Innovative social services program improves accessibility to mental health treatment.
They’re innovators in an era where innovation is desperately needed. Not giving credence to the nay-sayers who believe a distance education platform for youth mental health programming is a utopian quest for a quick fix, Dr. Patricia Lingley-Pottie and Dr. Patrick McGrath developed a mechanism that has given families struggling with mental health issues the help they require. With 15 to 18 per cent of children in Canada facing mental health challenges, and less than 30 per cent of those children receiving timely interventions, someone needed to come up with an alternative to the snail’s-pace traditional approach to mental health care for youth. Lingley-Pottie and McGrath think they have come up with a plan that could both help the health care system and help the children and families that need the help the most.
Here’s how the two innovators came up with their model. Academic and professional colleagues for the better part of their careers, both Lingley-Pottie and McGrath wondered why traditional mental health services had such a poor retention rate. One would think that, after a long wait to get in to see a mental health professional, the client(s) would be eager to stay the course and work toward a resolution to what was ailing them. However, a staggering 40 to 70 per cent of those who start traditional mental health treatment wind up leaving before their issues are resolved. McGrath noted, “I naively thought they weren’t motivated. But it dawned on me that the system was the problem and we needed a better system to deliver care.”
This prompted Lingley-Pottie and McGrath to delve into the systemic problems that were causing mental health patients to give up on services and they came up with a few common sense explanations:
- long wait times (often up to a year) to get in to see a child psychologist or psychiatrist.
- a shortage of qualified youth mental health practitioners
- the social stigma associated with seeking help for mental health problems
- appointment times mostly occurred during the work day, causing many patients or parents of patients to have to book off work for the day. In many cases, this affected their livelihood and they were forced to make a choice: work or therapy.
- a spinoff of the work day appointments was the problem of travel and expense. Besides the lost wages (which is huge!), the cost of travel and day care expenses, traditional mental health care proved to be a costly endeavour.
Lingley-Pottie and McGrath set about creating a mechanism for providing youth mental health care that addressed the issues listed above. One thing was clear from the start: any program needed to have metrics to measure success or failure. Research colleagues at Dalhousie University in Halifax, the two were committed to tangible solutions to real life mental health problems that could stand the rigours of scientific testing. In other words, no program would be put in place without evidence based research to back it up. Drawing on a wealth of knowledge and experience from their work at the IWK Health Centre, Lingley-Pottie and McGrath determined that a distance education model could be employed to help people learn to address their mental health concerns and/or the mental health problems that emerge in their families. And so, in 2011, in the face of plenty of skepticism, the Strongest Families Institute (SFI) was founded.
Mental health education programs were created by the two innovators and their team of associates that targeted the mental health concerns of children and their families. The programs themselves were informed by the clinical and research work of Lingley-Pottie and McGrath. To this day, SFI focuses on family-centred care with a primary focus on anxiety and behaviour problems. Clients referred to SFI are usually dealing with moderate mental health challenges that are interfering with their everyday lives. People suffering with more severe mental health problems – ones where they might hurt themselves or others – are not strong candidates for the program. When SFI was founded as a not-for-profit in 2011, it quickly grew to a staff of 15 serving 700 clients and their families in Nova Scotia. Today, SFI has a staff of 60 serving 4 200 clients right across Canada. This year it earned charitable status which the institute hopes will help with the ongoing challenge of funding programs and maintaining service.
So, what makes SFI so effective? First, there is no wait time. When a client is referred to SFI by a partner agency, they get right in. This eliminates any kind of prolonged delay for those seeking help. Second, SFI programs are psychologically informed and based on best science. They are education oriented, not therapy oriented. Let’s say a young person is dealing with anxiety and is referred to SFI’s Defeat Anxiety program. That young person and their family would take part in a program that targets 11 to 12 key skills tailored to the particular challenge(s) they are facing. The young person and the family would be assigned to a coach who would guide them through a series lessons via handbooks (either print or online) and audio-visual materials that target certain essential skills. The coach would actively monitor and guide the young person and their family over 17 phone sessions. While some clients and their families may finish the program in a short period of time, the SFI model allows for more time if needed. In other words, the program is flexible and customized to the needs of the client and their family. For example, Coach calls are scheduled at the youth’s convenience (i.e., after school/work, evening, night) and SFI staff shifts extend to 2:00 a.m. to accommodate time differences. The ultimate outcome is the acquisition of coping and management skills that allows those participating to learn about what is impeding them and how to deal with those issues once the program is completed.
This begs the question: does the program work? SFI’s CEO and President Dr. Patricia Lingley-Pottie says the proof is in the data. Of all the clients referred to SFI, 90 per cent complete the program and 85 per cent of those participants report significant improvements to their mental health. This is an attractive alternative to traditional mental health care and it’s 30 to 60 per cent retention rate. While the work of the highly trained and dedicated coaches is integral to program delivery, SFI’s computer brain trust, IRIS, keeps everyone at the institute informed as to the program’s success. Lingley-Pottie calls IRIS a “huge brilliant beast” that drives down organizational waste, improves staff efficiency and, most importantly, makes sure no client slips through the cracks. In other words, Strongest Families is dedicated to quality assurance and client service with IRIS delivering important information that allows the project to evolve.
And what does all this mean for Guidance Counsellors across Canada? No doubt just about every jurisdiction has reported a rise in cases of anxiety and depression. They have also seen a growing rise in cases of attention deficit, hyperactivity and oppositional behaviour. Most of these cases warrant immediate attention and the traditional system is severely backlogged. This has put many a counsellor in the uncomfortable position of simply applying makeshift bandages to the institutional scrapes that each case brings to their portfolio of students. However, SFI programs have the potential to allow students and their families to enter into a treatment option in a timely manner. Ultimately, a student suffering from a moderate mental health problem wants to feel like they are (a) not alone and (b) are moving toward a solution to what is hindering them. Waiting for up to a year to see a child psychologist does not help in this kind of situation. However, enrollment in a program where a caring individual/coach helps them move forward could make a world of difference. According to Lingley-Pottie, “This is a program that has a long term impact because we’re teaching families, youth and children life skills they can use long after the program is over.” It is the teaching component that makes Strongest Families an attractive referral option for Guidance Counsellors across Canada.
Column item: To find out how to refer a student to the Strongest Families Institute, go to http://strongestfamilies.com/ and follow the Contact Us link. You can also email the organization: firstname.lastname@example.org.
Strongest Families Institute Fact Sheet
- SFI delivers timely educational programming for young people and their families dealing with moderate anxiety and behavioural challenges.
- SFI programs include:
- Parenting the Active Child (3-12 years olds with disruptive behaviour problems)
- Chase Worries Away (6-12 year olds with anxiety problems)
- Dry Nights Ahead (5-12 year olds who experience nighttime bedwetting)
- Defeat Anxiety (12-17 year olds with anxiety problems)
- SFI is based in Nova Scotia but offers programming in Newfoundland and Labrador, New Brunswick, Prince Edward Island, Ontario, Alberta and British Columbia.
- SFI hopes to expand beyond Canada’s borders and is currently working on a project in Vietnam.
- While SFI maintains its commitment to youth mental health, they hope to develop adult mental health services in the future.
- Awards: The Ernest C. Manning Principal Encana Award for innovation (2013); the National Mental Health Award in Social Innovation (2012) awarded by the Mental Health Commission of Canada; the Innovation in Practice: Health Award (2012) by Progress Magazine.
By: Sean Dolan