TOGETHER We Make it Work: Mental Health and Addictions (MHA) Nurses in School Boards for Student Well-Being Toronto, ON June 20 21, 2014 2
A Joint Presentation of Mississauga Halton CCAC Cynthia Johnston RN, BSN, Manager Shauna Johnston RN, BScN, BSc, MHA Nurse & Waterloo Wellington CCAC Becky Mantynen RN, BScN, MSW, Manager Billie Chornoboy RN, BScN, MHA Nurse and their respective School Board partners, Halton Catholic DSB Patricia Codner, MSW, RSW, Chief Social Worker & Upper Grand DSB Dr. Lynn Woodford, Psychologist, Mental Health and Addictions Lead
Disclosure Presenters: Rebecca Mantynen, RN, BScN, MSW, WWCCAC, Client Service Manager Dr. Lynn Woodford, Psychologist, Upper Grand DSB, MHA Lead Billie Chornoboy, RN, BScN, WWCCAC, MHA Nurse Patricia Codner, MSW, RSW, Halton Catholic DSB, Chief Social Worker Cynthia Johnston, RN, BSN, MHCCAC, Client Service Manager Shauna Johnston, RN, BScN, BSc, MHCCAC, MHA Nurse Relationships with commercial interests: Grants/Research Support: none; Speakers Bureau/Honoraria: none; Consulting Fees: none; Other: none. Disclosure of Commercial Support: This program has received financial support from the Ontario Ministry of Health and Long-term Care in the form of funding for mental health and addiction Nurses. This program has not received in-kind support. The potential for conflict of interest does not exist. The potential for bias does not exist.
Agenda Program Overview: What we started with; how we grew Similarities & Differences between Regions: The Mississauga-Halton MHAN Program: Nursing Perspective School Board Perspective The Waterloo-Wellington MHAN Program: Nursing Perspective School Board Perspective Sharing Stories: Video 1: Stacey s Story Video 2: Helping Halton Students
Overview Open Minds, Healthy Minds: Ontario s Comprehensive Mental Health and Addiction Strategy
Our Motivation Early signs of mental disorders frequently appear in adolescence, yet they are often undiagnosed and go untreated. Young people with mental health disorders are at great risk for dropping out of school, ending up in jail and of not being fully functional members of society in adulthood. UNICEF
Ontario s Response Mental Health & Addictions Nurses in School Boards Mandate: Identify mental health and addiction problems early; intervene by providing timely, high quality, integrated and persondirected health services Approach: Utilize the four Guiding Principles from Open Minds, Healthy Minds (2011): Awareness, Promotion, Prevention, and Intervention Create customized MHAN programs based on region Tri-Ministerial Involvement & Funding: Ministry of Education Ministry of Child and Youth Services Ministry of Health and Long-term Care
Target Population Students Who: Need fast access to support Have had multiple hospital / ER admissions Have complex medication issues and follow-up Have concurrent medical / mental health diagnoses Have competing / conflicted diagnoses Have families who could benefit from support Present a threat risk
Regionalized Implementation Intensity & Acuity Consultation / Education for School Staff Mississauga-Halton CCAC Waterloo-Wellington CCAC
MHA Nurse Services Using a range of activities and resources, MHA Nurses directly and indirectly assist students: Enhance school-based support services Direct service to students Capacity building Collaboration with system partners Student and family education Promotion of mental well-being
Thanks for being there! You have helped me in ways you can never I appreciated the support imagine Very Service was a great benefit helpful in transitioning
School Referral Process External Agencies Referrals (through the Chief Social Worker) Woodview School-based Support Staff, ROCK, Mental Health School Worker (North), CCAC MHA Nurse, MH Region Nurses Response to Intervention Multidisciplinary Team: Itinerant Psychology Board Team Referral to either: CYC Social Worker Intensity of need Teacher / Student / Parent in-school Team Meeting Halton Catholic District School Board Upper Grand District School Board 13
What Students & Families Say 91% felt student was appropriately supported What was helpful: Attending medical appointment with student Frequent check-ins Advocating Parent education Support over summer
What Teachers Say 78% felt MHANs were supportive to school staff What was helpful: Accessibility and availability Collaboration Communication Transparency We We have have seen seen an an immediate immediate impact impact on on our our students students and and our our schools schools from from the the implementation implementation of of this this program. program.
Value Added with MHA Nurses
Helping Halton Students 17
Special to have someone come Visits were invaluable into our home and school Great support in a difficult time Service was a great benefit Helped us understand medication
WW Student Success Jennifer s Story 17 y.o. came to MHAN summer school drop-in program, no current MH supports in place Symptoms of depression: low mood, self-harm, suicidal ideation, poor sleep, reduced functioning, weight gain Student had been struggling for months, but did not disclose symptoms to her family, school, or doctor With support from WWCCAC MHAN: Jennifer shared her concerns with her family Received Mental Health Teaching Referred to CMHA CBT coping skills peer group Safety plan developed Soft transfer to school supports (CYW, SW) Collateral provided to family doctor Initiated on sleep aid
WW Student Success Tamiko s Story 14 y.o. recently moved to the community, excluded by peers at her new high school Had 4 previous in-patient admissions within 12 months following suicide attempts Diagnoses of Major Depression disorder, Learning disorder, Eating Disorder (mixed anorexia and bulimia), and Social Anxiety Disorder Struggling with weight, body image, isolation from peers, academics, and nonsuicidal self-injury With support from WWCCAC MHAN Coordinated school conferences to support Tamiko s mental health needs; IEP updated Connected to community mental health agency for therapy Coordinated with community Eating Disorder Team and family physician; student s eating disorder symptoms decreased Achieved, and maintained, stability during admission to MHAN program; reduction in self-harm; no further presentations to hospital
Tri-ministerial initiative Collaboration Care coordination Enhanced services Mental Health Student well-being Tiered model PPM149 Health education MHAN Early identification System navigation
MH Student Success Melinda s Story 15 y.o girl, new to Canada Was identified by the school team with concerns about communication skills With support from MHCCAC MHAN Medical system navigation Family education and support School staff education and support Community supports navigation (both for ASD and support for signs and symptoms of anxiety) 22
Stacey s Story 23
Discussion 24