Connecting the Dots: Connecting the Dots · Connecting the Dots: Summary and Conclusions • Public...

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Connecting the Dots: Connecting the Dots How Ontario Public Health Units are Addressing Child and Youth Mental Health July 10 th , 2013, 1:00 - 2:30 PM

Transcript of Connecting the Dots: Connecting the Dots · Connecting the Dots: Summary and Conclusions • Public...

Page 1: Connecting the Dots: Connecting the Dots · Connecting the Dots: Summary and Conclusions • Public health units are undertaking a large number and wide spectrum of activities to

Connecting the Dots:

Connecting the Dots

How Ontario Public Health Units are Addressing

Child and Youth Mental Health

July 10th, 2013, 1:00 - 2:30 PM

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Connecting the Dots:

Agenda

• Review report findings

• Panel discussion

• Dr. Heather Manson, Public Health Ontario

• Lynne Hanna, Halton Region Health Department

• Dr. Robin Williams, Associate Chief Medical

Officer of Health for Ontario

• Questions & answers, discussion

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Connecting the Dots

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Project leads:

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Accessing the Report

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Public Health Ontario http://www.publichealthontario.ca

Centre for Addiction and Mental Health http://www.camh.ca/en/hospital/about_camh/provincial_systems_support_program

/Documents/Connecting%20the%20Dots%20FINAL.pdf

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Steering Committee

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Connecting the Dots:

Purpose

To capture the range of child and youth mental health activities, initiatives, services and programming occurring across Ontario’s public health system.

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*Mental Health or other terms of interest • Infant, child or youth mental

health • Psychological health • Emotional health • Mental well-being • Mental wellness • Mental illness • Mental health promotion • Mental illness prevention • Mental health literacy • Body image / self-esteem • Stress • Resiliency • Stigma reduction • Suicide Prevention • Prevention of self-harm • Bullying • Violence • Discrimination • Crisis support / management

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Scope

• Range of activities at public health level

• Children & youth (along the continuum from infants to young adults)

• Mental health focus*

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Methodology

• Ethics review

• Outreach • We contacted all Medical Officers of Health and invited staff

from each of Ontario’s 36 public health units to participate

• Data collection and analysis • Survey (on-line, collect information through key contact at

each PHU) • Two researchers independently cleaned and

reviewed dataset • Data was analysed in SPSS

• Key Informant Interviews

• Transcripts analyzed and coded by two researchers

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Overview of Findings • All 36 Ontario health units completed the survey.

• 325 activities or initiatives reported

• Ranging from 1 to 32 per PHU

• Many factors shape and influence the role of public

health units, both individually and collectively. Some of these are supportive in nature while others present barriers.

• Health units identified specific supports to improve work in this area.

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Survey Results

• Activity type

• Target audience

• Partnerships

• Funding

• Mandate/impetus

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Type of Activity

17.2%, n=56

0.6%, n=2

1.2%, n=4

1.5%, n=5

2.2%, n=7

5.2%, n=17

6.5%, n=21

16.3%, n=53

49.2%, n=160

0% 20% 40% 60%

1

2

3

4

5

6

7

8

9 Program delivered by your PHU

Knowledge exchange or capacity building

Communications

Planning

Policy or advocacy-related

Evaluation or research

Program delivered by another agency through a financial transfer from your health unit

Surveillance or population health assessment

Other

Program delivered in partnership with another organization

Committee participation

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Secondary Categorization

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Category Percent Count

School-based programming 32 104

Parenting supports and programs 23 75

Committees, networks and coalitions 10 34

Direct services 8 26

Community-based youth skills-building programming

7 23

Communication and awareness-raising activities

5 18

Strategic planning and policy-related initiatives

5 17

Training and capacity building for PHU staff and/or service providers

5 17

Research and surveillance activities 3 11

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Target Audience

62.5%, n=203

52.9%, n=172

44.3%, n=144

44.3%, n=144

26.5%, n=86

20.6%, n=67

18.8%, n=61

11.4%, n=37

8.9%, n=29

5.5%, n=18

0%

20%

40%

60%

80%

Children orYouth

Parents, CareProviders, or

Gaurdians

Education Public HealthStaff

Social ServiceProviders

MentalHealth

Providers

Other HealthProviders

GeneralPublic

Government Other

Other community organization Non-PHU staff Law enforcement Volunteers Faith-based organization Pregnant teens / youth Researchers

