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Basic service continuum components?

2017

Good day, morning, evening everyone,

My name is Ernie Hilton and I have had the privilege of working in this field for a while now and I would like to exploit your insights. Often times I read about residential services with both good and bad references; usually the good is a rebuttal to the bad. What I regularly notice is residential services are often "judged" in isolation of a greater continuum that is or is not operating effectively either surrounding those residential services. Subsequently, this portrayal of residential services, in my opinion, paints an unfair picture of residential and more importantly a simplistic account. A specific residential service may be portrayed as effective or ineffective on its own merits, however the external context of services or lack thereof influences and impacts the specific residential service being reviewed. I have, over the years seen the same method of analysis used for other services as well. It is almost as though the greater continuum's need a specific "scapegoat" for some nefarious reason (Insert conspiracy theory here).

Intimate analysis of specific services is relevant and necessary to do as stand-alone reviews of course. However, considerations and analysis for the overall efficacy(outcomes) of the continuum of services surrounding each component that make up that continuum needs to be taken into consideration as one does an analysis of a specific service. After all, understanding a child's reality cannot be properly undertaken without understanding the family and contexts that surrounds the situation,....now, to my "ask".

If you can, please comment in short, even "bullet" responses, what services are essential to complete a basic continuum of care for a region/community that would be a "minimum" of services. Since. most communities and regions rarely have an endless supply of money/resources, the maximum allowable (broad) service provisions can only be to a maximum of 10 for this task. Who knows, At the end, maybe the CYC-Net world can come up with the minimum characteristics that need to be accessible in a broad "Regional Family Service Continuum" in each region as criteria for effective reviews of specific services. If we end up with a a huge list at some point, I will re-list them(essential services) all in one email so we can keep track.

Thank you in advance for your insights. To get us going I will comment on a few services I think a community/region will need: (remember, Broad Services)

1) Residential Services :)
2) In-home based supports
3) Outreach services
4) After Care/Independent Living services
5) Emergency Crisis-Response Services(Mobile)
6) "Specialized" Foster Care
7) Day/Evening "treatment" tailored programming..school, vocational, activity-based, Family-focused etc...

Thank you
Ernie Hilton
...

All the services you listed sometimes exist independent of one and another. Services need to be put in place as a complement to one and another, therefore we must identify those services that benefit from the presence of other complementary services. In this way we can be more efficient in terms of positive outcomes and financially as well.

For example, group homes for at risk youth between the ages of 12-18 must have access to clinical supports like an addictions or sexual abuse counsellor. Judges and attorneys must be aware of the services provided as they can often have a large impact on the lives of the youth. For example, mandating anger management counselling or curfews are often most prudent implements. But they are often not imposed. Once a youth turns 16, they have the option of signing out of care. What transition programs exist? Not many. I've seen several in Ontario that transition youth 16-24 so long as they have full time jobs or go to school full time. These are just some examples.

Danny

Hi Ernie,

In Ontario, the Ministry of Child and Youth Services (MCYS) has been revisioning child and youth mental health services in the province and the project is called “Moving on Mental Health”. See attached link to public documents: http://www.children.gov.on.ca/htdocs/English/professionals/specialneeds/momh/moving-on-mental-health.aspx

This page provides an overview of what Moving on Mental Health is all about and the purpose of the revisioning meant to support children, youth and families to know where they can go in their region of the province, how to access services and what services are available.

The second document on this website gets into more detail about the structure and continuum of services that will be made available in each region of the province so it is more predictable and easier to understand what type of services children, youth and families should be able to access in their home region. In the attached link, the PRG#1 document outlines this http://www.children.gov.on.ca/htdocs/English/professionals/specialneeds/momh/pgr.aspx

In a nutshell, the MCYS in Ontario has identified 2 key processes and 7 core service areas for child and youth mental health (CYMH) that are to be accessible in each region and they are:

Key Process: Access/Intake (how youth and families seek initial access to the CYMH service system)

Core Service Areas: Targeted Prevention
Family/Caregiver Skill Building and Support
Brief Services
Counseling and Therapy Services
Specialized Consultation/Assessment
Crisis Support Services
Intensive Services (includes day treatment, in home/respite, out of home/residential services)

Key Process: Case Management (case management provided during assessment and treatment and upon exiting the CYMH system)

The Moving On Mental Health revisioning of children’s mental health services in the province continues to be a work in progress to date.

Julia Margetiak
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