Final Report Early Youth Interventions Project Report March 31, 2009 Transitional Age Youth and Health Promotion Summary The Early youth interventions project charter identified the need to establish best practice guidelines for health promotion and to establish a task force for transitional age youth in order to assist in the transitioning of youth into the adult mental health and addiction network. The project team reviewed mental health and addiction promotion by identifying best practice guidelines (10 best practice guidelines, Centre for Addiction and Mental Health) and compared them to existing youth mental health and addiction services. The findings revealed a range of health promotion and prevention services in the children and adult mental health and addiction services network. Gaps in services included opportunities for organizational change and policy development. Also, the project team investigated 5 areas for transitional age youth: psycho-social rehabilitation services, housing, referrals and assessments, a best practice service for youth, and a service delivery model for transitioning youth into the adult network. The project team saw this as a means of creating the journey for transitioning youth into the adult mental health and addiction network and to support the work of the Task Force which met on 25 March, 2009. Process and Methodology- Literature Review A number of best, leading and promising practices were identified in the literature, government reports and field practices. The information would suggest that a best practice for early youth interventions was not associated with any one approach to service provision, but rather a multi-intervention approach, where risk factors are managed and protective factors are enhanced. Government reports support an integrated, collaborative, seamless approach involving service providers, consumers and families in all aspects of treatment. Current services and practices in the community reveals that the management of risk and enhancement of protective factors approach is in place and there were indications that integration of services and programs have been successful in health promotion, education and mental health and addiction interventions. Process, Methodology and Summary of Findings - Health Promotion: A health promotion environmental scan was completed in order to identify youth mental health and addiction promotion and education services. The scan involved site visits, telephone interviews with children and adult community mental health and addiction agencies , (69 service providers), meetings with consumers, families and community groups (70 persons), and completion of a literature review regarding best practices in the area of mental health and addiction promotion. Also, a survey was forwarded to 2 service providers in November, 2008 in order to confirm findings from site visits and telephone interviews. The environmental scan revealed a number of best practices and approaches. The Centre for Addiction and Mental Health has developed a best practice guideline(s) for mental health promotion promotions interventions for children and youth. The guidelines include evidence based approaches in the application of mental health promotion concepts and principles for children and youth and are based upon mental health principles that have been identified through critical analysis of literature reviews. The guidelines are based upon ideal mental health promotion interventions. A comparison of current services to best practices in the literature was completed and a leading practice in the field of mental health and addiction promotion was identified. Findings reveal that there are many youth mental health and addiction health promotion and education services are available to youth and provided in a variety of setting (schools and community based service settings). Most mental health and addiction health promotion services address risk and protective factors. All service providers were client centered in their approach to mental health and addiction education services to youth, with a goal of educating and empowering the consumer. Curriculum associated with the programs varied in research, quantity, quality and evaluation processes. Available information through agency websites supported principles of cultural appropriateness, sensitivity and accessibility to the public. Youth mental health and addiction services focused on peer relationships, resiliency, and effects of bullying and stigma related to mental illness and addiction. A gap in services may be identified in the area of education information to families and youth which are linguistically appropriate and in most cases, ongoing training for health promotion services. Process, Methodology and Summary of Findings – Transitional Age Youth The Transitional Age Youth project team was comprised of 13 members (consumers, family and service providers in the children and adult mental health and addiction network) and met on 5 occasions. The project team supported a terms of reference which included a multi intervention approach to transitioning youth into the adult mental health and addiction network. Literature and data supports the need to provide mental health and addiction treatment for youth. The project team researched and investigated the following areas: Service delivery model: A summary of evidence demonstrates that Assertive Community Treatment (ACT) programs improve clinical status and reduce hospitalizations; 3 Psycho-social rehabilitation programs and services: While there are many best practices programs and services identified, education, employment and family support services for transitional age youth were identified as most important for transitional age youth. Housing was identified as fundamental for successful transitions into the adult mental health and addiction network. Some gaps in mental health and addiction supportive housing, use of emergency shelters by youth and a lack of available data were some of the findings and a need to initiate further research in the area of youth housing. Referrals, assessments and communication issues were also reviewed by the project team members. Referral forms were developed and standardized tools of assessment for youth over and under the age of 18 years were investigated. Communication between and amongst service providers and ensuring that privacy of individuals is protected is highlighted as central to success transition for youth. Best Practice principles for service delivery identified 3 main areas: orientation to client, approach to practice and appreciating the context. The team supported these guidelines for use by children, youth and mental health and addiction practitioners, noting that it was of particularly importance for clinicians and practitioners who may be delivering services to youth in the adult system. The issues for youth who will not transition into the adult system may be understood by potential waiting lists in the adult system at the time of transitioning; situations where youth choose not to access mental health and addiction services; family breakdown and youth leaving parental home and experiencing homelessness; those who choose to leave care. Systems Map Logic Model – Findings A Youth Service Matrix Model was developed which outlined youth mental health and addiction services and service providers from both the children and adult systems. Services include a wide range of providers and services from mental health and outlines common areas for the network. The map is also a useful tool for agencies, consumers and families in order to identify who provides what services for children and a means of navigating through the children and adult mental health and addiction network. (See appendix # 1). Recommendations of the Transitional Aged Youth Project Team based on the Findings 1. Youth are best supported when using a model of Best Practice • That a recovery model of practice is incorporated into treatment approaches (wellness philosophy). Best practices support a recovery model approach involving a number of interventions and treatments for youth. The Project team recognizes the importance of client centred care, respect, choices, potential for change in children and youth. , The project team supports the need to avoid labels which can stigmatize and emphasize illness rather than wellness. 4 • That youth are supported in their home communities. The project team recognizes the importance of family, peers and community in wellness of children. • All Services should be planned, implemented and evaluated using evidence- based Best Practice Guidelines. 2. Youth are best served when Agencies have the capacity to provide the highest quality of service. • Both the Youth and Adult Mental Health and Addictions System require capacity building in order to address the needs of Transitional Aged Youth. Part of this capacity building involves funding for Infrastructure development which will permit the implementation and maintenance of a connected system of service. • That agency needs are recognized in the provision of transitional age youth services. When changing, expanding and creating new services for transitional aged youth, adequate funds and resources must be in place. Such resources should be seen as a social investment and not a cost. • The project team recognizes that Agencies require enhanced funding which is specifically targeted to serving Transitional Aged Youth. • The project team also recognizes the importance of communications