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Target Age Groups

47.2%, n=154

57.4%, n=187

64.1%, n=209

25.8%, n=84

16.6%, n=54

0%

20%

40%

60%

80%

0 - 6 7 - 13 14 - 18 19 - 25 25 +

Top 6 discrete age-ranges 1. 0 to 6 16.3% 2. 7 to 18 15.7% 3. 14 to 18 13.2% 4. 0 to 18 12.3% 5. 7 to 13 9.8% 6. “All ages” 7.1%

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Partnerships

14.5%

0.3%, n=1

2.5%, n=8

6.8%, n=22

11.4%, n=37

17.5%, n=57

11.7%, n=38

5.5%, n=18

1.8%, n=6

1.8%, n=6

24.9%, n=81

50.5%, n=164

23.4%, n=76

2.5%, n=8

6.2%, n=20

4.9%, n=16

17.8%, n=58

33.5%, n=109

27.4%, n=89

23.7%, n=77

10.5%, n=34

8.0%, n=26

35.7%, n=116

21.2%, n=69

0% 20% 40% 60%

Other

Business

College/University

Government

Hospital/CHC

Local Social Service

Mental Health Org.

Other Dept. in PHU

Other Mun. Dept.

Other PHU

School/Board

None

Informal Formal

Committee, coalition or network Community organization Ontario Early Years Centre Health care provider Law enforcement

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Impetus

46.5%, n=151

22.2%, n=72

16.0%, n=52

14.2%, n=46

3.7%, n=12

2.8%, n=9 0.3%,

n=1

30.2%, n=98

2.2%, n=7

0%

20%

40%

60%

Local Need Board ofHealth

School orSchoolBoard

ExternalPartner

City Council OntarioMentalHealth

Strategy

FederalMentalHealth

Strategy

Other Don’t Know

Part of existing program or plan

Mandated program – HBHC

Consultation / report

PHU leadership / initiated

Service gap - youth engagement

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National

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Primary Funding Source

63.1%, n=205

8.9%, n=29

2.8%, n=9

1.2%, n=4

17.2%, n=56

6.8%, n=22

0%

20%

40%

60%

80%

OntarioGovernment

LocalMunicipality

NGO User Fees Other Don’t Know 17

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63.1%

8.9%

2.8% 1.2%

17.2%

6.8%

0%

20%

40%

60%

80%

OntarioGovernment

LocalMunicipality

NGO User Fees Other Don’t Know

Primary Funding Source (Breakdown of Government of Ontario as Primary Source)

Source Proportion

1. MOHLTC 68.3%

2. MCYS 12.7%

3. Unknown 4.9%

4. MOE 4.4%

5. MOHLTC / MCYS 2.0%

6. MTCS 1.5%

7. MOHLTC / MOE 1.0%

8. MOHLTC / MCYS / MOE 0.5%

9. Ontario Trillium Foundation 0.5%

10. Public Health Ontario 0.5%

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Use of OPHS or Guidance Documents to Guide the Activity

3.7%, n=12

3.7%, n=12

7.1%, n=23

0.3%, n=1

0.9%, n=3

1.8%, n=6

4.9%, n=16

14.5%, n=47

16.3%, n=53

19.7%, n=64

35.4%, n=115

38.2%, n=124

0.9%, n=3

8.0%, n=26

42.5%, n=138

44.3%, n=144

28.9%, n=94

0% 20% 40% 60%

Don't Know

None

Other

Emergency Prepardness Pro. Std.

