Changing the landscape for student mental health
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Transcript of Changing the landscape for student mental health
Changing The Landscape for Student Mental Health: The Case of the Mobile Mental Health Team Karen Cornies, Phd – Redeemer University College Louisa Drost – Mohawk College Su-Ting Teo, MD – Ryerson University
Challenges for Student’s Who Need Mental Health Services The origins of mental disorders are in childhood and adolescence (Kessler
et al., 2005)
Graduates of child and adolescent services “aging out”
Young people with emerging mental health problems can fall between the gaps between child and adolescent services and adult services, which can delay receiving appropriate intervention (Department of Health and Ageing 2005)
Left undiagnosed and unchecked these disorders can have a worsening course in affected persons for decades
“Service system is weakest where it needs to be strongest”
Transition more complex for students who require more intensive services
Severe
Moderate/Mild
Mild
Students with Mental
Illness/Marked Distress
Distressed Students
All PSE Students
Mental Illness Addictions Prevention
Short Term Support/Treatment
Mental Health Promotion Enhance Resilience/Life Skills
Responsible Risk Taking
Mental Health Needs of Students in Post Secondary Institutions
Campus Challenges Global Burden of Disease
Brain Development Brain development is significant from puberty through mid 20s
Today’s Student Impacts PSE Wellness Staff
Increased stress managing a complex, crisis oriented caseload
Counselling is not meant as a long-term therapy relationship
Back log/wait times in services
Staff stress managing complex, crisis oriented caseload resulting in case manager function
Need for clinical supervision
Service demands exceed service delivery models resulting in campus treatment facility for students
Increase risk and liability on institution give high risk profile
Context – brief, SF, skill based practice; career/academic
counselling
Lack of community referral sources
Lengthy wait times for outpatient
services
Increased stress managing a
complex, crisis oriented caseload
Impact of Students in Crisis to Institution
Student in crisis
Counselling
Security
EMS/Police
Instructors SSA’s
Manager
Risk Team
Current Challenges with Services for Post Secondary Students
Post Secondary Community Supports
Hospital
The Ideal Health Service System for Post Secondary Students
Post Secondary Community Supports
Hospital
MHCC Executive Summary on Emerging Adults
Shifting Perspective
There are well over 50 community partners working with youth and/or working with people with mental health and addictions concerns in Hamilton. The
evidence base
Draft model
Community partners consultation
Revise model
Youth feedback
process of developing a model
Less intensive mental and/or addiction services Less intensive youth services
More intensive mental and/or addiction services Less focus on youth
Less focus on Mental Health and Addiction Services More Intensive Services for Youth
Most intensive mental and/or addiction services Intensive services for youth
Benefits of Community Collaborations
Streamlined referral system Increased communication between Post Secondary, health, and
community stakeholders
Shared responsibility for care
Increased awareness for student mental health needs. Collaboration strengthens working relationships between PSE and
community partners
Youth centred care resulting into successful effective practice
A Sustainable Community of Practice!
Goal in the Hamilton Model
The Youth Wellness Centre seeks to lay the foundation for a clinical program aimed at reducing psychiatric morbidity through early identification and treatment that is: Efficient
Evidence-based
System linked
Youth-based
Designing a Youth-Centred Model
Youth Participation Peer Support
Family Support Accessible
Tech-friendly
Model Chosen
The YWC will provide two main services:
Early Intervention: For youth struggling with mental health and addiction difficulties. This includes the mobile team engaging youth on campus.
Transition Support: For youth transitioning from PSE Services to community and adult mental health and addictions services.
How Have We Operationalized these Ideas and input? Youth Wellness Centre is co-located in downtown Hamilton with
Alternatives for Youth (addictions).
The YWC will serve youth ages 17 to 25, and will remain involved with youth for up to 3 to 5 years.
Participate in the Hamilton Community Protocol on Violence Threat Risk Assessment.
Raise awareness of mental health and addictions issues through education and outreach at Post Secondary Schools.
