Reaume-Zimmer Paula, Chandrasena Ranjith, Malla Ashok, Joober Ridha, Boksa Patricia, Shah Jai L, Iyer Srividya N, Lal Shalini
Mental Health and Addiction Services, Bluewater Health and Canadian Mental Health Association Lambton-Kent, Ontario, Canada.
ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
Early Interv Psychiatry. 2019 Jun;13 Suppl 1(Suppl Suppl 1):48-55. doi: 10.1111/eip.12818.
This study describes how mental health services for youth are being transformed within the context of a semi-urban and rural region of Canada (Chatham-Kent, Ontario), based on the framework of ACCESS Open Minds (ACCESS OM), a pan-Canadian youth mental health research and evaluation network.
Transformation has focused on the five key objectives of ACCESS OM, namely early identification, rapid access, appropriate care, continuity of care, and youth and family engagement. A community mapping process was conducted at the beginning of the transformation to help develop a comprehensive inventory of services, identify challenges and optimize partnerships to address the five key objectives.
The following strategies represent key elements in the transformation: coordination and partnerships between hospital, community and voluntary organizations, as well as different sectors of the community (e.g., Child and Youth Services, Education, Community Safety and Correctional Services, CSCS); working with local champions (e.g., Youth Diversion Officer and the Mental Health and Addictions Nurse in the school sectors); establishing a youth-friendly space in a central part of the community, where services are co-located and operate within an open-concept design; training of ACCESS Clinicians to conduct an initial assessment; engaging youth and family in service-level recruitment, planning, daily operations, and evaluation, including hiring of youth and family peer navigators; and, engaging the community through awareness and educational events.
The success of this transformation needs to be measured on various outcome parameters, but it is notable that neighbouring communities are already beginning to implement a similar model.
本研究描述了在加拿大一个半城市和农村地区(安大略省查塔姆-肯特)的背景下,基于全加拿大青少年心理健康研究与评估网络“ACCESS开放思维”(ACCESS OM)的框架,青少年心理健康服务是如何转变的。
转变聚焦于ACCESS OM的五个关键目标,即早期识别、快速获取、适当护理、护理连续性以及青少年和家庭参与。在转变开始时进行了社区绘图过程,以帮助编制全面的服务清单,识别挑战并优化伙伴关系以实现这五个关键目标。
以下策略是转变中的关键要素:医院、社区和志愿组织以及社区不同部门(如儿童和青少年服务、教育、社区安全和惩教服务,CSCS)之间的协调与伙伴关系;与当地倡导者(如学校部门的青少年分流官员和心理健康与成瘾护士)合作;在社区中心设立一个对青少年友好的空间,服务在此集中并在开放式概念设计中运营;培训ACCESS临床医生进行初步评估;让青少年和家庭参与服务层面的招募、规划、日常运营和评估,包括雇佣青少年和家庭同伴导航员;以及通过宣传和教育活动让社区参与进来。
这种转变的成功需要根据各种结果参数来衡量,但值得注意的是,邻近社区已经开始实施类似模式。