Nutritious Food Basket GD

Child Health Program Oral Health GD

Comprehensive Tobacco Control GD

Prevention of Injury GD

Prevention of Substance Misuse GD

Healthy Eating, Physical Activity and…

Child Health GD

School Health GD

Environmental Health Pro. Std.

Infectious Diseases Pro. Std.

Family Health Pro. Std.

Chronic Disease and Injuries Pro. Std.

Foundational Std.

HBHC Protocol / GD Sexual Health Pro. Std.

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20 *Refer to Appendix D for the complete list of activities

Activity Examples*

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Qualitative Results

1. Successes

2. Enablers

3. Barriers

4. Suggested supports

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1. Successes in promoting mental health/preventing mental illness in children and youth

• Engaging in specific activities & initiatives

• ‘Starting the conversation’

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2. Enablers for Promoting Mental Health/ Preventing Mental Illness in Children and Youth

• Partnerships

• Indirect Approaches

• Leadership & Commitment

“Public health doesn’t have a mandate within their Standards for mental

health. There are some things that can be linked with mental health and

that we need to address, such

as some of our Standards around nutrition and

addressing eating disorders. Eating

disorders are a mental health issue”

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3. Barriers to Promoting Mental Health/Preventing Mental Illness in Children and Youth

• Lack of a provincial government mandate

• Limited resources at the health unit level

• Coordination challenges among community partners

“We’ve got standards for everything else, but

mental health is nowhere. People are

talking about it more…it’s almost like the floodgates have opened, and we’re

not – we can’t respond to the

volume…”

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• Lack of focus on mental health promotion and mental illness prevention

“the backbone stuff around resiliency and youth

asset development and positive mental health promotion…is one area

that we think maybe isn’t being as well addressed because the focus is so

much on treatment, and access to service”

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3. Barriers (cont’d)

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4. Suggested supports for promoting mental health/preventing mental illness in children and youth

• Provincial Guidance and Coordination

• Evidence on Best Practices

• Mental Health Indicators

• Training for Public Health Staff

• Knowledge Exchange

“Specific recommendations for action

would be helpful. Policy or documentation that made it a

Standard that we had to address would mean we would have to

devote time and resources to it”

“The impetus for developing a School Health Team was really the OPHS and I feel our health unit really works that way…it’s very based on the Standards,

like it’s really, really based on the Standards. So I think it would provide

a gateway to staff – permission to staff – to be able to address it. And

the guidance documents provide a lot of direction in terms of what activities we should be looking at. It also helps

define our role as a community partners”

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Summary and Conclusions • Public health units are undertaking a large number and

wide spectrum of activities to address mental health in children and youth often driven by local need.

• Enablers: partnerships, integration of mental health, alignment with evidence, leadership, and evaluation of efforts.

• Barriers: mandate, need for greater coordination, stigma.

• Future opportunities: exploring identified supports and the role of public health in mental health

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Questions and Answers

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Panel discussion: The role of public health in mental health

“I think public health has to look at the mental health of children and youth. It cannot reach its goals without doing

that…We just can’t look at physical health and sexual health and nutrition in isolation from the mental

component of a person’s growth and development.”

“We think our role as public health is to really focus on health promotion, mental health promotion, and on skill-

building in relation to resiliency and managing stress.”

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Panelists

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Connecting the Dots:

Dr. Robin Williams Associate Chief Medical Officer of Health for Ontario

Lynne Hanna Manager, School Years Health Halton Region Health Department, Region of Halton

Dr. Heather Manson Chief, Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario

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Connecting the Dots:

Questions and Answers

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Connecting the Dots:

Thank You!

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For more information about the report, please contact:

CAMH Health Promotion Resource Centre [email protected]

Public Health Ontario

[email protected]

Toronto Public Health [email protected]

Access the report:

http://www.camh.ca/en/hospital/about_camh/provincial_systems_support_program/Documents/Connecting%20the%20Dots%20FINAL.pdf

http://www.publichealthontario.ca