Build capacity for youth-centered care within St Joe’s mental health and addictions program.
Key Lessons in Collaboration and Service Needs • For psychosis, a system of early intervention services exists • Policy and reform documents highlight the need and a need of increasing
priority An Early Intervention service should: • Raise awareness of mental health issues • Have a distinct clinical identity that is friendly to youth and their families • Provide multi-modal treatments across the biopsychosocial spectrum • Be involved for medium to long term (2-5 years) • Evaluative/Research Capacity
The Mobile Wellness Team
Substance Counselling
Peer with lived experience
Mental Health Nurse
Therapist
Family Care Coordinator
https://youtu.be/KSc8Ha02VTE
Challenges for Post Secondary Sector
Who are the stakeholders? How do you start the conversation Role overlap and role confusion Competing factors between community
hospitals/health and PSE
Evaluation
Evaluation: YWC will provide • Screening (GAIN-SS and GAIN-Q3)
• Assessment (GAIN-I)
• Early Interventions (DBT Skills, online, face-to-face CBT, peer support, family education)
• Transition support to SJHH and community programs
• Mobile outreach
• Ongoing monitoring of outcomes
• Pre and Post measures for shared groups
Progress To Date
Launched March 16, 2015 over 40 referrals - the majority (aprox 40%) self-referrals
Youth Council launch in May
Mobile Team—service at PSE has started. Marginalized youth strategy in planning phase.
Coordination of Youth MHA initiatives across the LHIN, including Niagara via the Region’s Mental Health Program
Where To Start in Your Community
Implementation through community discussions Proposals to Fund Initiative Engaging youth with lived experience, through a youth
council to support creation of the model Youth Leadership roles
Emerging Model
Campus Groups: a Postsecondary Schools, Community Services, and Hospitals partnership for Substance Use/ Addictions
Mental Health Innovation Fund – Ministry of Training, Colleges, and Universities
Collaboration between Ryerson University, OCAD University, and George Brown College AND LOFT Community Services AND CAMH, Hospital for Sick Children, and St. Michael’s Hospital
Components of LOFT’s TAY Addictions Campus program Weekly
psychiatrist
Trained peer mentors Specialized Addiction
program – evening groups on campus
Supportive Housing- low, med
, high support
Timely tight referral to community / hospital
resources
Care coordination pilot through Health Links
Students from Ryerson University
George Brown College OCAD University
Crisis phone/text 24/7
Staffing Mon-Fri 9am-9pm
Sat: 1-9pm
Groups and recreational
activities
Acceptance and
Commitment Therapy
Partners and Roles Partners Roles PSE: George Brown College, OCAD University, Ryerson University
- Referral of students - Shared/ collaborative care - Sites for treatment groups
LOFT Community Services - Case management - Group facilitation - Train and support peer mentors - Crisis phone/ text 24/7 - Housing supports - Recreational activities
Hospital for Sick Children - Consultation to LOFT staff on Acceptance and Therapy model
Centre for Addictions and Mental Health - Evaluation Framework - Urgent Care Clinic – psychiatrist access
St. Michael’s Hospital - Access to weekly psychiatrist
Take Home Messages
The system as a whole needs to be able to actively monitor individuals at risk and focus on preventing first episodes or relapses as well as treatment.
Partner with community agencies, primary care, schools, and other key stakeholders is critical to success for youth.
Talk to you LHIN or equivalent about funding/grants to begin your community of practice.
Consider delivery of services in the most convenient location and least intrusive manner with the mobile team.
Service Assessment Tool for Post-Secondary Student Mental Health Concurrent Session Eight | 75 Minute
Interactive Session 4:45PM – 6:00PM East Meeting Room 1
Questions or Comments?
Questions for us?
These are conversations that we need to continue as a CACUSS community to “think outside the box” to service student
What do you see as possible challenges with teams?
What have you tried in your community?
What are your concerns?