Children's Mental Health Ontario Conference November 2012 Denis Boileau

Children’s
Mental Health Ontario
     Conference

   November 2012

    Denis Boileau

                    Maison Fraternité   1

   The number is right

   Project S.T.E.P.

   School based program evaluation

                              Maison Fraternité   2

1.) According to recent data,
workplace depression afflicts
XXX percent of employees in
North America

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2.) XXX percent of
those who live with
depression are active in
the workplace
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3.) Addictions and mental
health illness will affect XXX
% of people during their
lifetime.

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4.) Mental illness is associated with
more lost work days than any other
chronic condition, costing the
Canadian economy $ XXX billion a
year

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5.)   Every    day, XX
Canadians are absent
from work due to mental
health problems

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1) 70%

2) 20%

3) 25%

4) 51 billion

5) 27%

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A community response

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   S.T.E.P stands for

                  Support
                Treatment
                Education
               Prevention

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o   Community’s response to addressing the need for residential
    substance abuse treatment, education and prevention for young
    people.
o   Support of community partners, local champions and leaders,

o   GOAL:
     o Campaign will raise the funds needed to support the
       development of a comprehensive substance abuse education
       and prevention program in our high schools
     o and provide specialized treatment and counselling in a 24-hour
       residential setting.

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Project S.T.E.P. partners include
   Premier McGuinty’s office and the Province of Ontario,
   the Champlain Local Health Integration Network,
    Health Canada,
   the Sens Foundation,
   the Cowan Foundation,
    Ottawa’s four school boards,
   Ottawa Police Service,
   Ottawa Public Health,
   the Royal Ottawa Hospital,
   Maison Fraternité ( Club Richelieu is also a partner) in the building
   Dave Smith Youth Treatment Centre.

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OPDI, OAPC & OFCMHAP Joint Conference & AGM

Paul Welsh, Rideauwood/Addictions Ontario -
          Federation Transitional Board Member
Denis Boileau, Maison Fraternité

   multi-sector community partnership, brought together to address the
    issue of substance abuse among students in Ottawa.

   Substance Abuse and Youth in School (SAYS) Coalition. Coalition
    members include all four local school boards, youth-serving
    addiction agencies, Ottawa Public Health, United Way / Centraide
    Ottawa, enforcement and allied professionals.

   2011 Ontario Student Drug Use and Health Survey, 1 in 8 Ontario
    students (Grades 7 – 12) may have a drug use problem, but only a
    small fraction of students have received treatment.

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Overview
 School trained to understand, recognize, refer, support;

 Multi Disciplinary Team (Rideauwood/Maison Fraternité
  Counsellor, Vice Principal, Guidance Counsellor, Social
  Worker, Special Education);
 School refers to Counsellor;

 Counsellor coaches school on referral, M.I., etc.;

 Counsellor does Screening, Engagement, Assessment;

 Counsellor provides individual counselling; flexible
  length - 1, 2, maybe 3 times weekly;
 Groups provided – “Moderation” or “Recovery”.

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Rideauwood Began School Programs in 1986.
 In 49 English Catholic & Public Schools 2-4 days
  weekly; each school – 52 weeks a year;
 Grades 7-12 – all Catholic Schools + 2 Sr.
  Elementary;
 Critical Mass: 14 hours weekly per school X 52
  weeks;
Maison Fraternité began in 1993.
 Now in 17 French Language Catholic & Public
  Schools;

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Client Profile
 60% Grade 9 & 10; 55% Male

 Students are in difficulty, substance abuse known;

 Cannabis use 20 days out of 30;

 Binge drinking 8 days of 30;

 1 in 5 students are failing;

 48% “High Risk for Dropout”,

 Many have identified related Mental Health Problems;
  – Depression, Anxiety, Trauma, Eating Disorder, Anger.

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Parents
 About 30% have Substance Use Disorders;
 Other Mental Health Problems also;
 Parents are served in schools;
 Provided counselling, education, address their
  distress;
 Why? THEY ARE CLIENTS TOO. Service is
  accessible.

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Assessment Tool – Basis 32

   The MOH approved assessment tool, the Basis 32, was
    used to assess changes in the well-being of students,
    between the beginning and end of the academic year.

   The Basis 32 is a five point scale from where:
    0 = No difficulty, 1 = A little difficulty, 2 = Moderate
    difficulty, 3 = Quite a bit of difficulty, and 4 = Extreme
    difficulty.

   Overall improvements were most pronounced in those
    clients with the more severe problems.

