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Out of the Shadows at Last

Out of the Shadows at Last. Transforming Mental health, Mental Illness and Addiction Services in Canada. Out of the Shadows at Last. Final Report of the Standing Senate Committee on Social Affairs, Science and Technology Hon. Michael Kirby, Chair Hon. Wilbert Keon, Deputy Chair

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Out of the Shadows at Last

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  1. Out of the Shadows at Last Transforming Mental health, Mental Illness and Addiction Services in Canada PREPARED BY CHERRY MURRAY FOR MHWG TELECONFERENCE

  2. Out of the Shadows at Last • Final Report of the Standing Senate Committee on Social Affairs, Science and Technology • Hon. Michael Kirby, Chair • Hon. Wilbert Keon, Deputy Chair • www.parl.gc.ca • Released May 09th, 2006

  3. Chapter 6 Children and Youth PREPARED BY CHERRY MURRAY FOR MHWG TELECONFERENCE

  4. Overview • Introduction • Early Intervention • Shortage of C/Y MH Professionals • Inclusion of Youth and Family Caregivers in Treatment • Autism • Conclusion

  5. Introduction • Conservatively estimated that 15% of children and youth living with mental illness • 1.2 m young Canadians with anxiety, attention deficit, depression, addiction and other disorders • Failings of the mental health system affect them more acutely and severely

  6. Early Intervention • Importance cannot be overstated • Interventions must be sustained through the transitions in all stages of development

  7. The Pre-School Years • Two challenges: • Identify and provide services to children • Manage effectively the transition from early childhood to school

  8. School-Age Years • Importance of teachers having the necessary training to recognize better mh issues and help them find effective treatment • Development of the school as a site for effective delivery of mental health services is essential

  9. School-Age Years • Mental Health Screening • Strongly supportive but mindful of roadblocks • Legal roadblocks • Practical roadblocks • Stigma and Discrimination • Conclusion: No screening at this time

  10. School-Age RECOMMENTATIONS: • RECOMMENDATION#16 • That School boards mandate the establishment of school-based teams made up of social workers, CYW’s and teachers to help family caregivers navigate and access the mh services required and that these teams make use of a variety of treatment techniques and work across disciplines

  11. School-Age RECOMMENTATIONS: • RECOMMENDATION #17 • That mh services be provided in the school setting by the school-based mental health teams • That teachers be trained to be involved in early identification of mh • That teachers be given the time and practical resources and supports necessary to take on this new role

  12. School-Age RECOMMENTATIONS: • RECOMMENDATION # 18: • that students be educated in school about mh and its prevention and educators develop promotion campaigns (to reduce stigma and discrimination

  13. Post School – Transition to Adulthood • Recommendation #19: • That governments work to eliminate legislative and other silos that inhibit their ability to deal in appropriate fashion with transition.

  14. Post School – Transition to Adulthood • Recommendation #19 (cont:) • Determine age cutoffs for children and youth by clinical rather than other considerations • Where age cutoffs are employed link services and avoid gaps of time where not eligible

  15. Child and Youth issues • Mental health system is: • Fragmented and under-funded • Interventions are delayed • Critical shortage of professionals • Young people and families not being involved in workable, long term solutions

  16. Shortage of Professionals • Only 10 trained child psychiatrists a year • Shortages of other mh professionals who specialize in c/y • Unacceptable waiting times

  17. Shortage of Professionals • Transition Measures • Sharing Existing Resources—Tele-psychiatry • Emphasizing Alternative Treatment Modals—Group Therapy • Working Cooperatively—Case Conferencing

  18. Recommendation # 20 • That provincial and territorial governments coordinate mental health and social services, and pay particular attention in this regard to ensuring that age cut-offs for social services for children and youth be synchronized with those established for mental health services.

  19. Recommendation # 21 • That governments take immediate steps to address the shortage of mental health professionals who specialize in treating children and youth.

  20. Recommendation # 22 • That tele-psychiatry be employed both for consultations and for the purposes of education and training of health professionals who work in rural and remote areas.

  21. Recommendation # 23 • That standardized, evidence-based group therapies be used, where clinically appropriate, to reduce wait times for children and youth who need access to mental health services.

  22. Recommendation # 24 • That provincial and territorial governments encourage their health, education and justice institutions to work closely together in order to provide seamless access to mental health services for children and youth. • That greater use be made of case conferencing so as to coordinate and prioritize mental health service delivery to children and youth.

  23. Inclusion of Youth and Family Caregivers in Treatment • It is important to include children and youth and family caregivers at every stage of the process • Shifting to this model of service delivery will require a change in mindset to suit the needs of clients and not service providers.

  24. Recommendation # 25 • That evidence-based family therapies be employed so that all family members are provided the assistance they need. • That professionals interacting with C/Y with mh illness be offered training opportunities to ensure they can properly address the mh needs of their younger clients. • That family-based treatment of mental illness be integrated into the curriculum of mh professionals and primary care physicians.

  25. Recommendation # 25 (cont.) • That professionals interacting with family caregivers be compensated for this time, in addition to the time spent with the young person living with mental illness. • That all practitioners working with children and youth be trained in children’s rights.

  26. Autism • Sharply divergent views on what autism is and how mental health system should respond to it. Ranges from: • ‘Autism is an illness’ that left untreated will have serious consequences for affected individuals and their family. IBI is only effective tx. • Autism is not a mental illness’ – what is needed is accurate and unbiased information • Committee recognized that family caregivers are struggling emotionally and financially. • Concluded committee is not well placed to make recommendations at this time.

  27. Other Relevant Recommendations • # 1: that a uniform age at which youth are deemed capable to consent be established. • #9 That the government of Canada create a Mental Health Transition Fund to accelerate the transition to a system in which delivery of mh services and supports is based predominantly in the community • #12 that a Basket of Community services that have demonstrated their value in enabling people living with mh … to live meaningful and productive lives in the community be eligible for funding through the MH Transition fund.

  28. Other Relevant Recommendations • # 13 …That the Knowledge Exchange Center to be established as part of the Canadian MH Commission (chapt. 16) actively pursue the promotion of best practices in the development and implementation of collaborative care initiatives. • #14: that initiatives designed to make respite care services more widely available to family caregivers and d better adapted to the needs of individual clients…be eligible for funding through the MH Transition Fund. • Chapter 11: Various recommendations for more funding of research. • # 107: That a Canadian MH Commission be established and that it become operational by 1 Sept 2006

  29. Other Relevant Recommendations • # 111: That the Basket of Community Services component of the MH Transition Fund average $215 million per year over a ten year period for a total of 2.15 billion. • # 113: that the Govt.. include as part of the Transition Fund $50 million per year to be provided to provinces and territories for outreach, treatment, prevention programs, and services to people living with concurrent disorders. • # 114: that the Govt.. provide the provinces and territories with $2.5 million to help them move forward with their plans for telemental health. # 116: that the Govt. commit $25 million per year for research • # 117: that the Govt.. raise the additional revenue needed through raising the excise duty on alcoholic beverages by 5 cents a standard drink.

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