Supporting Children/Youth T hrough Enhanced Mental Health Initiatives June 16, 2014

1. Supporting Children/Youth Through Enhanced Mental Health InitiativesJune 16, 2014

2. Overview of Children’s Mental Health Initiatives The context: • Increase in joint planning between Alberta Health, Alberta Health Services and Human Services • Focus on children/youth involved with Child Intervention Services • Commitment to increased funding to better support these children, youth, their caregivers and our staff

3. Provincial structure 2014: Appointment of a Chief Medical Officer for Mental Health and Addictions to lead the work - Cross Ministry Partnership - Creating an Action Plan - Priorities for Alberta - Identified Need for children in care - Continuation of 2013 funding - Announcement of 2014 funding

4. Continued Initiatives from 2013 • Mental ealth Learning Series • Mental Health First Aid • Support to Parent Link Centres • Initial after hours support – launched in Edmonton Crisis Unit

5. 2014 initiatives • Best Practice Sites: Calgary, Edmonton and Red Deer • Mental Health Consultation regarding psychotropic medications and psycho-social interventions: 2 positions serve the province • Assessment and Brief Intervention: Calgary project “Brief Intervention and Caregiver Support” BICS for short.

6. The details and the link to caregiver support

7. Best Practice Sites • Calgary’s site is at Hull Homes • Reshaping of the Pre-Adolescent Treatment Program • With additional funding a day treatment / wrap-a-round service has been added to the program • Purpose is to support more children in their family based placement by the provision of treatment support after school, evenings.

8. Supporting Caregivers • Family based care is the environment of choice • Provides the type of support a caregiver needs to develop effective interventions in the home environment with the support of highly skilled professionals from the Hull program • Caregiver is an integral part of the treatment team and is actively involved in planning and implementation of strategies that will work in a home environment • Decreases the impacts of residential care on young children – trauma reduction

9. Mental Health Consultation • Many children involved with child intervention are prescribed psychotropic medications • Ritalin and other ADHD related medications • Anti-psychotic medications • Mood stabilizers • Implementation of treatment plans/strategies recommended by mental health professionals may be a part of a child’s plan • Implementing in a home based environment may require additional support, revision, clarity and skill building on the part of adults involved in supporting the child/youth

10. Supporting Caregivers • Sheena Stevens, BN. RN. CPMHN(c) • Registered Nurse • Certified psychiatric mental health nurse (CPMHN) from the Canadian Nurses Association. • Experience in medical, oncology/ palliative care and adolescent child acute mental health. • Past 3 years at the Alberta Children’s Hospital in-patient mental health unit and at the Foothills Medical Center at the Young Adult Program (YAP) unit 26 in Calgary. Alberta. • Working in partnership with Child and Family Services and Dr. Roxanne Goldade (P-KIC physician lead)

11. Supporting Caregivers • She will be consulting with our staff • You may see her at a P-KIC appointment • She may follow up with you regarding medication trials or new medication responses, medication adjustments that pediatricians have prescribed • You can access Sheena through the child’s caseworker or your foster care/kinship care support worker • Contact information will be forward to Agency foster care and Kinnections this week

12. Brief Intervention & Caregiver Support - “BICS” • A collaboration between Calgary Family Service, Catholic Family Service and Calgary Counselling Centre • Bringing the 3 agencies together allows for a wide range of skill and areas of expertise among the team • One clinician from each agency has been recruited and are currently being trained • Soft launch – a few cases over the summer • September targeted for full implementation

13. Introducing the BICS approach • A new approach to caregiver support • Home based early intervention • Trauma/toxic stress reduction • Creating a strong support network for each child and their caregiver • Community focussed • Implementation of individualized profiles and plans

14. How it works…… • Approximately 3 working days after a child is placed a referral will be made to BICS • The Clinician assigned will contact the caseworker, foster care/kinship support worker and the caregiver • You and the clinician will do an initial screen over the phone to see how the child is doing and using the Green, Yellow, Red approach a plan for an in person first meeting will be made • You will likely get a follow up phone call just to check in and see if there are any emerging issues that might warrant an earlier connection with you

15. The Research: Key Concepts – Toxic Stress

16. How it works ….. • A screening tool focussing on trauma will be completed to obtain a baseline of how the child is coping • ASQ/ASQ SE • age 0-5 • Trauma Symptom Checklist for Young Children • ages 3-12 • Trauma Symptom Checklist for Children • Ages 8-17 • Other screening tools as appropriate

17. How it works….. • A profile of the child/youth will be created with you and input from others in the child’s support network – family, school, … • If needed a positive behavioral approach plan will be developed or a developmental plan or whatever will best meet the child’s needs and assist with caregiving. • The plan should be transferable to other environments – respite, school, family home • Length of involvement will be flexible and individualized • You can re-enter the program for further support if the need arises

18. Final Comments • New and needed opportunities for Children’s Mental Health • Priority on children involved with Child Intervention recognizes that coming into care is another traumatic event for a child • The research of the brain, toxic stress and interventions that work is at a critical place to inform this type of work • A team approach is the only approach that works for a child/youth

19. BICS