The Sooke Navigator Project: Mental Health and Addictions Service Access in a Rural BC Community: Community Initiated Participatory Action Research Ellen Anderson, Susan Larke, Sooke Family Resource Society, Mheccu, UBC, UVic, VIHA

The Problem: Sooke Region Access to Mental Health and Addiction Services Limited local service; nothing for youth hours travel to services long waitlists Clients with fewest resources negotiate most complex service system People ‘bounce off’ or ‘bounce around’ the system If no assessment, clients don’t show up in any health database as requiring service Need local data to inform service planning; no system for collection

The Model One phone number, navigator comes to client “every door is the right door” Collaborative, client-focused strength-based assessment and planning Navigator co-ordinates referrals with formal/informal service sectors Navigator doesn’t do therapy Navigator does do brief case-based follow-up of service access, documents barriers to client service Navigator ‘tends referral lines’ - nurtures and documents linkages in the community to services and resources

The Goals Quantify and characterize local need Improve interagency communication and connection Integrate community mental health services with primary health care Improve access, assessment, and engagement for clients

The Questions 1.What are current mental health and addictions (formal and informal) service needs in the Sooke area? 2. Are available programs and resources able to meet local need when: organizational informational access barriers are modified or reduced? 3. Will a Navigator model enhance community capacity by improving linkages between formal mental health, addictions and social services, and informal community resources?

Methodology/Measures Standardized assessment data on all clients with consent No client denied service Pre/post Navigator client focus groups Pre/post Navigator physician survey Pre/post Navigator semi- structured interviews on service-provider experience and needs Define service agreements and charter Documentation of provider referral patterns Waiting times for access to service Documentation of barriers to access Development/analysis of MHAS assessment tool

Researchers will: Analyze quantitative and qualitative data on local service need, access, barriers Participate in locally based ‘navigation steering committee’ Evaluate service provision and standardized assessment tool in an action-research model Translate knowledge to community and health authority Participate in future planning with the community and health authority

Preliminary data (June-Sept) N = 31 (25 full assessments; 6 brief meetings with families) 16 Female (52%), 15 Male (48%); <19 yrs (youth): 29% <25 yrs: 53% yrs: 47% Referral Sourcen (%) Family/Self9 (29%) RCMP2 (6%) Employment Agency9 (29%) Crisis Centre1 (3%) GPs4 (13%) Family Dev. Workers1 (3%)

Mental Health & Addictions Issue# Reported Mood Symptoms28 (90%) Trauma (witnessed/experienced)12 (39%) Acute situational distress27 (87%) Aggressive/disturbed behavior7 (23%) Functional psychosis4 (13%) Self-harm (incl. suicidality)7 (23%) Difficulties with primary relationship14 (46%) Substance misuse (recent/current)18 (58%) Brain injury or other organic1 (3%)

Gaps & Barriers Still developing qualitative protocols and defining criteria Anecdotally… –Lack of affordable housing/crisis housing has a MAJOR impact on mental health – transportation is a key issue for our clients Even when one appointment can be kept, traveling to multiple appointments over time is a significant barrier –No local drug/alcohol or other counseling services available for youth