1. Systems Approach Workbook A Systems Approach to Substance Use Services and Supports in Canada Communication Tools: Sample PowerPoint presentation The original template text for this file, as well as other useful material, is available in the Tools & Templates section of the Systems Approach website (www.nts-snt.ca). Production of this material has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.www.nts-snt.ca 9/24/20121

2. Outline  Background  Why pay attention to the treatment system?  Systems Approach recommendations  Tiered Model  Systems Approach implementation 9/24/20122

3.  Treatment is one of 13 priorities under the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances  40+ National Treatment Strategy Working Group members were tasked with producing recommendations toward “improving the quality, accessibility and range of options to treat harmful substance use, including substance use disorders” 9/24/20123 Background

4. Background (cont’d)  The Working Group released its report in October 2008  The report makes 20 system- level recommendations to  Improve the quality, range and accessibility of services and supports  Close the gap between “need” and “response” 9/24/20124

5. Why Pay Attention to the Treatment System?  Treatment for problematic substance use works and is an efficient use of resources  Substance use problems drive health and social costs beyond the addictions treatment field  Substance use is a major contributor to chronic diseases such as cancer and diabetes  There are large gaps in service and barriers to accessing the help people need 9/24/20125

6. Systems Approach Recommendations  Develop a continuum of services and supports  Improve care, coordinate services and make better use of existing investments by shifting the focus toward integrated, community-based care rather than specialized care  Look at the system using a tiered framework representing logical groupings of services and supports and varying levels of risk and harm  Develop knowledge exchange capacity  Promote evidence-informed policy and practice 9/24/20126

7. Systems Approach Recommendations  Reduce stigma and discrimination  Develop a targeted, evidence-based approach  Increase the understanding of substance use problems and the treatment system to reduce the barriers faced by those who might access the system and those who work within it  Develop a research program  Support and enhance efforts to build system capacity 9/24/20127

8. Systems Approach Recommendations  Measure and monitor system performance  Collect information in a consistent way to inform and monitor system improvements  Promote leadership and implementation  Coordinate allocation of resources  Develop collaborations across systems and sectors 9/24/20128

9. Tiered Model: A Service Perspective  Each tier represents a cluster of services and supports that  Respond to varying levels of risk and harm  Address problems of similar severity and provide services of similar intensity and specialization  Movement within and across tiers is facilitated  In a comprehensive continuum, each tier has the tools, resources and supports required to meet population needs 9/24/20129

10.  Lower-tier services and supports  Meet the needs of the greater number of people  Represent a higher level of community integration and lower degree of specialization  Upper-tier services and supports  Meet the needs of people with more severe substance use issues  Represent a higher level of specialization Tiered Model: A Service Perspective 9/24/201210

11.  Tiers represent groupings according to levels of individual risk and harm  Movement through connected tiers is facilitated as individual needs and risk/harm profiles change over time  Five Tiers  1: Individuals with low risk/harm  2: Individuals with moderate risk/harm  3: Individuals at risk of acute harm  4: Individuals experiencing harm  5: Individuals experiencing harm and with complex risk profiles (e.g., concurrent disorders) Tiered Model: A Population Perspective 9/24/201211

12.  No wrong door  Availability and accessibility  Matching  Choice and eligibility  Flexibility  Responsiveness  Collaboration  Coordination Tiered Model: Guiding Principles 9/24/201212

13.  Flexible  Responds to the particular needs of Canada’s jurisdictions and populations, but…  Based on common principles that can be applied in any context  Promotes the efficient use of resources  Emphasis on developing capacity in the lower tiers rather than relying on more resource-intensive, specialized services Benefits of the Tiered Model 9/24/201213

14.  Variations of the Tiered Model can be found in  Healthy Minds, Healthy People: A Ten-Year Plan to Address Mental Health and Substance Use in British Columbia (2010) Healthy Minds, Healthy People: A Ten-Year Plan to Address Mental Health and Substance Use in British Columbia  The Action Plan for Mental Health in New Brunswick, 2011-18 (2011) The Action Plan for Mental Health in New Brunswick, 2011-18  Creating Connections: Alberta’s Addiction and Mental Health Strategy (2011) Creating Connections: Alberta’s Addiction and Mental Health Strategy Variations of the Tiered Model 9/24/201214

15. EXAMPLES OF WHAT TO INCLUDE:  The reasons improvements are needed in your jurisdiction; for example:  Responding to or proactively addressing  New research evidence  Population trends  An emerging problem  An identified gap  The ways areas that are working well can support and be supported by system change Systems Approach: Rationale for Change 9/24/201215

16. EXAMPLES OF WHAT TO INCLUDE :  Address benefits to  The clients  The services  The practitioners  The system  Cost savings associated with earlier intervention  Reduced reliance on specialized, intensive services  Reduced health and social impact of substance use Systems Approach: Rationale for Change 9/24/201216

17. EXAMPLES OF OUTCOMES AND BENEFITS: [TO BE CUSTOMIZED]  Increased partnerships and coordination between services  Improved client outcomes through increased access to appropriate services  Increased capacity to identify and address gaps in the service continuum Systems Approach: Outcomes and Benefits 9/24/201217

18. EXAMPLES OF ACTIVITIES: [TO BE CUSTOMIZED]  Examined provincial strategy for consistency and guidance  Examined strategic plans for consistency with the Systems Approach  Identified areas of the system that need improvement or are working well  Identified benchmarks through provincial reports and national indicators (e.g., CIHI, National Treatment Indicators) Systems Approach: Work to Date 9/24/201218

19. [TO BE CUSTOMIZED] Systems Approach: Decisions Required 9/24/201219

20. [TO BE CUSTOMIZED] Systems Approach: Next Steps 9/24/201220

21.  www.nts-snt.ca www.nts-snt.ca  www.ccsa.ca www.ccsa.ca  [ADD RELEVANT REGIONAL LINKS] Additional Information 9/24/201221