Strongest Families Institute: Kati LaVigne Vice President of - - PowerPoint PPT Presentation

Kati LaVigne Vice President of Operations

Strongest Families Institute:

Pediatric Mental Health

Very common with early symptom onset

• Ontario, Canada- 20% have a diagnosable disorder (Offord et al.,1987)
• United States of America - 1 in 5 children (Centre for Disease Control, 2013)
• World Health Report- 10 to 20% (WHO, 2001)
• 1-16 year olds: India 13%; Ethiopia 18%; Switzerland 22%
• 12-15 year olds: Japan 15%; Germany 21%

Untreated conditions exacerbate overtime

• More difficult to manage
• Inflict a heavy burden on the child, family and society
• Lead to co-morbid conditions, tracking into adulthood

(Costello et al., 2005; Kessler et al., 2005)

Issue: Barriers to access timely care

Current System

• Limited availability of evidence-based, early intervention services for

children and youth

• System unable to serve all who need help  wait lists

Barriers families can encounter:

• Day time appointments for 16 weeks can be difficult to commit to
• Travel burden inconvenient for 16 weekly sessions
• Financial burden with travel or time off work, especially rural/remote
• Time from school; child resistance
• Stigma associated with receiving mental health services
• Long waitlists, problems become worse over time

Result in : High attrition rates  untreated conditions  track into adulthood and more difficult to manage

Access solution: Removes Barriers to Care

Strongest Families Institute: Not-for-profit, Bilingual (EN & FR)

Evidence-based, Distance Education Model (Skill-based learning)

 Programs target Behaviour, Anxiety, Bedwetting problems

Delivered to families in comfort and privacy of their own home

 Weekly coaching phone sessions at convenient times

 Days, evenings, nights

 Receive materials (handbooks or web-interface)  Skill demonstration media

Removes barriers to care

• No travel, no financial burden, no missed work/school, no stigma

Compliments existing system: SFI sends letter updates to referring source

Evidence-based Programs

Programs and mode of delivery

 Handbooks/DVDs or Smart web-site  English & French  Coaching modes- 1:1 or group based

 Group- 10clients: 1 coach

Anxiety (6-17 yrs): Relaxation skills & exposure

 Performance, social, specific phobia, generalized, separation

Behavior (3-12 yrs): Parenting

 Oppositional defiance, ADHD, conduct

Night-time Bedwetting (5-12 yrs): Urine alarm ~ Intelligent Research and Intervention Software (IRIS) technology at the core of operations

How does Strongest Families work?

 Self-help design with coach facilitation

 One skill-based session per week (11-12 skills, total of 16)  Practices implementation of skill daily – matched to address problems

 Highly trained telephone Coaches

 Perform protocolized telephone sessions (problem solve/encourage families)  Quality assurance monitoring to ensure program fidelity

 Calls are recorded and monitored (2-5% recorded calls scored)

 Weekly caseload review by coach supervisor  Customize the intervention to meet family needs

 Family-centred approach (child special needs; family challenges)  Care plan based on intake results, risk management protocols

Outcomes

Outcomes are consistently measured & reported

Validated tool pre/post intervention (Brief Child & Family Phone Interview - BCFPI)

Service delivery (Publication in preparation)

 Service results strong

 > 85% child outcome success  Strong impact on academic progress, bullying (72%), victimization (68%)  Strong impacts on family functioning and parental mood  <10% attrition

 Other facts:

 32% families <$30k annual income; 63% single parents  Canadian First Nations children and youth: strong outcomes at 96%  Past 1.5 years rise in LGBTQ2+ youth referrals: strong outcomes June 8, 2009

Behaviour: Parents Empowering Kids (3-12)

Positive Parenting: COPE (adapted) (Cunningham et al., 1995) Increase pro-social/Decrease antisocial Emotional regulation Strengthen family relationship Parents Empowering Kids

Anxiety: Chase Worries Away (6-11)

Parent & Child/Youth component

• Relaxation skills
• Changing thoughts
• Imagery
• Gradual exposure

Story of two junior high students with high anxiety who learn skills then become superheroes (comic book style)

Mobile Responsive Examples

June 8, 2009

Anxiety Program (Alberta)

Anxiety Program Outcomes

 Depression among 11-17yo (351 cases)

 38% presented with significant depression  96% resolved at least one of Anxiety OR Depression  87% resolved BOTH Anxiety and Depression

 84% increased school attendance – those that weren’t attending regularly

are now attending classes on a regular basis

 Indirect impact on socialization June 8, 2009

Referral Process

 Referral process varies based on where the child/youth resides and

funding availability in their area.

 Inclusion criteria: Cases that fit the age parameters of our programs

 Must have Significant problems (>6 mos) PLUS Significant impairment  Includes complexities (e.g., comorbidities, complex family situations,

past abuse/neglect, some involvement with authorities)

 SFI contacts within 24-48 business hours to pre-screen

 SFI will follow-up at various time points (day, evening, night) at all

contact numbers provided, and leave messages

 If we are unable to reach families, a ‘difficulty contacting’ letter is sent

and referring source copied (with permissions)

Exclusion Criteria

 Imminent risk to harm self and/or others  Active psychosis  Current significant involvement in the Criminal

Justice System with severe presenting issues

 Active youth substance abuse issues/dependency

June 8, 2009

Awards Received

www.strongestfamilies.com

 Governor General Innovation Award, 2017  Ernest C. Manning Encana Principal Award, 2013  Mental Health Commission of Canada, 2012

 Progress Magazine Health Innovation Award, 2012

June 8, 2009

Expanding services to those in need

Canada Newfoundland & Labrador: Provincial (Dept. of Health) Nova Scotia: Provincial (Dept. of Health & Wellness) PEI: Provincial (Health PEI) New Brunswick: Provincial (Multiple Dept. collaborative) Ontario: Peel Children’s Centre, Woodview Children’s, New Path/Kinark/Le Cle, Simcoe-Muskoska LHIN, Kingston MFRC Alberta: Calgary Zone & Edmonton zone National: Military Family Services Other Interest:

• New Zealand: National e-health <Launching soon country-wide>

June 8, 2009

Conclusion

Removing Barriers to Care

 No travel, no time from work/school, no cost, no stigma

A cost-effective, timely access solution

 Highly effective, highly accepted with low attrition  Convenient, accessible and scalable  Timely- intervening early before problems become worse

Providing outreach to families when & where they need it

 Especially those in rural and under-resourced regions

Harnesses advantages of technology

 Enhance the client care experience

• Continue to respond to the needs of families, involving youth feedback

Kati LaVigne, Vice President of Operations

klavigne@strongestfamilies.com www.strongestfamilies.com