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CLINICAL APPLICABILITY AND

CLINICAL APPLICABILITY AND COMMUNITY CAPACITY BUILDING IN SUBSTANCE USE AND MENTAL HEALTH EDUCATION. Presented by: Debora Steele, RN BScN C.P.M.H.N.(C) GNC(C), Providence Care Mental Health Services Jennifer Barr, B.A., CAMH Healthy Aging Project Lead Centre for Addiction and Mental Health.

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CLINICAL APPLICABILITY AND

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  1. CLINICAL APPLICABILITY AND COMMUNITY CAPACITY BUILDING IN SUBSTANCE USE AND MENTAL HEALTH EDUCATION Presented by: Debora Steele, RN BScN C.P.M.H.N.(C) GNC(C), Providence Care Mental Health Services Jennifer Barr, B.A., CAMH Healthy Aging Project Lead Centre for Addiction and Mental Health

  2. Conflict of Interest Declaration • CAMH led project – quantitative and qualitative evaluation results • Collaborative agreement with P.I.E.C.E.S. Consult Group

  3. Developing Training and Education Resources “Making the Connection Work: Identification and Support for Older Adults with Substance Use and/or Mental Health Problems” • A one-day community based workshop

  4. Training Description • Developed and piloted by the Centre for Addiction and Mental Health in partnership with P.I.E.C.E.S. Consult Group • Target audience for this training is Ontario professionals working with older adults in a variety of roles, as well as those in the addiction and mental health fields.

  5. Training Team • Integral to this training is the model of an older adult addiction specialist teaming up with a Psychogeriatric Resource Consultant as co-facilitators.

  6. Ontario older persons specific addiction programs • COPA (Toronto) • LESA (Ottawa) • Sister Margaret Smith (Thunder Bay)

  7. Content of the Workshop • Information on older adults with mental health issues &/or substance use • Integrates a P.I.E.C.E.S. approach • Community capacity building component

  8. Alcohol is still most common problem substance As people get older they become more sensitive to the effects of alcohol and may be more vulnerable to alcohol’s negative effects Injuries due to falls Liver disease Can worsen: Diabetes Heart disease or elevated BP Stomach problems Mental Health Issues Alcohol Issues

  9. Illicit Drugs - The Next Generation • 44.5% of Canadian have tried marijuana in their lifetime. • Important fact is that drug use as a whole has increased in the last decade. • Are we screening for it? Older Adults are still largely not seen as users. • Beginning to see use of drugs like crack cocaine in men 55+ -- homeless and marginally housed

  10. Prescription Medication Misuse • Benzodiazepines • Sedatives/Sleep • Analgesics/Opiates

  11. Confusion Depression Disorientation Unsteady gait/falls Recent memory loss Loss of interest in activities Social isolation Tremors Irregular heart rate Poor appetite Stomach complaints Signs of Aging or an Alcohol/Drug Problem?

  12. Personal Barriers: Shame Guilt Stigma Uncertainty about the process Accessibility Attitudes: Societal Family Health Cultural Health Prof. Health Status Barriers to Treatment

  13. Best Practices • Recognizes that isolation and on-going losses are risk factors for addictions • Is client-centred & older adult specific • Utilizes outreach services • Takes a harm reduction approach • Is flexible, non-threatening, unhurried • Addresses basic living needs

  14. Best Practices • Addresses socio-cultural differences • Demands collaboration among treatment and health care professionals

  15. Key Approaches • Go to where the client is at physically, mentally and emotionally • Assess stage of change • Employ principles of harm reduction

  16. Putting the P.I.E.C.E.S. ...Together Physical Cornerstones Intellectual of the Emotional P.I.E.C.E.S. Capabilities philosophy Environment of care Social/ Cultural

  17. Goals ofP.I.E.C.E.S.Learning Initiative: To provide: • a common vision and set of values • a common language and knowledge for communicating across the system • a common yet comprehensive approach for thinking through problems

  18. 3-Question P.I.E.C.E.S. Template • Q. 1 What has changed? • Avoid assumptions; think atypical. • Q. 2 What are the RISKS and possible causes? • Think P.I.E.C.E.S. • Q. 3 What is the action? • Investigations • Interactions • Information

  19. Community Capacity Building • Understanding the Problems and Identifying Stakeholders • Building Community Capacity • Leveraging Resources • Follow-Up

  20. Evaluation • Three-month post-event evaluation of first pilot training has shown that participants are able to recall and have applied concepts that they have learned in the training to their clinical practice. • Of 43 participants tested after the second pilot 15 reported they were “quite likely to” and 21 “definitely will” implement some of the things they learned in the workshop into their work/practice.

  21. Promotion and Roll Out • To all Ontario Communities (Fr & Eng) • Promoted to PRC’s and CAMH Project Consultants • Presentation Kit includes • Sample Agenda • Presentation Slides • Training exercises and case studies • Promotional flyer • Budget template • Letter of Agreement

  22. For more information: Jennifer Barr CAMH Healthy Aging Project Centre for Addiction and Mental Health Tel. 613 256 1397 Jennifer_Barr@camh.net

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