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Doing Whatever It Takes:Doing Whatever It Takes:
Building Responsive Service Systems for Children and Building Responsive Service Systems for Children and Youth in Complex Service SituationsYouth in Complex Service Situations
CMHO/OACAS Joint Conference June 2, 2008
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Who We AreWho We Are
Lydia Sai-Chew, M.S.W., R.S.W., Manager, Community/Family Support Services, Griffin Centre, Toronto
Sandra Kidd, M.S.W., R.S.W., Social Worker, WIT Program, East Metro Youth Services, Toronto
Rahat Pye, M.S.W., R.S.W., Social Worker, WIT Program, Griffin Centre, Toronto
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Service System ChallengesService System Challenges
Lack of coordination and communicationThe needs of the child/youth exceeds the capacity of any one agency or service sectorComplex or unclear diagnoses that do not meet the mandate of any one organizationTimes of transition“Silo-ing” of servicesReluctance to change
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Whatever It Takes (WIT)Whatever It Takes (WIT)
Facilitates the development of shared solutions for children/youth in complex service situationsComplex clinical profilesUnclear and/or confusing mental health diagnosisNeeds of child/youth are such that multiple agency/sector involvement is necessary
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How WIT Can HelpHow WIT Can Help
Enhance the continuum of support and serviceOffer interim intensive case managementDevelop partnerships that facilitate access to specialized assessments and servicesGenerate collaborative service responsesIdentify service system gaps and needs
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WITWIT’’s Visions Vision
Access to mental health systemEasy navigation through the service systemSeamless transitionsCollaboration and coordination among organizations and sectorsService system is perceived as welcoming and inclusiveBuilding of capacity in the service systemShared responsibility that is based on mutual trust and collaboration between partnerships
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Literature Supports that:Literature Supports that:
To be effective, service planning and delivery must be coordinated at individual, program, and system levels
Better outcomes are achieved by utilizing a community based partnership approach
An ideal model of services and supports is one that does not create artificial barriers and gaps
Sound evaluation practices be put in place to inform stakeholders of what is working
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What makes a service situation complex?What makes a service situation complex?
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What makes a service situation What makes a service situation complex?complex?
Lack of clinical formulationMany service providers are involved and each have their own perspectiveTime limited nature of servicesSpecific mandates of service providersLack of resourcesComplex clinical profile of child/youth/familyCommunication between agencies and/or sectors
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Case PresentationCase Presentation
18m3511121617
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Family ProfileFamily Profile
Single mother7 children, ages 18 months – 17 yearsExperienced violence in home countryEach child has identified needs, such as autism, developmental disability, depression, conflict with the law, drug and alcohol useMother is illiterateMother has medical issues
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Referral RequestReferral Request
Referral initiated from community hospital requesting long term case managementNo agency has been able to assume service coordination for the entire familyMultiple agencies are involved but all have time limited and specific mandates
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What do we do?What do we do?
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How to Identify Gaps in ServiceHow to Identify Gaps in Service
Use our own clinical experience/formulationSpeak to all involved parties ie service providers and family membersConsult with internal agency teamConsult with relevant community servicesPsychiatric or psychological consultationSystems approachStrengths based
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ChallengesChallenges
Intra- and inter-agency politicsInvestment in one perspectiveLength of time of involvementBurn outLack of resourcesLack of clarity re clinical profileFear, feelings of incompetencePerceived lack of flexibility
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Community Meeting
• What is it?– Bring to the table all involved parties and any
other party that can offer a new perspective/resource/relevant knowledge/etc.
• Why have it?– Generate solutions– Facilitate shared responsibility – Create and develop partnerships– Find innovative ways to work together
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How do we know when our work is done?How do we know when our work is done?
Shared clinical formulationDevelopment of collaborative service plan with clear goalsFocus for interventions is the service plan
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Contact usContact us
Lydia Sai-Chew, Griffin Centre, 416-222-1153 ext. 164 or [email protected]
Sandra Kidd, East Metro Youth Services, 416-438-9419 ext. 247 or [email protected]
Rahat Pye, Griffin Centre, 416-222-1153 ext. 160 or [email protected]
