EVALUATION OF THE ONTARIO COMMON ASSESSMENT ... - CCIM

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OCAN Evaluation for Aboriginal Mental Health Programs In particular, programs endorse widening the use of OCAN within other Aboriginal mental health programs only if there is a commitment to resolve key cultural issues as well as cross jurisdictional impediments to health information sharing. Results of the survey (see Appendix E) illustrate the hesitation of participating program staff to recommend the adoption of the tool as it exists currently in other Aboriginal mental health programs. One participant has suggested the following: “standardized assessment is a useful aspiration for communication between mental health services providers but some items in this tool are not capturing helpful information. We need a long term research strategy to amend and validate an improved version of this tool that will tap into Aboriginal health needs” We expand on this assertion in the following Recommendations. 2. Training RECOMMENDATION 2: Develop Aboriginal service specific training modules and support groups, including: ► Aboriginal specific cases for training that reflect the Aboriginal service environment, client realities as well as culture and language and literacy issues. ► Opportunities for Cree speaking programs and staff to enhance their OCAN lexicon and vocabulary and develop translation aids to better support effective interpretation at the community level. ► Refresher training at more frequent intervals. ► Ensure that the portal is user-friendly and accessible for providers with good instructions on how to access and navigate the portal. Rationale: Program staff described a number of training enhancements that could better support Aboriginal program participation in the implementation of OCAN. For example, workers found they were met with language and cultural challenges when they implemented OCAN, and they were not prepared for these challenges based on the case scenarios. Participants were clear they did not expect nor want OCAN to be translated into Aboriginal languages, however they felt they needed to brainstorm with other Aboriginal mental health services providers on how to best present, communicate, interpret and implement OCAN. As discussed, providers felt that many of their clients were not willing to use OCAN, and therefore they filled out few assessments in a particular time period. Refresher courses would help those staff members who are relatively inexperienced with OCAN due to their relatively infrequent use. Online tutorials for Aboriginal mental health service providers may be one way to address this issue. Sutherland & Maar - March 2010 Page 43
OCAN Evaluation for Aboriginal Mental Health Programs 3. Client population RECOMMENDATION 3: In the Aboriginal Mental Health System, the implementation of a common assessment tool should focus on stable long-term clients, who have established trust relationships with service providers. Rationale: Although the OCAN is proposed as an assessment tool having universal applicability for all clients seeking mental health services, based on their experience and knowledge of their clientele, Aboriginal program participants suggest that OCAN implementation is not realistic for some of their clients. They believe that OCAN does not fit with the following presenting concerns: clients who are presenting in crisis, because they are not able to focus on OCAN due to more pressing immediate concerns. clients who are accessing brief services and are unlikely to return for months or even years. They will generally refuse to take the time to complete the OCAN. clients with abuse or trauma histories and presenting concerns, because OCAN is presently not designed to capture important culturally safe services provided to these clients, nor is it effectively capturing the relevant circumstances of these clients. Programs note that they’ve had most success with this tool with stable, long term clients with whom they’ve already established a relationship and note its usefulness potentially in case management. 4. Reliability, validity and cultural safety of the current version of the OCAN in Aboriginal mental health services RECOMMENDATION 4: Develop a process to modify specific aspects of OCAN’s interface, protocols and several domains for use with Aboriginal Mental Health Services to ensure cultural safety of the tool. Focus on keeping the main data elements consistent in OCAN. Rationale: OCAN has not been validated in Aboriginal communities in Canada, nor any other Indigenous communities. Our research provides evidence that puts the validity and reliability of several OCAN domains with Sutherland & Maar - March 2010 Page 44
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