EVALUATION OF THE ONTARIO COMMON ASSESSMENT ... - CCIM

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OCAN Evaluation for Aboriginal Mental Health Programs time of open water (September). Recently, a winter road to Gillam, Manitoba has been prepared; it is the world’s longest winter road 11 . The Service Context: the James Bay Community Mental Health Program 12 Alemotaeta, the James Bay Community Mental Health Program, is committed to establishing a healthier and happier environment for the people in each community along the James Bay Coast. The program provides services with a holistic approach, in a manner that recognizes the local cultures, heritages and traditions. Individuals, families and whole communities are offered ongoing support and developmental assistance to honestly face the aspects of their lives which stop them from being fully healthy, physically, emotionally, mentally and spiritually and to develop their strengths in living a more balanced life. The program networks with other community resources and agencies within the local communities and outside area. The program offers front-line services that are always respectful of the culture and language of the people. The service provides continuity of care for those people over the age 16 living in the James Bay area, particularly those struggling with depression, concurrent disorder, court support & diversion, follow-up and after care, grief, addiction to alcohol/drugs, effects of abuse, problems with relationships, low self-esteem, Moderate Mental Illness and Severe Mental Illness. The following service providers are available: Mental Health Counselor (available in all sites): To provide a variety of appropriate client-directed counseling services. Regional Team Leader: To provide counseling and professional support for program staff and community partners. To provide counseling and referral services for individuals, couples and families as appropriate. Regional Clinician Worker: To provide community based counseling services to persons with mental illness which are culturally relative, accessible, and effective in the client’s home community as part of the program’s clinical team. To provide joint clinical counseling with a Community Counselor in the coastal communities served by the James Bay Community Mental Health Program. Regional Concurrent Disorder Worker: To provide culturally appropriate assessment, crisis management, supportive counseling and referral services in their language of choice in home community for clients with SMI (Serious Mental Health Illness) and/or CD (Concurrent Disorders - a major mental illness in combination with addictions issues and substance misuse). Regional Court Worker/Case Manager: The primary goal of the program is to divert people with mental illness away from or out of the criminal justice system to more appropriate community mental health services. Regional Crisis Intervention/Early Episode Clinician: Provides comprehensive case management and crisis services to clients that are experiencing early psychosis. 11 Peawanuck website accessible at www.peawanuckcree.myknet.org/index.html 12 Adapted from the James Bay Community Mental Health Services Program literature, prepared by James Bay Community Mental Health Services Program staff Sutherland & Maar - March 2010 Page 21
OCAN Evaluation for Aboriginal Mental Health Programs Addictions Worker: The program provides intake, assessment, referral, community treatment, group intervention, public education and community awareness to adults, youth, family members and Problem Gamblers. The head office is located in Moosonee and regional specialized workers fly into the coastal communities to provide outresearch services; workers also provide sessions to clients over the phone. Due to the geographical barriers, workers see their clients only rarely in person (often 1-3 times per year) and some workers have never met some of their clients in person. Larger coastal communities have, in addition to visiting workers, also a full time worker in the community. Telehealth/telepsychiatry facilities are only accessible in Moosonee and Moosefactory, there is no telemedicine within the coast communities. Internet access is unreliable with slow connections when it is working. Phone access to the communities normally works, however even this connection is at times quite poor. The services are geared to address the broad range of need of the client population, including: family issues, crisis, court referrals for anger management, suicidal ideation, mood disorders, depression, trauma, Post Traumatic Stress Disorder and anxiety disorders. These presenting concerns are in most cases complicated by intergenerational trauma, that may include residential school trauma, physical and sexual abuse and other issues. Substance use is mostly confined to alcohol. Suicidal ideation is a major concern and suicide waves have occurred in some communities in the recent past. The current client case load for JBCMHS is approximately 600 -700 clients, however many more contact this team for brief mental health services and these clients often return for further brief services after a period of time. Common presenting concerns according to staff are: family issues, crisis, court referrals (e.g.,: for anger management) mood disorders, depression, anxiety disorder, trauma, complicated trauma, Post Traumatic Stress Disorder, suicidal ideation is a major issue as well as addictions to alcohol. During our site visit, local staff explained that need for services and travel demands are overwhelming for workers. Overview of the OCAN Implementation at the James Bay Coast In this section we report on successes and challenges of implementing OCAN in the JBCMHS program. Providers’ Understanding of OCAN Providers explained that their interest in participating in the OCAN pilot was rooted in their desire to be involved in important new initiatives that were implemented elsewhere in the province or region. They generally expressed a deep appreciation of the opportunity to provide feedback on an initiative that could potentially be rolled out in Aboriginal mental health services in the future. The James Bay service area is geographically quite isolated and providers felt that participating in the OCAN pilot might result in better connection and networking with other programs within the LHIN and the province as a whole. Providers clearly understood that the OCAN is a standardized tool that has been piloted in mental health programs in North Eastern Ontario, including some Aboriginal mental health services. They also understood that OCAN has not been used in Aboriginal services previously and that their feedback on the fit of OCAN with Aboriginal people and services was sought as part of the evaluation phase. Sutherland & Maar - March 2010 Page 22
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