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

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

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

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.

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

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

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

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

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

Search National Caregiver Guidelines

Components

Values and Principles to care

41 Recommendations

Pyramid

MHCC Pyramid of Family Care Framework

Family Therapy

Consultation

Psychoeducation

General Education

Connecting and Assessment

Barriers to Providing Family Care

Group Brainstorm

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

Findings

Yes76%

No24%

Is your relative currently receiving mental health support?

Series1

0

5

10

15

20

25

30

35

What type of mental health support is your re-lative receiving?

Psychiatrist Counsellor Case Manager Family Doctor Other

Series102468

1012141618

If your relative is not receiving support, why not?

Currently on wait list Not eligible for appropriate supports

Lack of financial resources for non-OHIP services Not interested in support

Unable to find support that works for them

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

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.)

Case Study

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.

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

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

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

Thank you!

For more information visit:

www.familymentalhealthrecovery.org

www.mooddisorders.ca

www.schizophrenia.on.ca