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Outcomes
    The largest improvements in well-being were observed in
     those clients which exhibited signs of moderate to extreme
     difficulty in various aspects of their life on the Basis 32.
            Basis 32            n    Baseline        Reassessment              Change

Relation to self/Others         34     2.67                       1.87          0.8
Daily Living/Role Functioning   34     2.66                       1.87          0.79
Depression/Anxiety              34     2.58                       1.75          0.84
Impulsive/Addictive             34     2.26                       1.41          0.85
Psychosis                       34     1.25                       0.74          0.51
Overall Average                 34     2.32                       1.55          0.77

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Outcomes
      A typical client uses both alcohol and cannabis – using cannabis 19
       days a month and using alcohol 8 days a month;
      At the end of the school year, clients reduced in both the amounts
       and frequency of their use.

                                                                           Average        %
       Changes in Drug Use        N    Baseline   Reassessment
                                                                          Reduction    Reduction
Average Cannabis Use Per Month
                                 164    43.67        22.01                  21.66       ↓ 50%
(in Grams)
Average Alcohol Use Per Month
                                 142    54.67        35.32                  19.35       ↓ 35%
(in Standard Drinks)

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Outcomes
 > 10% of clients are also using “other” drugs, most commonly
  cocaine, hallucinogens, and/or ecstasy
 The greatest reductions in use were found with these drugs. More
  than 70% of clients completely ceased using, and more than 85%
  showed marked reductions.

         Became Abstinent                  Reduced Use
     Cannabis           18%        Cannabis                        38%
     Alcohol            19%        Alcohol                         21%
     Cocaine            71%        Cocaine                         14%
     Hallucinogens      80%        Hallucinogens                   13%
     Ecstasy            73%        Ecstasy                         13%

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   During 2011/12 school year, 1500 students
    served through school-based counselling across
    all four school boards,
   additional    5400     high   school     students
    participating in prevention and education
    programming,
   to better support students referred to
    counselling, 500 of their parents were also
    offered counselling support during the year

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   2011/12, 900+ new students referred to the counselling program.

   Estimated that 75% of the students who meet with a school-based addiction
    counsellor engage in ongoing counselling.

   Also, many students continue receiving counselling services for multiple
    years; (42% of the clients who were seen in 2010/11 continued with
    services in 2011/12).

   “Ongoing counselling” implies that the student has attended at least three
    sessions, after which a client is formally admitted to counselling.

   Variety of reasons why a student may not be admitted, including lack of
    readiness/motivation or referral to other services.

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   For many students, a few months of counselling is not sufficient time
    to overcome their substance use issues and develop the necessary
    positive behaviours and skills, so this high proportion of returning
    clients is seen to be an important outcome.

   High rate of student engagement and commitment is one of the
    hallmarks of this school-based model, and differentiates this
    program from other types of service delivery models.

   Getting adolescents to act on a referral and engage in ongoing
    counselling is one of the most challenging aspects of intervention
    and treatment.

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   The program’s success is because of the close partnership
    between school staff and the service providers, including the
    physical presence of the counsellors in the school building.

   Each counsellor makes an effort to visit as many classes as
    possible early in the school year to introduce themselves to new
    students, and to be a visible part of the school community.

   The counsellors have earned the trust of students to the point
    where some students have self-referred or have brought friends to
    see a counsellor.

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   From the sample group of students participating in this program:
   7 out of every 10 students were able to reduce or stop using one or
    more drugs during the evaluation period
   56% of the 150 cannabis-using students in the group reported that
    they decreased or stopped their use of this drug. Overall alcohol
    consumption decreased by 35%.
   Over 70% of the clients who previously used cocaine and/or ecstasy
    reported that they achieved abstinence from these drugs. For clients
    who used hallucinogens, 80% had stopped use.
   Students who were experiencing the most difficulty upon entering
    the program showed the biggest improvements in health and
    wellbeing (as measured by the BASIS 32 assessment tool).
   89% of the students admitted to the counselling program completed
    the school year.

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   “An excellent, collaborative program which works very
    well in our school community.”

   “They [the counsellors] are extremely professional and
    work with the students in a kind, and caring manner. I
    would hope that the time increases at each school for
    the number of days a counsellor visits to better address
    the number of students requiring support. This time
    could also be used to educate and visit Gr. 7/8 classes
    for preventative measures.”

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 Denis Boileau
   Executive Director, Maison Fraternité
   613-741-2523
   dboileau@maisonfraternite.ca

 Paul Welsh
   Execive Director, Rideauwood Addiction and Family
   Services
   613-724-4881
   paulwelsh@rideauwood.org

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