Court Outcomes Data Project Thursday, February 26, 2015 Michael Dunn, Provincial HSJCC Co-Chair Sarah Gauthier, Canadian Mental Health Association - Sudbury/ Manitoulin Hélène Philbin-Wilkinson, North Bay Regional Health Centre @HSJCC Provincial HSJCC

HSJCC Webinar Thank you to CMHA Ontario and the Evidence Exchange Network (EENet) for providing support to host this webinar! To ask a question, please type your question in the chat box. Power-point presentation will be emailed to you following the webinar. Please complete the brief feedback survey following the webinar. @HSJCC

Overview of Presentation About the HSJCC Northeast Regional Outcomes Project Live Tour of Online Portal Questions & Comments @HSJCC

Presenters Michael Dunn, Director of Research, Evaluation & Quality Improvement, Canadian Mental Health Association - Simcoe County Branch, Co-Chair of the Provincial HSJCC Sarah Gauthier, Justice Program Coordinator at CMHA - Sudbury/ Manitoulin Branch, Chair of the Sudbury /Manitoulin District HSJCC and Co-chair of the Northeast Regional HSJCC Hélène Philbin-Wilkinson, Director of Dual Diagnosis and Mental Health & the Law Services at North Bay Regional Health Centre, Northeast Regional HSJCC Member @HSJCC

HSJCC Network Established based on the Provincial Strategy to Coordinate Human Services and Criminal Justice Systems in Ontario (1997) Responding to a recognized need in the province to coordinate resources and services, and plan more effectively for people who are in conflict with the law Priority consideration is for people with a serious mental illness, developmental disability, acquired brain injury, drug and alcohol addiction, and/or fetal alcohol syndrome @HSJCC

HSJCC Network HSJCC Network is comprised of 43 Local HSJCCs 14 Regional HSJCCs Provincial HSJCC Each HSJCC is a voluntary collaboration between health and social service organizations, community mental health and addictions organizations and partners from the justice sector including crown attorneys, judges, police services and correctional service providers Funded by the Ministry of Health and Long-Term Care @HSJCC Provincial HSJCC

Provincial HSJCC Provincial HSJCC consists of Regional HSJCC Chairs representing their Regions Ex-officio members from important stakeholder groups such as Correctional Service of Canada, Ontario Provincial Police and Ontario Association of Chiefs of Police, Legal Aid Ontario, and Community Networks of Specialized Care Ex-officio representatives from 5 Provincial Ministries: Attorney General Children and Youth Services Community and Social Services Community Safety and Correctional Services Health and Long-Term Care @HSJCC

Stay tuned for further details on these webinars! Upcoming Webinars March 26, 2015, 12 pm to 1 pm – Pre-Charge Diversion April (date and time to be determined), 2015 – Hamilton Rapid Response Team Stay tuned for further details on these webinars! @HSJCC Provincial HSJCC

Contact Information For more information about the Provincial HSJCC, or to join the mailing list visit: www.hsjcc.on.ca For more information about CMHA Ontario, visit: www.ontario.cmha.ca For more information about EENet, visit: www.eenet.ca @HSJCC Provincial HSJCC

Northeast Regional Outcomes Project Sarah Gauthier BA Hélène Philbin-Wilkinson BScN, Reg. N., MN

Agenda Background Development Process Measures Regional & District Trends Implications Lessons Learned Live Tour of Online Portal Sarah

Northeast Region Spans 400 000 square kilometers Represents over 40% of Ontario’s land mass With 4.2& of population Compared to rest of the province we have higher rates of: Alcohol abuse, smoking Chronic conditions Unscheduled emergency department visits for mental health and substance abuse Hospitalizations related to mental illness and self-injury (ages 15years and older) 25 hospitals (4 x Schedule 1, 1 x Regional Health Centre) 48 community mental health and addictions services 1 CCAC Hélène

NBRHC Mental Health & the Law 8 Community agencies 24 Court locations NBRHC Mental Health & the Law Hélène

Partnerships with Purpose Service agreements since 2000 Outlining roles and responsibilities Timely access Optimizing resource utilization Track service trends Inconsistent definitions and unclear rational for data collection Inconsistent methods of reporting Unclear understanding of the system demands in each area Inability to validate trends and inform funding How do we hold ourselves accountable? Common goal of improving access and connections to service Hélène

Background How do we know we are making a difference? How do we measure program & system performance? Surveyed other programs across the province No provincial standard measures or common definitions Traditional data collection aka “ caseload statistics” Support from Northeast Regional HSJCC & North Bay Regional Health Centre Sarah or Hélène

Timeline CMHA- Sudbury/ Manitoulin went live 2012 with three process measures Demonstrated data after 6 months to HSJCC and partners Partners agreed to the development of a Regional portal building on the three measures Agreement to engage consultant and financial commitment Northeast Regional Portal went live April 1, 2013 Phase 2 was funded by the NE LHIN to enhance current measures and further develop system outcomes measures Sarah

Development Process Sarah Improvement Define Measure Analyze Improve Control Sarah

Collaborative process guided by Brian Tramontini Sarah and Hélène - Represents the groups thinking

Measures Phase 1 Diversion Success Rate: How successfully are people diverted from the criminal justice system and into the mental health system? Alternate Disposition (diversion) Success Rate:Are we successful in advocating for improved dispositions? Admission Aversion Rate:How many clients inappropriate admissions to forensic units are avoided? Sarah

Measures Phase 2 Diversion Recidivism: How many people, while on a mental health diversion, were known to reoffend within the diversion period? Fitness Recommendation Consistency Rate: Was the agency fitness recommendation consistent with the physician assessment recommendation? Release from Custody Rate: How many clients are released on a recognizance back to the community based on the involvement of the mental health court worker? Sarah

Data Collection No unique identifiers Each agency utilizes their own client data base reference # Agency & Court Demographics: age category, sex, aboriginal, primary and secondary diagnosis, needs Sarah

Data Collection Use of OCAN categories / language Data integrity – permissions, mandatory fields Integrated into current practices age gender Dx Outcomes Sarah

Sarah

District and Regional Trends Youth recidivism rates are higher in Sudbury & Nipissing Intervention increases success rate of release on bail for Dual Diagnosis population Courts consistently follow recommendation of Justice Programs when ordering Fitness to Stand Trial assessments Demographics: more males being diverted than females in most districts, gap is narrowed with youth Hélène

Sarah

Implications Combines qualitative and quantitative data Common language and measures to achieve our common goal Allows for flexibility in processes within the districts Outcome based accountability framework that informs service delivery Relevant evidence to identify system pressures Starting to understand cost savings at a program and system level Supports a culture of quality improvement in line with the Excellent Care for All Act Despite barriers of geography and distance it fosters collaboration and a supportive partnership Assists in determining allocations of funds and resources Hélène

Lessons learned Commitment at all levels Different levels of readiness Need a champion and evidence that it works Competing priorities and needs Common language early on to motivate engagement Essential to have expertise in outcome performance and data management Requires training and on-going support and involvement of all partners Utilizing partnership agreement Hélène

Future Directions Continued data collection & analysis Quality Improvement Planning Re-establishing the baseline and targets Setting the standard for an evaluative framework Sarah

Online Portal Tour Sarah to do tour of portal

Thank you / Questions?