e1 dr.tara guthrie - it takes a village to support child & youth mental health
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www.pspbc.ca
It Takes a Village to Support Child & Youth Mental Health
Dr. Tara Guthrie
Quality ForumVancouver BC
March 1, 2013
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At the end of this presentation, you will learn:
How family doctors, MH clinicians, and school counsellors can use new clinical tools
How everyone works together in local communities forming a ‘wrap-around’ care team for young people, and use the same language
Learning Objectives
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Prevalence Rates in Children and Youth in BC
Disorder
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Within 6 - 8 months, we aim to:
› Improve child and youth mental health in participating practices as evidenced by improved scores on clinical scales
› Help create an interdisciplinary community of practice for child and youth mental health in local communities
Module Aim
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Early identification, diagnosis and management
Appropriate use of evidence-based treatments
Appropriate application of standardized methods of measurement
Awareness of community mental health resources available
Family doctor collaboration with community partners
By Focusing on…
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Program Structure
• Why Child and Youth Mental Health?
• Lifespan framework• Suicide risk assessment• Non-disorder specific
tools• Action planning• Measures
LS1 AP1 LS2 AP2 LS3 Ongoing support
LS = Learning session
AP = Action period• Screening• Building relationships• Psychotherapeutic
support• Track outcomes
• Sharing and learning• Anxiety-specific tools
Depression and ADHD
• Medications• Strongest Families
BC• Action Planning
• Sharing and learning• Community
resources• CYMH billing• School boards• Sustainability
• Identification, diagnosing, treating and managing anxiety, ADHD and depression
• Track outcomes• Expanding the role of the
MOA
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Located in the southeast interior of BC, Creston`s catchment area covers the Town of Creston, Area B & Area C
Creston, BC-School District #8
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1. Who are our team members?2. School counsellors3. Physician4. +/-child and youth mental health workers5. +/-addictions counsellors6. +/- school administrators and teachers7. +/- parents8. +/-family physician9. +/- pediatrician10. +/- child psychiatrist
Team Approach to Mental Health
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What gets in the way of STUDENTS going to the DOCTOR?
Barriers to Mental Health Resources
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Identifying students with potential Mental Health concerns or high risk behaviors
Identification
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Triage meetings Self-referral Counsellors Family/parents Family physician
How does a student get referred?
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Students identified……..So what now?
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Wednesdays with Tara
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Flow Through the Clinic
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Clinical Global Impression (CGI)
Screen for Childhood Anxiety Related Emotional Disorders (SCARED)
Swanson, Nolan and Pelham (SNAP) – IV
CRAFFT
Tool for Assessment of Suicide Risk – Adolescent (TASR-A)
Kutcher Adolescent Depression Scale – Six Item (KADS-6)
Teen Functional Assessment (TeFA)
Tools
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Practice Support Programhttp://www.pspbc.ca
Kelty Teen Mental Healthhttp://keltymentalhealth.ca/
Teen Mental Health http://teenmentalhealth.org
Websites
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Grappling with CONFIDENTIALITY
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Autonomy of students - they guide us as to who is part of the mental health team and who they would like to participate in their care. Points for discussion include family physician and parents.
Goal is to preserve the confidentiality of the student in the context of a team environment
Sealed assessment packages and electronic medical records ensure no paper trail is left at the school.
Confidentiality
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Changing the Culture of Mental Health in the Classroom
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So what are students saying
It was easy to
get to
It is a great
things for
troubled kids. it
has helped me a
lot
Did not have to go far.
comfortable
environment
Made a huge
difference
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17 students screened
Of screened students:
› 76% diagnosed with the Anxiety, ADHD, and Depression
› 38% of diagnosed students who are treated with protocol- driven medications
› 100% of diagnosed students treated with psycho-therapeutic interventions
› 69% showed substantive improvement
Results from November to June….
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100% I was more likely to access this service because it was in my school
100% I was comfortable seeing [doctor] at the school
83% I would recommend this clinic to my friends and other students
83% I would come to another appointment at the school
100% Overall I was satisfied with my appointment
Students Report (6 Students)
Conclusions
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“... By bringing in the GP or the school, you bring in more comprehensive
support” -GP
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But best of all…
GP Champions’ Confidence with Tools and Resources for
Child and Youth Mental Health Care
Number (Percentage) of GPs who Rated Themselves as “Very” or “Moderately Confident” on Several Aspects
Related to Mental Health for Children and Youth: Comparison Over Time
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The potential impact of this work is BIG
We are increasing capacity in primary care
Collaboration is embedded
Real results can be seen quickly and appear to be sustainable
System change is leveraged
Summary
www.pspbc.ca
For more informationPractice Support Program
115 - 1665 West BroadwayVancouver, BC V6J 5A4
Tel: 604 638-2854
www.pspbc.ca