EVALUATION OF THE ONTARIO COMMON ASSESSMENT ... - CCIM

More documents

Recommendations

Info

OCAN Evaluation for Aboriginal Mental Health Programs The providers generally welcome the concept of a standardized assessment tool. They had formulated a very concrete and strategic picture of their requirements for a standardized assessment tool and how such a tool could benefit clients and service development. Perceived Adequacy of OCAN Staff Training and Support A service coordinator took part in the “train the trainer” session provided by the CMH-CAP OCAN trainers. Local staff including two NSTC visiting mental health providers were then subsequently trained. The community level providers felt that the locally conducted training was quite good, however a refresher course was very necessary, particularly since the OCAN had not been used by many providers nor for all clients at this point. Workers believed that the client cases provided during the training sessions would benefit from an Aboriginal specific cultural component, as Aboriginal clients’ interaction related to the OCAN assessment tool vary considerably from the provided example cases. Developing Aboriginal client cases would better prepare workers to respond to the barriers and concerns perceived by many Aboriginal clients with respect to the OCAN. Current status of OCAN implementation At the time of this evaluation, staff has not been able to complete any of the staff or consumer assessments in all but two of the participating sites. None of the sites had been able to make significant progress implementing the OCAN in their service delivery model. Those sites that had completed some assessments had only managed to complete very few. The challenges related to the OCAN implementation are described in the following sections. OCAN’s fit within the service delivery on the North Shore Perceived importance of a standardized assessment tool Providers explained that there was lots of excitement, when the OCAN pilot was first discussed. The lack of a standardized assessment tool had long been perceived as a problem. In particular this lack of a standardized assessment tool has resulted in clients having to tell their story over and over. One worker explained that “clients are assessed to death” in the current system. The notion of a culturally appropriate standardized assessment tool is therefore strongly supported by staff as is the basic concept of an assessment tool with a broad range of domains designed to provide a holistic overview of each client’s individual situation. Furthermore, the prospect of collecting and accessing standardized information that can be summarized to provide current statistics on services and needs of clients is seen as a very important incentive to participate in the implementation of a standardized electronic assessment tool. Workers believed this would help in more strategic and evidence based development of mental health and supportive services. Finally, the implementation of a comprehensive assessment tool within the mental health services is also seen as contributing to building skills and capacity at the community level. Sutherland & Maar - March 2010 Page 29
OCAN Evaluation for Aboriginal Mental Health Programs The realities of implementation of OCAN into the daily workflow At the NSTC, the OCAN pilot was initially planned to occur with all client services funded under the NE LHIN. It was not to be restricted to clients with SMI or other groups; rather all providers and clients were to be invited to use the OCAN. It was also planned that a local worker was to complete the OCAN if he/she referred a client to a visiting professional (funded under the LHIN). Mangers believed that this approach would then encourage the use of OCAN as a case management tool. If however the client was not referred by the local worker, then the visiting professional was to complete the OCAN. While this approach was very well thought out, when it came to implementation, this model posed several unexpected but significant challenges in all of the service locations. Time and resources constraints were identified as a major barrier to completing OCAN, because visiting professionals have just a few hours per week to spend on client contact in each community. The services provided by visiting specialists are seen as scarce and urgently required by clients and providers. As a result, most visiting professionals feel that it does not make sense to use the few hours they have to provide direct services to complete the OCAN. Specialized providers were clear, that they would need to reduce their client load in order to implement OCAN. This sentiment is compounded by the fact that providers believe the OCAN does not provide any immediate benefit to their clients needs at this time. Most visiting providers feel that a better approach would be to have an intake worker complete all of the OCAN assessments. Some of the local (some federally, some provincially funded) community workers also faced barriers with clients when they attempted to complete the OCAN for the visiting professionals. Local workers who had in the past not been involved in the circle of care with visiting professionals faced resistance from clients. When they invited clients to participate in the OCAN, clients often perceived this as a significant and undesirable deviation from the way services were previously provided. Given the small community size, clients are frequently uncomfortable revealing in-depth sensitive information to local workers. Therefore, many clients refused to complete the OCAN in those cases. Furthermore workers reported that some clients were opposed to participate in OCAN right from the start, while others were initially willing to complete OCAN, but later did not want to follow up. “They just keep putting it off” explained one worker. Workers felt that for many of their clients the word “assessment” represented a significant barrier. Some clients were suspicious of reasons for the assessment, because trust in the health care system is an issue with many Aboriginal clients. Clients frequently questioned the worker: “Why all of a sudden do you want all this information?” or “You already know me! Why are you asking this” As the OCAN tool is explicitly voluntary and cannot become a barrier to access to services, many workers did not feel that they should press their clients any further. Many new clients already have to complete multiple lengthy forms for referrals etc. At this point, the OCAN cannot be shared with other services such as treatment centres or hospitals. From the perspective of clients and providers, OCAN therefore currently adds to an already overwhelming bureaucracy. Much more client awareness and client education is required to make the OCAN acceptable to Aboriginal clients. In addition, realistic client scenarios during the training sessions would better prepare worker to respond to the concerns Aboriginal clients might have regarding OCAN. Furthermore, implementation of OCAN in the hospital and addictions treatment, coupled with implementation of OCAN information sharing protocols are necessary to realize the potential important benefits associated with OCAN in these Aboriginal communities. Sutherland & Maar - March 2010 Page 30
Page 1 and 2: EVALUATION OF THE ONTARIO COMMON AS
Page 3 and 4: OCAN Evaluation for Aboriginal Ment
Page 29: OCAN Evaluation for Aboriginal Ment
Page 53 and 54: Sutherland & Maar - March 2010 Page
Page 55 and 56: Sutherland & Maar - March 2010 Page

EVALUATION OF THE ONTARIO COMMON ASSESSMENT ... - CCIM

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?