November 2015 - March 2016
The child and youth mental health system in Wellington Dufferin is a system of people—people who have goals, needs, challenges, and hopes. Whether they’re providing or receiving support from services, many of their core needs and goals are the same. Everyone wants to feel heard, respected, and free from judgement. They want to know what to do, and who to call for help. Every person in this system is motivated to support children, youth and families to the best of their abilities. And above all, parents just want their children to be happy, healthy and safe.
Much of what’s outlined here likely won’t surprise you—many of the current challenges in this system have been discussed for years. However, it’s critical to notice the wide diversity of perspectives and experiences across this system, and leverage the momentum and readiness for change so very apparent in the community.
Moving on Mental Health Wellington Dufferin is part of provincial and local momentum driving toward mental health services that align with the needs of children, youth and families, and a desire to provide the best possible service experience to people who need support.
Moving on Mental Health (MOMH) is a province-wide initiative that defines the action needed to realize Ontario’s Comprehensive Mental Health and Addictions Strategy. As part of this initiative, lead agencies were identified to represent regions across Ontario. The Canadian Mental Health Association of Waterloo Wellington Dufferin (CMHA WWD) was identified as the lead agency for Wellington Dufferin.
As part of its role as lead agency, CMHA WWD was tasked with identifying priorities for child and youth mental health services
in Wellington Dufferin for the next year. In order to create a system that puts people at its core, it was critical to ground these priorities in a deep understanding of the needs of children, youth, and families with mental health needs in this region.
The following page outlines what we did, what we learned, and the priorities for action that were identified for the next year. Please see the Insights Report for a complete summary of this phase.
The majority of the Insights Phase was spent engaging with two groups: the children, youth and families who access mental health services; and the people who provide these services. This work used tools and workshops including journey mapping, stakeholder labs, interviews, and online surveys to get a deep understanding of the needs of families, layered within the context of the system. Learning from both of these groups helped us get a more holistic sense of the range of people and diversity of needs across the child and youth mental health system.
An overview of the activities that were done with each of these groups is outlined below.
Child, Youth & Family Engagement
In an effort to hear from as many people as possible, we created an online survey that aimed to understand a few important aspects of services. At a high level, this survey asked about access to support, communication, the kinds of supports available, and how it feels to access supports.
Understanding someone's journey—the steps they took, the goals they had, and how that went—helped us to identify areas where we can improve services. Throughout January and February of 2016 we worked with eight families to learn about their experiences with child and youth mental health services. Through this process, we worked with each person to understand their goals, needs, and obstacles; the services they've accessed or would like to access, and what those experiences have been like for them. These interactions were mostly conversation-based, and were combined with paper-based activities that participants completed independently.
During and after the Journey Mapping process, we conducted a few 30-minute interviews with members of the participants' network in order to better understand different parts of each journey. These interviews were complemented by interviews with service providers and others with a system-level perspective.
After completing Journey Mapping and most of the interviews, we had a fair understanding of eight different journeys. This gave us a powerful perspective for reimagining services, but it will be important to validate and build on these journeys with the experiences of others. A youth stakeholder lab workshops helped to expose us to a broader range of experiences.
Service Provider Engagement
The people working to serve children, youth and their families are service experts in their own way. They're familiar with what works, what doesn't, and have many ideas for improvement. They're also likely to know of many work-arounds and "tricks" that help to get things done faster and better for the people they serve—we used an online survey to learn from this experience from as many service providers as possible.
We completed fifteen 30 to 60-minute interviews with service providers from across the system to dig deeper into what we learned through the online surveys and journey mapping. Some of these interviews focused on the child and youth mental health system as a whole, and others focused on specific successes, gaps and obstacles.
We held two stakeholder labs (workshops) with service providers, which gave us an opportunity to share what we'd learned from journey mapping and interviews, get feedback, and better understand some of the insights that had been identified. Participants helped us understand some of the inner-workings of services, as well as the constraints and opportunities within the child and youth mental health system.
Four major themes were identified as a result of the engagement phase. These attempt to summarize the many, many stories that we heard, while articulating them in a way that is actionable. These insights were presented at the strategic retreat that was held in March of 2016 in order to identify priorities for action. The major themes are:
A system built to manage crisis is not aligned with the needs of children and families.
A system built for crisis
Service models don’t match the complexity of real life
Impact of stigma
A fragmented and siloed system creates inconsistent service experiences and disruptive transitions; a struggle for families and service providers alike.
Fragmented and inconsistent services
Wellington Dufferin is not one homogenous region
Steep learning curve
Planning and managing transitions
Service providers and families need to feel confident that they know what to do and who to call. Schools feel like natural hubs for supports, yet aren’t set up to play this role.
Difficult to know what to do
Schools feel like connectors and experts in services, but aren’t designed for this
The needs of a child are likely nested within the needs of a complex family. Parents may be acting as case managers, managing their own mental health, and trying to hold their family together.
Parents have a lot to manage
Supporting a child likely means supporting a complex family
Burnout and the need for respite
A Common Vision for the Future
A one-and-a-half-day strategic retreat was held in March 2016, during which leaders from different services, youth, and parents reflected on what was learned throughout the research phase, and envisioned what they wanted to achieve for the child and youth mental health system over the next three years and beyond. This vision painted a picture in which the child and youth mental health system in Wellington Dufferin boasts:
Equitable, Accessible and Effective Services;
Coordinated Continuum of Service;
Early Collaborative Care;
Diverse, Transformative Services; and
Empowered Kids, Youth and Families.
Please see more detailed descriptions of this vision in the Insights Report. Based on this vision, the following three priority areas were identified for the next year:
Acting as One Team with Children, Youth and Families;
Leading with Clarity, Courage and Accountability to Inspire Action; and
Fostering and Accepting Shared Responsibility for a System That Works.
Reporting & Next Steps
Three reports were produced as a result of this project in March of 2016. Overlap produced an Insights Report, which describes what was done, what was learned. It also paints a common vision for the future of child and youth mental health services in Wellington Dufferin over the next three years and beyond. Finally, it outlines the three priorities that CMHA WWD will focus on over the next year as Lead Agency for child and youth mental health in Wellington Dufferin.
Two complementary reports were produced for the Ministry of Children and Youth Services: the Core Services Delivery Plan, and Community Mental Health Plan. These reports summarize the state of child and youth mental health services in Wellington Dufferin, and outline next steps for action in detail.
The next phase of work will take action based on what was learned, and the priorities that were identified. Please check back soon for more on next steps.