive intervention * Footnote

  7. Characteristics Minimum BA level Intensive training program Excellent communication skills Bright, capable, personable Ability to problem solve Role Guide families through modules Track progress Encourage and support Problem-solve Ensure compliance Supervised by health care professional Calls recorded for quality assurance Follow risk management protocols Strongest Families Coaches

  8. Strongest Families Post-Treatment Satisfaction Ratings (n = 157)

  9. Strongest Families – Referral Criteria • Inclusion • Age 3 to 12 • Exhibits disruptive, defiant, oppositional behaviour and/or attention deficits • Ongoing problem • Symptoms mild to moderate • Exclusion • Autism spectrum disorder; early psychosis • Significant intellectual impairment • Severe symptoms

  10. Referral Mechanism • Complete standardized Strongest Families Referral form • Provide parents/caregivers with the patient brochure • Fax Referral to CMHA – BC Division • Fax # 1-877-688-3270 • Package of referral forms and brochures will be sent to your office next week

  11. Strongest Families - What to Expect • Once referral is made, parent/caregiver contacted within 72 hours • Telephone assessment using the Brief Child and Family Phone Interview (BCFPI) • Coaching sessions set up to accommodate family schedule • Brief notes to GP on initiation of program, mid-treatment, end of treatment

  12. Strongest Families For More Information Contact: Strongest Families Coordinator Canadian Mental Health Association Ste 1200 – 1111 Melville Street Vancouver, BC V6E 3V6 Tel: 1-855-297-4777 With funding from the Province of British Columbia

  13. Referral Mechanism • Complete standardized Strongest Families Referral form • Provide parents/caregivers with the patient brochure • Fax Referral to CMHA – BC Division • Fax # 1-877-688-3270 • Package of referral forms and brochures will be sent to your office next week

  14. Strongest Families - What to Expect • Once referral is made, parent/caregiver contacted within 72 hours • Telephone assessment using the Brief Child and Family Phone Interview (BCFPI) • Coaching sessions set up to accommodate family schedule • Brief notes to GP on initiation of program, mid-treatment, end of treatment

  15. Strongest Families For More Information Contact: Strongest Families Coordinator Canadian Mental Health Association Ste 1200 – 1111 Melville Street Vancouver, BC V6E 3V6 Tel: 1-855-297-4777 With funding from the Province of British Columbia

  16. Ministry Health Services for Children and Youth Debbie Saari

  17. The Child and Youth Mental Health & Substance Use Service System in BC Debbie Saari, Director MCFD Child & Youth Mental Health October 4 & 5, 2011 <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>0,0,0</gridFillColor><gridOpacity>100%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Blue</insertObjectUsingColor><showResults>Yes</showResults><teamColors>User Defined</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>Slides with Get Feedback Objects</showControlBar><defaultCorrectPointValue>100</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName><AutoRec></AutoRec><AutoRecTimeIntrvl></AutoRecTimeIntrvl><chartVotesView>Percentage</chartVotesView><chartLabelsColor>0,0,0</chartLabelsColor><isChartLabelColorKnownColor>True</isChartLabelColorKnownColor><chartLabelColorName>Black</chartLabelColorName><chartXAxisLabelType>Full Text</chartXAxisLabelType></Settings> <?xml version="1.0"?><AllAnswers />

  18. The Child and Youth Mental Health & Substance Use Service System in BC Outline • Importance of children’s mental health • History • Context • MCFD CYMH Services • Referral and Intake Process • Regional Team Discussions

  19. The Child and Youth Mental Health & Substance Use Service System in BC Importance of the mental health of children and youth • Early mental health contributes to future health, productivity, and responsible citizenship. • Working together and using resources effectively can lead to improved outcomes for children and youth.

  20. The Child and Youth Mental Health & Substance Use Service System in BC 1 in 7 children are likely to have a mental disorder • BC - estimated130,000 children and youth under 19 with mental health disorders • 3/4 of all those with mental health disorders have onset by age 24

  21. The Child and Youth Mental Health & Substance Use Service System in BC A Continuing Challenge From: A Review of Child and Youth Mental Health Services in BC (2008)

  22. The Child and Youth Mental Health & Substance Use Service System in BC • CYMH Plan (2003-2008) • Some highlights: • First of its kind in Canada • Based on consultation and research evidence • Investment in human resources • Evidence based interventions • Aboriginal CYMH plans • Information management system

  23. The Child and Youth Mental Health & Substance Use Service System in BC Current Context British Columbia: The 10 -Year Plan Canada: Mental Health Commission of Canada

  24. The Child and Youth Mental Health & Substance Use Service System in BC A Population Health Approach

  25. The Child and Youth Mental Health & Substance Use Service System in BC Collective Action A System of Care

  26. The Child and Youth Mental Health & Substance Use Service System in BC A Tiered System: Tier 5 - e.g., BCCH, Maples Tier 4 - e.g., CYMH teams, Psychiatrists, Paediatricians, Tier 3 - e.g., Primary Care, School Counsellors, Public Health Tier 2 - e.g., community group leaders, coaches, religious/spiritual supports Tier 1 – e.g., family, friends, self-help Low High Number of children and youth Costs/ Service Intensity High Low

  27. The Child and Youth Mental Health & Substance Use Service System in BC MCFD CYMH Services • Community-based Child and Youth Mental Health teams • Maples Adolescent Treatment Centre • Youth Forensic Psychiatric Services

  28. The Child and Youth Mental Health & Substance Use Service System in BC MCFD CYMH Teams & Services • Continuum of mental health promotion, prevention of mental disorders and treatment for mental health problems and disorder • Promotion – Health literacy initiatives • Prevention – FRIENDS • Treatment – evidence based interventions • Multi-disciplinary approach • Treatment and Support services include intake, assessment, treatment, and clinical consultation.

  29. The Child and Youth Mental Health & Substance Use Service System in BC Accessing MCFD CYMH Services • Open and voluntary referral. • Initial screening for urgency. • Strive for best fit of resource for the identified needs. • Demand vs. capacity.

  30. The Child and Youth Mental Health & Substance Use Service System in BC CBIS handouts From: A Review of Child and Youth Mental Health Services in BC (2008) A continuing challenge ...

  31. The Child and Youth Mental Health & Substance Use Service System in BC From: A Review of Child and Youth Mental Health Services in BC (2008)

  32. The Child and Youth Mental Health & Substance Use Service System in BC Reminder : • A number of resources available, such as CHARD, that can assist with system navigation • CHARD Clicker question: • Check the material and resources at presenter tables • Discuss/share local/regional information during networking Regional Team Discussion Groups Will start the process of acting locally by working within your regional team discussion groups. Here are the questions ….

  33. The Child and Youth Mental Health & Substance Use Service System in BC Regional Team Discussion Groups • What would be the ideal scenarios for giving or receiving expert consultation from the point of view of a GP? A specialist? A school counsellor? A community group? (10 min) • What is currently working well for you in giving or receiving expert consultation or referral? (10 min) • If you had to pick 1-2 areas to improve in your current referral or consult process what would they be? (10 min) • What are some areas that you feel your group could work on in this area? What would be the first step in this process? (10 min)

  34. Closing Notes for the Day Dr. Ellen Anderson

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