1. SAFE RELATIONSHIPS, SAFE CHILDREN: MAKING THE “INVISIBLE” VISIBLE Provincial Implementation - September 2014

2. Safe Relationships, Safe Children  3 Phase Provincial Initiative – currently in phase 2 – 20 pilot communities across the Province  Phase 3 - full Provincial Roll Out starting 2015  Shifting practice in Adult Health, Mental Health and Addictions services to Family Centered Practice – improve support to Parents, reduce risk to Children

3. Background – Safe Relationships Safe Children

4. Reaffirmation of Recommendation 1 Lost in the Shadows: How a Lack of Help Meant a Loss of Hope for One First Nations Girl - Investigative Report Recommendation 4 – February 2014 Children at Risk: The Case for a Better Response to Parental Addiction – June 2014 Subsequent Representative for Children and Youth Reports

5. RECOMMENDATION GOAL  Develop adult healthcare and child service systems that promote child safety and wellbeing of families affected by serious untreated mental illness, problematic substance use and/or domestic violence Focus:  Family Centered Practice  Reducing gaps and streamlining services  Enhancing outcomes by collaboration and coordination  Supporting the whole family

6. WHAT IS NEEDED  To Identify adults in a parenting role (including expectant parents) in case work planning  To Identify and connect to support services parents - families impacted by untreated mental illness, problematic substance use, and/or domestic violence  Identify children’s needs in relation to parental mental illness/substance use and/or domestic violence  To identify needs – including need for additional assessment, case management coordination of services, and ongoing follow up and check in

7. DEVELOPING A RESPONSE  Literature reviews on best practices in identification/screening methods (Carolyn Oliver) and risk and protective factors for children (Lorna Templeton)  Reviews accessed UK and Australian work of similar reviews of deaths in those countries  Currently no standardized tool for screening all three areas Intimate Partner Violence, Mental Health, Substance Use, and for identifying parents  The key risk factor identified is that children are mostly “Invisible” in these families – they are “Invisible” to our system of care

8. Greatest Risk factor for Children is their “Invisibility” in our systems  Invisible need equals unmet need  We need to make the Invisible, VISIBLE What is Needed – Risk Factors

9. How we can ensure VISIBILITY Include questions about adult parental role at intake:  Intake/initial triage form requires documentation of parental or other carer responsibilities, note name, age, current whereabouts of dependent/s  Are you a parent, or do you have children living with you at home?  What are the children's names, dates of birth and address?  If dependant children are living elsewhere what is the nature of your involvement with your children?  Include questions about mental health, substance use, domestic violence and perceived impact on children at intake

10. Care Pathway – Steps for Engagement Step 1: Think Parent  Identify Adults in a Parenting Role  Engage Parent on Potential Needs Related to Three Core Issues Step 2: Think Child  Inquire about Child Needs  Identify Risk and Protective Factors for Children Step 3: Think Safety  I Identify Emergent/Urgent Issues that Require Immediate Action  Stabilize and plan for Future Safety Step 4: Think Family  Collaborate with Parents and Others to Actively Connect Families to Required Supports  Share Information to Support Safety and Wellbeing Step 5: Think Outcomes  Monitor Risk and Review Goals and Progress  Reflect on Progress and Practice

11. Family Centered Practice  A paradigm shift is required in which families are viewed as a key part of the solution rather than as part of the problem.  Emphasizes the need for systems to work collaboratively to identify and support families. The “whole family” approach consists of assessing and addressing the needs of the children, adults and the family and ensuring that support provided to them is focused on concerns affecting the whole family  Family Centered Practice is NOT Family Therapy

12. Family Journey Mapping

13. WHAT FAMILIES TOLD US  Our services are fragmented and programs/systems do not communicate to another  Families want services to share information about them: they find it hard to “carry the burden” of information sharing.  When information is not shared proactively it lead to crisis  Families are relied upon by professionals to support the client, but not included in the care team

14. WHAT FAMILIES TOLD US What worked well:  Professionals maintained a child centered lens – made decisions around what was best for the child, regardless of mandate or other priorities  Children are consistently Invisible when adults are accessing service, but Children are a motivating factor and a place to intervene: talking about the children in therapy, helps parents get to a place of change

15. What is Needed - Training  Training: -Introduction to the Safe Relationships, Safe Children Initiative (background, context, parenting and the three core issues) -The Practice Pathway: Think Parent, Think Child, Think Safety, Think Family, Think Outcomes -Identifying Risk and Protective Factors for Children -What is Family-Centred Practice? -Promoting Collaborative Practice to Meet Child and Parental Needs (including information sharing)

16.  Family Involvement Policy  Information Sharing with Law Enforcement  Safe Relationships, Safe Children Information Sharing  Provincial Privacy Impact Assessment (MCFD/MOH)  Information Sharing Protocol(MCFD/MOH) – under development Developing a Response

17. Current State Activities within the Pilot Sites are designed to help facilitate an assessment of systemic and individual professional competence and capacity. To identify existing strengths to build upon and areas requiring greater attention and learning to be able to incorporate the Practice Pathway consistently into our work with individuals and shift to a Family Centred Practice lens.

18. Current State: Phase 2  Next 18 Pilot Sites:  VCH – Powell River, Sechelt/Gibsons, Squamish  VIHA (IH)– Campbell River, Victoria, Nanaimo, Duncan  IHA – Kamloops, Salmon Arm, Castlegar  NHA – Dawson Creek, Masset-Haida Gwaii, Terrace, Quesnel  FHA – Hope/Agassiz, Abbotsford, Langley, Tri-cities  Ongoing Implementation in Richmond and Vernon of Enhanced Practice Guide and Information Sharing Protocol - training  Phase 3 – Province Wide Roll Out

19. Links: On Line Resources  Link to RCY Report (Recommendation 1, p.95): http://www.crvawc.ca/documents/SchoenbornReportFINAL%20Feb%2027.pdf http://www.crvawc.ca/documents/SchoenbornReportFINAL%20Feb%2027.pdf  Link to In Response to 2012 RCY Report Honouring Kaitlynne, Max and Cordon: Make Their Voices Heard Now: http://www.mcf.gov.bc.ca/podv/pdf/domestic_violence_response_booklet.pdf  Link to RCY Report (Lost in the Shadows): http://www.rcybc.ca/Groups/Our%20Reports/RCY_Lost-in-the-Shadows2014.pdf http://www.rcybc.ca/Groups/Our%20Reports/RCY_Lost-in-the-Shadows2014.pdf  Link to RCY Report (Children at Risk: The Case for a Better Response to Parental Addiction): http://www.rcybc.ca/reports-and-publications/reports/cid-reviews- and-investigations/children-risk-case-better-response

20. Questions? Discussion? SAFE RELATIONSHIPS, SAFE CHILDREN Provincial Implementation – September 2014