Full Report

MENTAL
HEALTH
Improving inter-branch
communication
According to staff, the project has improved
communication between health and social
services. Historically, the independence
of these branches has impeded the flow
of clients information between them. One
interviewee indicated that it “seems like
there is a Grand Canyon… between mental
health and the health centre.”
Use of the referral pathways, however,
appears to be breaking down barriers and
enabling staff throughout the system to
collaborate effectively in referring and
monitoring the progress of clients. 110 Staff
noted improved relationships between
providers, better handoff of clients through
the use of the referral pathways and an
increase in the use of case management
practices. 111 These changes are indicative of
future support for more case management
among health and social service staff. Case
management has also been identified in
the NWT Action Plan, which states that the
Department will work with other government
departments to formalize practices and
improve both accessibility to the system
and appropriateness of services.
What we found
As the CDM pilot projects strive to improve care
across NWT, they are not without their own
limitations. As already noted, Fort Simpson saw
interactions with only two clients who came from
the outlying cabin communities; Fort Good Hope
received no clients. Both communities are small,
suggesting larger pilot sites with a greater ability
to draw on client populations may have offered the
potential for a more meaningful experience with
the new process and tools.
This scarcity of clients makes it difficult to discern
the impact the project may have had on client
care. Of interest, a post-pilot survey by staff noted
an increase in quality care across the system as a
result of the pilot projects. 108 The Department feels
it is prudent to interpret this and similar opinions as
expectations for future improvement that may flow
from project work – and also as a measure of staff’s
belief in the potential for the standardization work
at the project’s core.
Despite these particular limitations, the pilot sites
reported a variety of professional and organizational
improvements. As the survey reflected, staff are convinced
of the benefit of standardized pathways for
referring mental health clients. Staff also found value in
the information sharing tools, such as the checklists for
referral, as well as the pathways for referral to inpatient
and outpatient psychiatry. All staff surveyed after the
piloting phase recommended the continued use and
spread of the toolkit beyond the pilot sites. 109
Spreading the benefits
At STHA, the inpatient psychiatry unit for the entire
territory, staff adapted the pilot project’s referral
checklist for use in all communities. Since the project
ended, STHA has sent a number of discharge plans
to clients’ home communities – clear evidence of
improved communication, acceptance of the process
and pathways, and spread of the practice beyond
the pilot sites. 112
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Making the Case for Change