A client’s perception is widely seen as a key indicator of the quality of the care they have received. One of the key features of the Ontario Ministry of Health and Long-term Care’s children and youth mental health action plan–Moving on Mental Health – is to collect and report on child, family and caregiver responses to questions about the quality of the services that they receive.

Core service providers have always collected client and family feedback, however they were doing this in different ways and asking different questions in their surveys. 

With support from PSSP's western region Hamilton Office, and lead agency Lynwood Charlton Centre, the Hamilton community responded to this challenge by engaging key service providers, intermediary organizations, researchers, as well as clients and their families. This project was a first attempt to ask the same questions about service experience across all core service providers in order to get a clearer picture of young people and family members’ experience with the mental health and addictions system.

Existing surveys

The team initially looked at Ontario Perception of Care questionnaire (OPOC-MHA), but the questions did not match the required data (OPOC comes from Health so this sector was not involved in the development) and staff rolling out the OPOC were already stretched without adding new sectors. The best option available to the team was to develop its own client and family feedback service experience tool. 

The Youth and Parent/Caregiver Feedback Forms

The collaborative co-developed and piloted the Youth and Parent/Caregiver Feedback Forms that are now employed in the Hamilton Service Area.  Available in English, French, Arabic, Spanish and Somali – the form requests information about: 

• wait times for service;
• level of involvement in treatment planning; and
• the ability of young people to manage their behaviours and feelings as a result of services.

Catherine Ahern, Manager of Quality Improvement and Evaluation at Lynwood Charlton Centre led the initiative and stated that, “everyone involved in developing the feedback form brought a different perspective, such as research, quality, and lived-experience. The end result was much better than any one of us could have created independently”.

What is done with the data?

Agencies will be developing individual reports based on the data gathered in order to aid in the planning and provision of services across the twelve child and youth mental health agencies in the Hamilton Service Area. Reports will also be consolidated across core service providers and the evaluation data will also be used to enhance service planning. This will ensure that clients and families have a positive experience with the service they receive.  

The Pilot Phase

A research team at the Offord Centre for Child Studies at McMaster University piloted the forms with youth and families seeking mental health services, recruited through the Child and Youth Mental Health Program at the Ron Joyce Children’s Health Centre, McMaster Children’s Hospital.

Researchers collected comments from families and youth about the questions, and about the length, order and format of the questionnaire. This feedback was used to identify issues and to make improvements to the questions and the forms in general.

Laura Duncan, Research Coordinator and PhD student at the Offord Centre for Child Studies, who led the pilot testing observed that, “the development process was strengthened by diverse contributions that recognized the importance of evidence-based decision making, clinician and family and youth experience, and the service area context.” 

Members of the local Parents for Children’s Mental Health chapter were also consulted with much of their input being incorporated. 

User Manual for Clinicians

On the PSSP side, Alan Cudmore and Michael Weyman from the west region’s Hamilton office lent their expertise to designing the survey, while Alan led the initiative to create the accompanying user manual to guide clinical staff core service providers in the implementation of the surveys into their practice setting. This manual provides practical tips on the administration of the survey and helps to ensure the consistent collection of data.

Other lead agencies in the province that would like to collect client/family feedback across different services will be interested in the survey/manual as well as the process that the team used to develop both. The manual can be downloaded below.

Next Steps

Now that the feedback forms and manual have been launched, this group is developing standardized guidelines aimed at collectively reporting positive outcomes of the core services through the use of established outcome measurement tools.

If you, your agency or service area require more information about in using the feedback forms, please contact the development team at alan.cudmore@camh.ca.