1. Families Matter Effective Solutions to Support Families in Mental Health & Addictions Services Leanne Needham MSW, RSW, BMT - Mood Disorders Association Ontario Gillian Gray MSW, RSW - Family Outreach & Response Program Candice Hamilton-Miller RP, MSc – Schizophrenia Society of Ontario

2. Mood Disorders Association Ontario  Focuses on promoting recovery of mood disorders for individuals and families  Provides peer support groups across the province  Provides onsite, telephone and web-based counseling with social workers or peer-support workers in Toronto for individuals and families affected by mood disorders and psychosis  Provides innovative and evidence-based recovery programs such as Wellness Recovery Action Planning and Laughing Like Crazy, as well as facilitator training in WRAP

3. Family Outreach & Response  Recovery oriented family mental health supports  Early Psychosis Intervention Family Support  St. Joseph’s Health Centre Family Navigators  DBT-informed family support  Tamil family program (Scarborough)  All staff have either personal or family lived experience  Partnerships – CMHA Toronto, Fred Victor (formerly CRCT), St. Joseph’s Health Centre, Central Toronto Youth Services  In home support

4. Schizophrenia Society of Ontario  Various Family Focused Services:  Ask the Expert  Strengthening Families Together (SFT)  Youth Initiatives  Education, engagement and empowerment  Peer Mentoring Programs  EIP program support (Phoenix, Lynx, Royal Ottawa Hospt, Humber Regional Hosp.)  Partnerships in Local hospitals, and Mental Health Agencies (St. Joes, CMHA, etc).  Research and Advocacy  No waitlists for information, supportive counselling and resources.

5. Objectives At the end of this workshop you will:  Be familiar with the Mental Health Commission of Canada’s National Caregiver Guidelines  Better understand the needs of families and the important role they can play in their relative’s recovery  Identify challenges and successes to supporting families in your organizations  Be familiar with tools and tips to support families

6. Why don’t we have a family-focused approach in the mental health system?  Confidentiality  Boundaries  Lack of knowledge about working with families  Minimal or no contact with families  Assumption that families will seek out or have sought out help/support/education on their own  Time consuming

7. Why do families need support?  Guilt and sense of responsibility for loved one’s distress  Taking on caregiving role  Intrusions into the family life space, stress on relationships  Frustration, isolation, low mood, anxiety  Stigma and discrimination (both internal and external)  Neglecting own well being and self care  Lack of support options  Navigating complex mental health system

8. Why involve and support families?  Benefit to person living with mental health issue, family, health and social service sector  Families can help create an atmosphere or hope in which growth and change are possible  Recovery research shows that a supportive family can be a major attribute in the recovery process  Families require support, information and skills  Families themselves are at risk of having serious physical and mental health problems

9. What are the Family Caregiver Guidelines?  Printed in 2013 by the Mental Health Commission of Canada  Aim to advise system planners, policy makers and mental health managers in planning, implementing and evaluating a family friendly system of care  www.mentalhealthcommission.ca www.mentalhealthcommission.ca  Search National Caregiver Guidelines

10. Components  Values and Principles to care  41 Recommendations  Pyramid

11. MHCC Pyramid of Family Care Framework Family TherapyConsultationPsychoeducationGeneral EducationConnecting and Assessment

12. Barriers to Providing Family Care  Group Brainstorm

13. MDAO/FOR/SSO Family Survey  N= 58 (MDAO – 21, FOR – 37, SSO - 23)  Distributed to families who are current service users  Assisted us in profiling who we are serving and what they need from the system

14. Findings Is your relative currently receiving mental health support?

17. Challenges faced by families  Medication, agreement to treatment/support  Self-care for family member  Access to the right supports for both relative & family  Deficit focused services/supports, feeling hopeless/helpless  Learning how to be supportive and how to cope  Confidentiality issues  Loved one’s lack of awareness or acceptance of mental health issue

18. What have families found helpful?  Support from Family Support Organizations  Interactions with providers who are respectful & caring  Availability of support in the community  Getting the right support at right time & place (at discharge, in crisis)  Coordination of services between different programs  Providers in system offering education to families (psychiatrists, case managers etc.)

19. Case Study

20. Recommendations Medication/Agreement to Support (level 1-3)  Educating families on treatment options and side effects  Educating on communication strategies such as LEAP & MI Self-care (level 1-5)  Recognizing signs of caregiver burnout  Emphasizing self-care for sustainability  Are there gaps in services for families that would improve well-being, eg. housing support, financial support, culturally appropriate support  Connecting families to resources such as counseling, peer support groups, mindfulness programs, etc.

21. Access to Right Supports (level 1-5)  Providing families with information about community/hospital supports, family support programs  Following up to ensure they were connected with the intended supports (warm transfers)  Create resource lists that can be provided to families and clients i.e.. Crisis lines, CMH agencies, peer support etc.  Developing partnerships Instilling Hope (level 1-5)  Provide recovery oriented services/information  Be aware of programs in the community that support recovery and offer recovery tools, for example - WRAP  Consider the language you use. Would it make you feel hopeful about your own loved one?  Work with strengths not deficits

22. Strategies for Coping and Supporting (level 2-3)  Developing psycho-ed programs such as Strengthening Families, NAMI, or referring out  Have resources such as book ideas available, refer to resource list for families Lack of Awareness/Acceptance (level 1-5)  Provide psychoeducation  Listening to family, validating frustration  Involve families in assessment

23. Other tips  Setting clear expectations and boundaries with families regarding your role and referring out to fill the gap Other ideas?  Confidentiality  How to have a conversation about consent  Pros and cons of involving family  Don’t assume that a client does not want family involved  Conditions around consent

24. Thank you! For more information visit: www.familymentalhealthrecovery.org www.mooddisorders.ca www.schizophrenia.on.ca