inner city youth - steve mathias

Inner City Youth Mental Health Program: (Lead Funder Silver Wheaton)

Dr. Steve Mathias- Medical Manager Inner City Youth Mental Health Program St Paul’s Hospital (Providence Health Care) [email protected]

Inner City Youth Mental Health Program

Our Vision

We excel at giving inner-city youth and young adults their best hope for recovery, stability and self-sufficiency.

Our Mission

Through innovation, collaboration and evidence-informed practice, we improve the mental health and quality of life for inner-city youth and young adults in Vancouver.

Inner City Youth Mental Health Program: Conceptual Model

Psychiatrist led program

Urban Health Division of St Paul’s Hospital established in 2007

“Attachment informed” Therapy

Priorities are to foster attachment with the youth

Priority placed on stabilizing housing

Mental Health goals are set by the youth

Attachment >= Housing > Mental Health > Purpose > Addiction

ICYMHP Implementation

• Inclusion Criteria: •  Youth <24 at intake

•  With or without fixed address

•  Suffering from mental illness and/or addiction

•  Exclusion Criteria •  Youth with persistent and

chronic mental illness already served by a mental health team/service

ICYMHP Strengths

•  Inter-professional with large experienced group of psychiatrists and clinicians from various sectors of hospital

•  Staffing includes •  2 Social Workers

•  1 Nurse

•  1 Occupational Therapist

•  1 Social Worker (Coast Mental Health funded)

•  8 Psychiatrists and resident

Intensive Case Management

•  Targets the most disabled, is outreach based, increased contact, low client to staff ratio, and focuses on the nitty gritty.

•  The case manager provides direct services, linkage and coordination of services.

•  Services are provided on a long term basis

Intensive Case Management

•  Because of the degree of functional impairment clients need direct assistance in a number of areas.

•  Mental Health

•  Physical Health

•  Housing

•  Finances

•  Addictions

•  Leisure

•  Education

•  Work

•  Interpersonal

•  Life skills

•  Relationships

•  Crisis management

ICYMHP Strengths

•  Highly integrated with community

•  Covenant House: 4 Case Managers, 3 Master’s Clinicians

•  Broadway Youth Resource Centre: 3 outreach workers

•  Ministry of Social Development: 1 Income Assistance Worker

•  Coast Mental Health: 2-3 Support Staff

•  Vancouver School Board: 1 teacher

ICYMHP Strengths

•  Variety of Groups •  DBT

•  Contingency Mgmt

•  Photovoice

•  MBCT

•  Community Offices •  Cov House, Pacific Coast

Apartments, St Helens, VISU, St Paul’s Hospital

•  Multiple Housing Sites

•  St Helen’s (30)

•  Pacific Coast Apartments (13)

•  Thompson Court (4)

•  Subsidies (10)

Housing

ICY Mental Health Housing Continuum

•  >50 SRO units assigned to ICYMH youth in collaboration with various partners

•  Low threshold- St Helen’s Hotels

•  Medium threshold- Pacific Coast Apartments and Thompson Court

•  10 market rent housing subsidies

13

Housing Referrals

•  Come directly from Psychiatrist

•  When room is available Case Manager meets with youth and psychiatrist to discuss housing expectations and eligibility

•  Youth is toured building and introduced to building manager and Coast Staff and given move in date.

•  Program agreement is signed prior to move in and is in additional to Intent to Rents.

Program Agreements Conditions

•  As a CONDITION of my tenancy, I agree to

1) Have the Ministry of Housing and Social Development send monthly cheques for my rent directly to the property manager.

2) Have My income assistance checks are administered on a bi weekly basis

3) Take my medications as prescribed and to attend scheduled psychiatric appointments.

4) Attend weekly group meetings

•  Agreements are reviewed on an annual or on an as needed basis.

ICYMHP Metrics and Outcomes

ICYMHP Summary of Services

•  Total youth assessed: >400 since 2007

•  80-110 annual assessments

•  3000+ annual psychiatric appointments

•  60-80 visits / week

•  190 youth seen •  60+ youth in

housing •  Average wait time:

<1 week

•  18 youth with complex psychosis

ICYMHP Findings (Housing)


0

8

15

23

30

27

1714

6

Cognitive ChallengesPe

rcen

tage

of c

lient

s

Inte

llectu

al dis

abilit

y

feta

l alco

hol

effe

cts Lear

ning

disab

ility

Head

injur

y


-15

0

15

30

45

60Global Assessment of Function Change

GAF

chan

ge

Cllient number (0-54)

ICYMHP Awards

•  Canadian College of Health Leaders

•  Quality of Like Award

•  Premier’s Award Finalist

•  Partnership Category

•  BC Office of the Representative for Child and Youth Award

•  Partnership Category

ICYMHP Research/Evaluation

•  Mindfulness Based Cognitive Therapy

•  HOTEL Study- Youth

•  Technology Utilization and Barriers to Care Survey

•  Transformational Change in Four Organizations Addressing Youth Homelessness

•  Protocols and Guidelines for FEP/ EPI in hospital

•  ILS/OT assessments of ICYMHP Sample

ICYMHP Future State

ICYMHP Staff Expansion

2012: •  2 Social Workers (MCFD

and Vancouver Foundation)

•  1 Nurse (Janssen INC.)

•  1 Occupational Therapist (HSBC)

2013: •  Senior Mental Health

Clinician (Silver Wheaton)

•  2 Social Workers (SW)

•  1 Nurse (SW)

•  Rehabilitation Assistant (SW)

•  Nurse Practitioner (MOH)

•  Admin Staff (SW)

•  … and Providence Foundation

ICYMHP Expansion

•  Downtown Eastside Deliverables

•  200 youth seen by NP annually

•  40+ new case managed youth

•  20-30 new units

•  Peer Support and Culinary Program (Coast MH)

•  HOTEL Study

•  Centralized Intake •  SPH Inpatient and

ER •  Protocols and Guidelines

for Early Psychosis Presentations

•  Depot Clinics •  Recovery Star

Recovery Star

Thank you!

Special Thanks: Stephanie, Ron, Michelle and Jeff

Our Donors/Funders:

•  Silver Wheaton

•  HSBC

•  Janssen Ortho Inc.

•  Vancouver Foundation

•  Providence Foundation

inner city youth - steve mathias

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