What is Ontario’s Mental Health and Addiction Strategy?
In June 2011, the government of Ontario released Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy, a provincial strategy that commits to reducing the burden of mental illness and addictions by ensuring all Ontarians have timely access to an integrated system of coordinated care.
The initial three years of the strategy emphasize services for children and youth. Three priorities in this area will contribute to the goals of the overall Strategy:
- Providing children, youth and families with fast access to high quality services.
- Identifying and intervening in child and youth mental health issues early.
- Closing critical services gaps for vulnerable children and youth, children and youth at key transition points, and those in remote communities.
What is Systems Improvement through Service Collaboratives?
Systems Improvement through Service Collaboratives (SISC) is one initiative encompassed within the Strategy. In order to meet the three-year-plan’s third objective, closing critical service gaps, 18 Service Collaboratives will be created in communities across the province. Their goal is to support coordinated services for children and youth in transition.
What is a Service Collaborative?
The primary function of a Service Collaborative is to effect change in a local system. Membership in Collaboratives reflects the cross section of sectors that provide mental health and addiction services, and key agencies or individuals in each community who can implement the changes identified. They may represent organizations that work with children and youth, in schools, community centres, doctors’ offices, hospitals, courts and children’s aid societies, etc.
What are the Service Collaboratives doing?
Service Collaboratives focus on developing seamless services for children and youth ensuring more effective and timely transitions in the mental health and addiction system. These transitions may include:
- From child/youth to adult-focussed services;
- Between hospital and community services, and;
- Between health and justice systems.
How will the Service Collaboratives impact my organization?
Service Collaboratives will formalize collaboration between services in a community and enhance shared processes and tools for cross-sector service delivery (e.g., program guidelines and best practices). Through implementation science, quality improvement tools, the use of evidence, health equity and developmental and ongoing evaluation, organizations will improve the services provided and client experience, striving towards easier and faster access to more effective services.
What ministries are involved in this initiative?
The Centre for Addiction and Mental Health (CAMH) is working with six provincial ministries to ensure the Service Collaboratives’ success. They are:
- Ministry of Health and Long-Term Care;
- Ministry of Children and Youth Services;
- Ministry of Education;
- Ministry of Training, Colleges and Universities;
- Ministry of the Attorney General, and;
- Ministry of Community Safety and Correctional Services.
Who is facilitating the implementation of the Service Collaboratives?
The government has asked CAMH to lead the implementation of the Service Collaboratives. CAMH has consulted with local and provincial leadership to establish the key partners in the system who need to be involved in the Collaboratives to ensure local success. Although CAMH is sponsoring the initiative and is accountable to the Ministry of Health and Long-Term Care for reporting outcomes, the Service Collaboratives will be community-led.
CAMH is well-placed for this role. It has regional offices and the capacity to facilitate major provincial initiatives and provide expertise in mental health and addictions services, research and evaluation.
Who is involved in the Service Collaboratives?
Depending on the community and the system gap to be addressed, the Service Collaboratives may include representatives from:
- Children and youth services (e.g., mental health and/or addictions, youth justice)
- Mental health and/or addiction services
- Family health care service providers (e.g., community health centres and primary care physicians)
- Educational institutions and administrators (e.g., colleges, universities, district school boards)
- Justice programs (e.g., corrections, court services) and service providers (e.g., police, crown attorneys)
- Hospital-based services (e.g., acute and emergency, outpatient and inpatient)
- Culture-specific services (e.g., Aboriginal friendship centres, Francophone health services)
- Public Health
What are the expectations of agencies in terms of getting involved with the Service Collaboratives?
The role each agency plays will depend on the needs in their community. Based on a needs validation conducted in the community, agencies will be asked to participate in implementing the system intervention.
As a member of the Service Collaborative, representatives are participating in the gap selection, implementation and evaluation by attending meetings, reviewing materials, liaising with their agency, and implementing changes and interventions selected by the Service Collaborative. Chairs will be selected from this membership to convene and facilitate meetings. Meeting frequency will be determined based on the Service Collaborative’s Charter and timelines.
What resources is CAMH providing to support this initiative?
CAMH’s Provincial System Support Program (PSSP) has dedicated central and regional resources to support the Service Collaboratives.
The Regional Implementation Teams will identify and engage potential members, provide consistent support to Service Collaboratives, and facilitate the exchange of information for evaluation and knowledge exchange purposes.
