Reaching Out: Changing Service Models for Youth

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Reaching Out Changing Service Models for Youth

• Adolescent Outreach Program, RMHC- London
• Primary Clinicians
• David Bogaert, RN
• Pam Geiger, RN CPMHN (C)
• Julie Jeanson, RN CPMHN (C)
• Jennifer Wilson, RN CPMHN (C)

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About the Program

• Core team 4 psychiatric nurses combined with
  intake worker, psychiatrist, and Social Worker
• Currently service London and Middlesex County
• Primarily community based
• Client centered
• Referral based

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Target Population

• Youth age 13-18, Voluntarily seeking support
• Presenting problems vary
• Mood and Anxiety
• Psychosis
• ADHD
• Suicide and Self harm
• Parent/Child conflict in
• the presence of Mental Illness

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Population contd

• Client needs better suited for community
• Transitional youth
• Current support network requires psychiatric
  consultation

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Outreach Program Features

• Based on client acuity and needs
• Individual appts once/week to monthly
• Service delivery flexible
• Maintain clients in the community
• Fiscally responsible

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Features contd

• Length of service variable
• Mon. Fri. daytime
• (Dialectical Behavioural Theray clients have
  access to 24 hr. skills coaching by pager/phone)
• Available to client and family

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Service provided

• Individual CBT, DBT, psychotherapy, social
  skills training
• Standard Psychology Testing
• Group therapy DBT
• Psychiatric Consultation
• Family Therapy- Social Work
• Education and Prevention
• Thames Valley District School Board partnerships
  
  
• School support- WD Sutton School/ consultation to
  home school

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Benefits

• Provides alternatives to hospitalization
• Cost effective
• Increased availability of psychiatric
  consultation in community
• Recognition of early onset and intervention
• Reduces length of stay in hospital with
  preadmission and aftercare service

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Challenges

• Time factor, driving
• Needs greater than resources
• Bridging the gap transition to adult services
• Expansion of services to other counties

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• ADOLESCENT OUTREACH
• DIALECTICAL BEHAVIOURAL THERAPY (D.B.T.)
• OUTPATIENT TREATMENT FOR YOUTH COPING WITH
• SUICIDAL AND SELF-HARM BEHAVIOURS
• WHO Age 15-18
• Living in London or Middlesex County
• Want to learn new coping skills to make life
  better
• WHAT 12 week intensive treatment program
  including
• weekly skills training group for youth and
  support person(s)
• weekly youth individual session
• on call telephone support/coaching
• WHEN Continuous group for 12 consecutive weeks
• Open entry points every 4 weeks (as space
  available)

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Provincial Centre of Excellence for Child and
Youth Mental Health Program Evaluation
Grantfor Adolescent Outreach DBT
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Why did we apply?

• Our Outreach DBT program was adapted from an
  adult service model combined with a pilot
  adolescent model to merge with our service
  delivery style
• No body of research on effectiveness of the
  adolescent model and limited research with adults
• Our initial anecdotal evidence from clients and
  clinicians shows positive response
• We needed assistance to set up a viable
  evaluation plan with hopes to potentially expand
  to a research project

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What we learned

• We are skilled clinicians but have limited
  program evaluation and research experience
• It was imperative to utilize the funding
  primarily to hire a research consultant to both
  direct and set up our evaluation plan complete
  with an integrated database
• We needed additional support from a psychometrist
  to administer testing materials
• We have just begun to enter initial data no
  outcome data available yet

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Lessons for the system

• Opportunities are available to think outside the
  box in terms of what your service can accomplish
• Think about using funds to purchase expertise or
  consultation

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Questions??