integrated SERVICES team Waawiyekidewan Presented by: Pierrette Waawiyekidewan meaning “They stand in a circle”

A bit about our Agency Vision Mission Dilico promotes healing and the well-being of the Anishinabek people using an integrated holistic approach in a way that honours values, culture and traditions. Mission To be identified as a self-governed organization that is recognized as a leader in the research and delivery of Child Welfare, Mental Health and Addictions and Health Services. Delivery of community-based services that embrace the well-being of Anishinabek children, families and communities in a culturally safe manner. Presented by: Pierrette

Integrated Services Team (IST) Danielle McLeod – IST Worker– Children’s Mental Health Pierrette McLeod–IST Nurse– Community Health Amy Price–IST Committee Member- Intake Worker Child Welfare Each IST member introduce self and attached manager

Presented by: Pierrette Teaching: The teaching originally was passed down from Lillian Pitawanakwat of Birch Island where one our Cultural workers Paul Francis’s Grandfather is from. Paul had family who worked with her and shared that teaching but he never met Lillian she has passed now. The purple is used to represent healing and the flower is the person/spirit/individual. It represents the individual - purple is for healing - rose symbol mirrors life - we are constantly growing - thOrns represent struggles in life - but over time and renewal - feeding our spirit we grow into a beautiful rose . Paul Client comes into contact with Dilico or may already be a client At that point they maybe screened for any risk A referral can be put into IST The client enters path for services They are surrounded by other community services The client and family is represented as the purple flower

WRAP AROUND CONSULTATION Dilico & Community Services Integrated Services Team Referring worker Person/ family at risk Presented by: Pierrette IST was initiated with the intent of ensuring Child Welfare, Mental Health & Addictions and Health Services are working collaboratively to identify, assess, and provide intervention to children and families who are involved with Dilico services and have been assessed as high risk. Respective staff from each area work together to ensure programs & services are set in place in a timely manner.

CONSULTATION TEAM Presented by: Pierrette Referring worker Assess risk Manager support Integrated Services Team Worker Mental Health screening Recommendations Crisis Mental Health Intervention Integrated Services Team Nurse Health screening Health services Crisis Health intervention Child Welfare Committee Member Support referring workers Review protection file as needed Presented by: Pierrette

DEFINITION OF HIGH RISK All infants under the age of 12 months that do not have formal supports in place that become involved with Child Welfare Services. Any child/youth/parent identified with imminent & immediate risk by a worker in consultation with their direct Manager. Presented by: Amy Assessing for risk handout.

PROTOCOL FRAMEWORK RISK LEVEL REDUCED Presented by: Amy CLIENT PRESENTS FOR SERVICE Child Welfare / Mental Health & Addictions / Health Services Risk level screened by Worker / Manager Low Risk level identified; Intake proceeds CLIENT ALREADY RECEIVING SERVICE Child Welfare / Mental Health & Addictions / Health Services Risk level screened by Worker / Manager HIGH RISK LEVEL IDENTIFIED Flagged - Meets Criteria: All infants 12 months & under that become involved with Child Welfare Services that do not have formal supports. Any child/youth/parent identified with imminent & immediate risk HIGH RISK LEVEL IDENTIFIED Flagged: meets criteria REFERRED TO INTEGRATED SERVICES TEAM Team members and the referring worker activate the Integrated Services Team Protocol INTEGRATED SERVICES TEAM ACTION PLAN DEVELOPED Referral processed for appropriate service(s) EMERGENCY MEDICAL SERVICES To be accessed when all services have been put into place and High Risk level continues Mental Health & Addictions Services Assess MH symptoms Family Preservation Infant/Child Development Services Community MH Services Clinical Services Cultural Consultation / Guidance Health Services Admission Medical (72 hours) Urine testing 48 hours after Admission Medical; CHN to attend home visit with worker Home assessed for Risk Cultural Consultation / Guidance Child Welfare Services Intake Services Family Services Children Services Alternative Care Services Cultural Consultation / Guidance EXTERNAL SOURCE(S) Presented by: Amy RISK LEVEL REDUCED INTEGRATED SERVICES TEAM FOLLOW UP Review of Action Plan Process/Risk Level Re-Evaluated INTEGRATED SERVICES TEAM PROCESS DOCUMENTED Referral Form / Consent / Action Plan / Evaluation completed Documentation to be uploaded to client’s clinical file (E-Case Notes, Supervision Tabs, CIMS Contact Note, Health Record)

Referral Sources July 2015 – June 2016 Presented by: Danielle CW Intake 44% CW Family Services 43% CW Childrens Services 10% Mental Health Services 0% Health 0% CW Kinship Services 3%

Top 7 referral reasons Presented by: Danielle Mental Health Issues-21% Addictions/Substance use- 20% Parenting Concerns-18% Trauma or history of Trauma-11% General Health Concerns-10% Domestic Violence-10% Behavioural Concerns-10%

Age Demographics July 2015 – June 2016 Presented by: Danielle Prenatal -1% 0-12 months – 12% 1-2 years - 5% 3-5 years – 13% 6-9 years -12% 10-13 years -6% 14-18 years - 11% 18 years & older – 40%

0-6 Childrens Mental Health referrals Presented by: Danielle July 2013 – June 2014 – 19% July 2014 –June 2015 – 19% July 2015 –June 2016 - 62%

What our data tells us It is important to work from a family-centred approach to ensure the best outcome for families & children Top referral reasons to IST are mental health issues, addictions/substance use, parenting concerns, trauma/history of trauma Referrals to Childrens Mental Health & Adult Mental Health Services have increased since IST has been introduced Our families needs are very complex and often require support from a number of services. Workers and families have had limited knowledge around the medical issues concerning our clients. Presented by:

Case example – Referral Presented by:

Case example – Action Plan

Action Plan continued

Case example – Follow Up

Follow Up continued

Lessons learned Our families are extremely resilient Residential school experiences impact our families on a daily basis The sooner families get support the better the outcome Families need to be treated as a whole unit to ensure the all their needs are being met Presented by: Pierrette

Lessons learned Client-centred home-based service Communication between workers is key Interactions need to be completed in a timely manner We have gained an appreciation for the different mandates and services within our organization Presented by: Pierrette

Successes Immediate assessments & intervention for families (Well baby and wellness checks with in 48 hours) Advocacy Less intrusive Child Welfare involvement Transfer of knowledge between services Building relationships with families Transfer of Mental Health and Health knowledge to families to empower them to reduce risk in the home to help preserve the family unit Presented By: Danielle

Next Steps - Future Goals To increase communication and strengthen working relationship between workers in the different programs To continue to develop working relationships with outside agencies To add an Adult Mental Health worker to our team To expand IST throughout Dilico’s district offices Presented By: Amy

Evaluation Feedback Presented by: Danielle Areas of evaluation: Have IST increased collaboration Did IST assist in clear planning and reducing risk Did IST provide intervention with in 48 hours Did IST support connecting with internal Mental Health & Health Services Did IST support connecting with external Mental Health & Health Services Was IST valuable resource to the client and family

Questions All presenters to answer