Making a Difference by Making Connections

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MAKING A DIFFERENCE BY MAKING CONNECTIONS A CURRICULUM TO ADDRESS CO-OCCURRING DOMESTIC VIOLENCE, MENTAL HEALTH AND SUBSTANCE USE PROBLEMS Robin Mason PhD and Susan O’Rinn

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Making a Difference by Making Connections. A Curriculum to Address Co-Occurring Domestic Violence, Mental Health and Substance Use Problems . Robin Mason PhD and Susan O’Rinn. The Connections. - PowerPoint PPT Presentation

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Page 1: Making  a Difference by Making  Connections

MAKING A DIFFERENCE BY MAKING CONNECTIONS

A CURRICULUM TO ADDRESS CO-OCCURRING DOMESTIC VIOLENCE, MENTAL HEALTH AND SUBSTANCE USE PROBLEMS

Robin Mason PhD and Susan O’Rinn

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THE CONNECTIONS

• Worldwide, nearly one third (30%) of all women who have been in a relationship have experienced intimate partner violence (Garcia-Moreno & Pallitto, 2013)

• >50% women who experienced IPV developed a mental health problem (Junior & Janson, 2008)

• 2/3 of those who experienced ‘severe’ IPV had 1 or more diagnosed mental health disorder (Roberts et al 1998)

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THE CONNECTIONS

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THE CONNECTIONS

• Substance use is associated with increased risk of IPV (Timko et al 2008; Martino et al 2005; El-Bassel et al 2005)

- 25-57% of women in substance treatment programs experienced DV

• IPV associated with increased risk of substance use (Ackerman et al, 2007; Greaves et al, 2011; Wingood et al, 2000)

• 67% of women with substance use problems have a co-occurring mental health problem (e.g. PTSD, depression, anxiety) (Sullivan & Holt 2008)

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CURRICULUM OBJECTIVE

To improve the knowledge, skills and influence the behaviour of frontline providers who care

for women who experience co-occurring domestic violence, mental health and/or

substance use problems.

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STEPS IN CURRICULUM DEVELOPMENT• 14 Regional Round Tables (taped, transcribed,

analyzed for common themes)

• Literature Review (Academic & grey literature reviewed for training/education, existing curricula, best practices, treatment modalities)

• Advisory Committee (experts from each sector including women with “lived experience”)

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EVIDENCE INTO COMPETENCIES

Learning

DOING

Practicing

CollaboratingKnowingManaging

Understanding

Referring

Communicating

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CURRICULUM LAUNCH SPRING 2012

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CURRICULAR ELEMENTSText Manual (six chapters)Six Interactive Online Modules (& videos)Online Discussion ForumFull Day, Cross-Sectoral WorkshopNewly Added: Module on Organizational Change Management

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DATA COLLECTION

Demographic Pre-TestWorkshop EvaluationPost-Test (~ 3 months)

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WORKSHOP/PARTICIPANT INFO (SEPT 2012 – APR 2014)

34 Workshops781 Participants

~ 23 participants/workshop Data from the first 24 workshops

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PARTICIPANT DEMOGRAPHICS (n=492)

VAW Shel-ter

VAW Counselling

Mental Health

Susb-tance Use

Dual Roles

Other

Profession

VAW ShelterVAW CounsellingMental HealthSusbtance UseDual RolesOther

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PARTICIPANT DEMOGRAPHICS (n=492)

Years of Experience

< 56-1516+

Age

20-3940-5960+Missing

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PARTICIPANT DEMOGRAPHICS (n=492)

Prior Education

YesNo

Confer

ence

Work

place

Schoo

l

Self S

tudy

Other

Missing

0

50

100

150

200

Type of Training

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PARTICIPANT DEMOGRAPHICS (n=492)

Policy or Protocol?

YesNoMissing

Treat;Refer;Combination

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PRE & POST (n=253)

PRE POST

KNOWLEDGE dfP

ValueWhich of the following is generally not considered a determinant of health? 147 63 197 48 1 0.00* **

Legal substances, specifically alcohol and tobacco, cause more harm to women than do illegal substances 201 49 230 22 1 0.00* **

What % of Canadian women over age 16 have experienced at least one incident of physical or sexual violence? 131 121 168 81 1 0.00* **

According to Ontario's DVDRC, which of the following is not a common risk factor for lethal violence? 91 135 167 75 1 0.00* **The most social criticism and stigma is directed at: 150 82 197 44 1 0.00* *** sig < 0.05; ** sig < 0.001

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PRE & POST (n=253)

PRE POST

KNOWLEDGE dfP

Value

Pregnant women who are heavy substance users should be encouraged to immediately stop using 211 34 237 15 1 0.00* **

Which of the following is not a good strategy to use when helping a women manage signs of dissociation? 206 34 233 15 1 0.00* **

Working with women who have experienced DV, mental health and/or substance use problems can result in: 60 190 97 156 1 0.00* **Which of the following is not part of the Stage of Change Model? 223 18 240 11 1 0.02*How many Canadians will personally experience a mental health problem at some point during their life? 216 33 231 22 1 0.01*

* sig < 0.05; ** sig < 0.001

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PRE & POST (n=253)

PRE POST

KNOWLEDGE dfP

ValueDomestic violence always precedes mental health or substance use problems 237 15 232 20 1 0.24

Mental health or substance use problems may increase the risk of domestic violence 244 9 245 5 1 0.07

In the context of mental health, a 'trigger' refers to: 99 149 107 145 1 0.40

Which of the following is not a factor in considering the immediate safety of a woman experiencing DV? 203 31 219 30 1 0.27

* sig < 0.05; ** sig < 0.001

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PRE & POST (n=253)

PRE POST

COMPETENCE dfP

ValueI understand the ways in which DV, mental health & substance use problems are interconnected 176 71 246 6 1 0.00* **

I can initiate a conversation, ask questions about, and appropriately refer a woman who has experienced DV, mental health and/or substance use problems 201 47 247 4 1 0.00* **

I can respond to crises related to DV, mental health and/or substance use 197 50 242 9 1 0.00* **

* sig < 0.05; ** sig < 0.001

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PRE & POST (n=253)

PRE POST

COMPETENCE dfP

ValueI can help a woman manage her distress even if she begins to dissociate while talking to me 151 96 229 21 1 0.00* **

I can outline the steps to building useful organizational partnerships 134 112 224 27 1 0.00* **

I can recognize the signs of burnout or compassion fatigue and have strategies for self-care 212 36 248 4 1 0.00* **

* sig < 0.05; ** sig < 0.001

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PRE & POST (n=253)

AS A RESULT OF THIS TRAINING:

93% of participants are "better equipped to identify DV, mental health and/or substance us problems“

94% of participants are "better equipped to provide appropriate supports to women who experience DV, mental health and/or substance use problems"

95% of participants have "increased knowledge about DV, mental health and/or substance use problems"

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PRE & POST (n=253)

AS A RESULT OF THIS TRAINING:94% of participants have "increased knowledge about the ways in which DV, mental health and/or substance use problems co-occur"

91% of participants have "greater familiarity with local referral networks, resources and services for women who experience co-occurring DV, mental health and/or substance use problems“

88% of participants have "made linkages among individuals across different sectors/professions"

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ACKNOWLEDGEMENTS

We gratefully acknowledge the contributions of :Advisory Committee memberFacilitators and co-facilitators of the workshopsWorkshop participantsMeaghan Morris for data support