The Performance Measurement and Implementation Research team, with the Regional Implementation Team, will evaluate the implementation and impact of the overall SISC initiative at both the local and provincial level. CAMH’s Knowledge Exchange team will increase engagement in knowledge generation and dissemination. Finally, the Health Promotion and Prevention team provides research, data and evidence relating to best-practices and programs.
How were the Service Collaborative locations selected?
The selection of locations for the Collaboratives were based on Environmental Scans of mental health, addiction and justice services, educational initiatives and existing networks in municipalities and regions across the province.
The selection criteria for the Service Collaborative were based on a mix of the following specifications:
- Need – Prioritizing communities with a high percentage of youth 18 years or younger, the amount of female-led, one-parent households per capita, the number of mental health and addiction visits to emergency, etc.
- Transition – Identifying communities where there is a service gap at transition points in the system, either between children and youth or youth and adult services, or between the mental health and addictions and the justice sector.
- Priority Populations – Providing support to regions that have a high percentage of priority populations, including Aboriginal and Francophone.
- Readiness – Considering existing leadership in mental health and/or addictions, system collaboration, as well as Quality Improvement and Implementation Science initiatives.
- Regional Distribution – Consideration of geographic and cultural diversity in terms of urban/rural and North/South/East/West Ontario.
How do the Collaboratives connect to Working Together for Kids’ Mental Health (Working Together)?
Working Together is a provincial initiative also encompassed in the Strategy. It focuses on providing mental health training to professionals in contact with children on mental health and identification/screening tools so they know how to identify kids with potential needs and link them to the right services. Service pathways and referral protocols are developed so that kids access the right service, as quickly as possible.
Service Collaboratives will identify and make improvements to processes (e.g., assessment, referral, client transitions between services) at key transition points to increase access and better integrate the sectors that provide services to Ontarians living with mental health and addictions issues and/or problematic substance use.
How is CAMH coordinating with other Strategy initiatives?
CAMH is working with several ministries to align communication efforts and to coordinate, where possible, the rollout of Strategy initiatives in communities across Ontario. At the local level, Regional Implementation Teams engage in regular, cross-ministerial meetings to keep agencies abreast of community-led initiatives.
How does SISC fit into CAMH’s provincial system role?
The Provincial System Support Program (PSSP) is a department of CAMH that identifies, implements and monitors evidence-based practices in Ontario’s mental health and addiction system. SISC’s goal of improving coordination of and enhancing access to mental health and addiction services aligns well with PSSP’s mandate.
When will the Service Collaboratives be established?
There are 18 Service Collaboratives in communities across Ontario. Of these, 4 focus specifically on improved connections and the coordination of services at key transition points between the health and justice systems.
- By the end of fiscal year 2011/12: 4 sites were established.
- By the end of fiscal year 2012/13: A second cluster of 7 Service Collaboratives have been established; 5 geographically based, and 2 justice + health related.
- By the end of fiscal year 2013/14: The final cluster of 7 Service Collaboratives are established in remaining communities; 5 geographically based and 2 justice + health related.
What do all the acronyms you use stand for?
AIT Agency Implementation Team
HE Health Equity
HEIA Health Equity Impact Assessment
HPL Health Promotion Lead
HPP Health Promotion and Prevention
ICES Institute for Clinical Evaluative Sciences
IEAC Internal Evaluation Advisory Committee
IS Implementation Science
KE Knowledge Exchange
KEE Knowledge Exchange and Education
KEL Knowledge Exchange Lead
MAG Ministry of Attorney General
MCSCS Ministry of Community Safety and Correctional Services
MCYS Ministry of Children and Youth Services
MOE Ministry of Education
MOHLTC Ministry of Health and Long-Term Care
MTCU Ministry of Training, Colleges and Universities
OEP Other Expert Panels
PCAG Provincial Collaborative Advisory Group
PGOC Provincial Government Oversight Committee
PME Performance measurement and evaluation
PMIR Performance Measurement & Implementation Research
POC Provincial Oversight Committee
PPT Provincial Partnership Table
PS Project Sponsor
PSSP Provincial System Support Program
QI Quality Improvement
REC Regional Evaluation Coordinator
RIC Regional Implementation Coordinator
RIS Regional Implementation Structure
RIT Regional Implementation Team
SC Service Collaborative
SCIT Service Collaborative Implementation Team
SCM Service Collaborative Member
SEP Scientific Expert Panel
SISC Systems Improvement through Service Collaboratives
SSI System Support Initiative
SUEP Service User Expert Panel