What is the system challenge?

The Region of Peel (Brampton, Caledon and Mississauga) is the most ethnically and culturally diverse region in the GTA; however the Peel Service Collaborative observed that this diversity was not reflected in those using mainstream mental health and addictions services.

Specifically, the Peel Service Collaborative noticed that racialized youth (such as visible minorities) were not commonly using formal mental health and substance use services, despite having a need for these services. They also found that these youth were over-represented in hospital emergency departments, and the justice and child welfare systems.

Racialized youth identified in focus groups conducted by the collaborative felt that this was due to several factors. They shared their belief that mainstream services are not culturally appropriate and were not meeting their needs of inclusivity and client and family centeredness.

Because of these factors, many youth seek help from informal supports such as faith leaders when experiencing mental health or substance use issues; however, these supports indicated that they needed to build their skills and knowledge to better understand mental health issues and help youth seeking assistance.

What are we doing about it?

With help from the Provincial System Support Program at the Centre for Addiction and Mental Health, the Peel Service Collaborative designed an intervention consisting of two components. The intervention is designed to bridge the gap between formal and informal supports in Peel region and build a system that better serves the needs of the diverse population in the region:

1. Holistic Crisis Planning:

To address the challenges identified with mainstream services, the Service Collaborative implemented Holistic Crisis Planning (HCP) across the region. HCP aims to reduce unsafe situations for, and the likelihood of harm to, children and youth experiencing mental health and addiction issues, and their families.

It involves the use of a holistic, strength-based and person/family-centred approach to crisis and safety planning that meaningfully engages children, youth and their families in a personalized crisis planning process. HCP was originally developed by Kappy Madenwald of Madenwald Consulting, and was adapted to meet the unique needs of the Peel community.

The videos below demonstrate the approach in different settings:

More information on HCP, along with all related tools and resources can be found on the EENET Community of Interest Page (insert link)

2. Mental Health First Aid:

To build the capacity of informal supports such as faith leaders, the Service Collaborative used a train-the-trainer approach to implement and sustain Mental Health First Aid (MHFA) training in the community. MHFA is an internationally recognized, evidence-based program that helps participants recognize mental health issues and provides guidance on referring those in need to community mental health services. The program also helps to fight the stigma that often prevents many individuals and families from seeking help.

The Service Collaborative also supported relationship-building between faith leaders and service providers by holder a variety of networking and knowledge exchange events that brought the two groups together to discuss how to work better together to address the mental health needs of Peel’s diverse youth.

One such event included an dialogue/engagement breakfast for Peel faith leaders and local service providers - see video highlights

?What's this?

Full Implementation

Since April 2015, over 400 service providers in the Peel Region had received HCP training. These service providers are now using this approach to create HCP Safety Plans with children, youth and their families in a variety of settings, including schools, emergency departments, day hospitals, mental health and addiction agencies and other local community service agencies. A group of Holistic Crisis Planning champions continue to meet as a Community of Interest and intend to stay connected as a group to further the spread of HCP across the region.

A local coordinator was hired for a two-year term to support MHFA in Peel. After their first year in the position, more than 364 people from across 10 different faith communities had received MHFA training.

How do we know it works?

69% of participants (25 people) said they 'always' or 'often' reflect back on the session based on their personal worldview (as defined by race, gender, religion, etc.) in relation to their clients (n=36)

75% of participants (27 people) said clients 'always' or 'often' incorporate informal/natural supports into their plans (n=36)

81% or 34 staff indicated the HCP approach is having a positive or very positive impact on their interactions with clients and families (n=42)

Next Steps

HCP Scaling up:

Based on initial success in the child and youth system, three adult-serving agencies have expressed intent to implement HCP across their services. One of these agencies represents a new sector for HCP implementation, which is housing. This agency is expected to begin implementing in one program this summer while building a champion base across the agency to spread the approach across services. The other agencies continue their involvement as the Holistic Crisis Continuum Community of Interest, where members are actively implementing the approach or have the intent to implement.

Mental Health First Aid (MHFA):

The Service Collaborative secured two-year funding from the Region of Peel’s Collaboration Fund for a Coordinator to support ongoing MHFA training. In addition, representatives from the agencies involved in HCP who have championed the approach within their agencies have come together as a Community of Interest to spread HCP through various knowledge exchange activities.

George Brown College- Holistic Crisis Planning Online:

George Brown College, CAMH PSSP, and Co-Design received funding from SSHRC (Social Sciences and Humanities Research Council) for 3 year project to create digital tools that support the process of crisis planning and management for youth aged 13 to 24 in Peel Region. The tools will be developed collaboratively by youth in Peel who have experienced crisis, their support networks (friends, family, and community), service providers, partner organizations, and students and faculty from the Interaction Design and Development program at George Brown College. The final product is expected to be completed in July 2018.

For more information, visit the project page here

Holistic Crisis Planning Resources

Resources to support Holistic Crisis Planning can be found on Evidence Exchange Network's website by clicking on the link below.