Supporting Transitions: Institutional and Rural Community Care

1. This research is funded by Alberta Health Services and Alberta Seniors and Community Supports as part of the Collaborative Research Grant Initiative: Mental Wellness in Seniors and Persons with Disabilities. Supporting Transitions: Institutional and Rural Community Care David Nicholas, Linda Kreitzer, Anne Marie McLaughlin, Grace Elliott; University of Calgary, Faculty of Social Work Stockholm Sweden, July, 2012 TRANSITION RESEARCH ACROSS COMMUNITIES This research is funded by Alberta Health Services and Alberta Seniors and Community Supports as part of the Collaborative Research Grant Initiative: Mental Wellness in Seniors and Persons with Disabilities.

2. International Issues Deinstitutionalization movement . UN Rights of the mentally ill to protection and care - 1991 World Health Organization reports – 2001, 2005, 2011. European Commission - 2009 Canadian National Mental Health Plan – Launched May 2012 – Changing Directions, Changing lives.

3. Map of Alberta

4. The Issue: Community Perspective High utilization rates for specialized institutional care; centralized services in urban centres Economic climate: fiscal resources scarce, threats of bed closures, community anxiety around services High profile cases of failed services: support workers killed by group home residents Lack of attention to special needs population.

5. Study Aims • To identify challenges for persons with mental illness and developmental disability as they navigate the transition from institutional to community care (and vice versa) • To examine particular challenges for rural and remote regions regarding service access • To consider strategies for improved access and coordination of mental health and developmental disability services in Alberta.

6. Research process • Focus groups (10) • Community and institutional service providers • Interviews (17) • Individuals with mental illness and developmental disability • Family/informal caregivers • Delphi consultation • Knowledge translation

7. Complexity of demands: Tenuous Balance Community relationships Individual Hospital Caregivers/ Family Helping professionals Education Training Development Support/respite

8. Rural Obstacles Underfunding: consider isolation, distance, weather Limited services/multiple roles/ multiple demands No continuum of care: “just move to the city” Burnout results in service breakdown (families and other providers) Lack of specialized training Staff shortage and high staff turnover Communication barriers: FOIP Inappropriate placements (long term care facilities) Lack of integrated care

9. Implications Raise awareness of high needs, underserved , unique population Human rights issue: promotion of just and safe communities Adequate supports imperative for both hospital and community care (not either/or) Need for seamlessness transitions in and out of care (free flow of communication) Specialized staff and caregiver training and development

10. Key Conclusions New model flowing from research: Base of acceptable care for all geographical areas Community mediation/dialogue Core concurrent competencies Broader view of “circle of care” Community education and capacity building

11. Thank You • For more information please contact Dr. Linda Kreitzer, University of Calgary, Faculty of Social Work • lkreitzer@ucalgary.ca