DELTA CHILD & YOUTH MENTAL HEALTH SERVICES

1. DELTA CHILD & YOUTH MENTAL HEALTH SERVICES CYC Meeting

2. Child & Youth Mental Health Services We offer a range of mental health services for children, youth and their families, including assessment, treatment, consultation and education.

3. How Services are Accessed • Referrals are made by parents, adolescents, doctors, ACRP (adolescent crisis response), and school counselors by calling or faxing Shannon or Tiina at reception. Shannon and Tiina record basic information and pass the information to a CYMH intake worker. • An intake worker will call the family and listen to their concerns. The parent and/or adolescent will most likely be asked to do a brief child and family phone interview. The intake worker may also direct the family to apply their extended health benefits for private therapy, or to access other community resources and/or groups. Reading materials that pertain to the individual’s situation may also be recommended. The child/adolescent may then be placed on a wait list and contacted by a therapist when it is time for his/her initial assessment. • For some individuals service needs will be met through groups and for others, individual assessment and treatment may follow.

4. Terms of Service • Time limited treatment may include 12 sessions (possibility of extension upon review). • Treatment is focused on specific goals. • Treatment is completed when specific goals have been reached. • Parent participation is often required (daytime appointments may be necessary). • In some cases it may be appropriate for older adolescents to access services independently.

5. Family Engagement CYMH Clinicians believe that parents/caregivers have significant influence over the course of their child’s development and mental health. We therefore design treatment plans to actively include both the child and his/her caregivers. A plan of treatment is designed based on the information gathered in our assessment which includes parent/caregiver input.

6. Parent Participation What does active parent participation mean? • Participation in assessment and treatment planning foryour child/youth. • Participate in family counseling sessions. • Be open and flexible to making changes. • Remain in the waiting room while children attendingindividual sessions. • Attend educational and/or therapeutic parent groups. • Support treatment successes after services are completed. • Discontinuation of services will be considered in the absence of parental participation.

7. Common Mental Health issues that meet our mandate • Depression • Anxiety Disorders • (including generalized anxiety, social anxiety, OCD, and panic disorders, separation anxiety, and PTSD) • Bipolar Disorder • Borderline personality Disorder • Psychotic disorders • Some behavioural issues (ie. ODD, ADHD if in conjunction with mental health issue) • We do NOT specialize in ADHD clients – Refer to Cedarwood program or BCCH • Suicidal ideation • Self-harm

8. Phases of Treatment • Therapy/Intervention:Interventions may include parental involvement in psycho-educational groups as well as other forms of individual treatment provided to the child alone or together with their parent. • Progress Review: Treatment will be reviewed with the family to determine if there has been substantial improvement in the treatment objectives. If not, necessary efforts will be made to identify the barriers to success and additional sessions may be provided. • Service Completion and follow-up: Families may be referred for additional community services if required.

9. Child &Youth Mental Health Team ATTACHMENT BASED APPROACH: • We believe that the healing of children begins when they are at rest in safe, secure relationships receiving the verbal and non-verbal communications that encourage a healthy sense of self and healthy development. • If basic attachment needs (stabilized housing, food, safety, an attachment to an adult, etc.) are not met at a minimal level and there is a push for therapy there is an increased risk of exasperating the youth’s behaviours and volatility of the parent-youth relationship.

10. Challenging Behaviors you may see • Children with moderate to severe attachment difficulties typically display the following symptoms: being angry, aggressive, controlling, manipulative, lying and stealing, hoarding food, lacking empathy, remorse, and genuinely loving relationships, and having self-contempt, anxiety, shame, and depression. • Children with severe attachment difficulties will often exhibit three very troubling additional symptoms – cruelty to animals, preoccupation with fire, and bedwetting. • Dissociation and hyper-arousal stress responses from trauma and broken attachments are often misdiagnosed as ADHD, hyperactivity, and Oppositional Defiant Disorder.

11. Interventions Applied by Clinicians • Attachment based psycho-education • Family Systems Approach • Cognitive Behavioural Therapy (CBT) • Dialectical Behavioural Therapy (DBT) • Narrative Therapy • Connecting families to community resources • Advocating for families • Providing access to psychiatric care • Helping caregivers increase self-care strategies • Emotional support

12. Possible Interventions applied by Early Childhood Clinicians • Expressive Therapies • Attachment Based Therapies • Child Parent Relationship Training parent groups • Occupational Therapy (Sensory Integration focus) • Psychiatric Consultation • Psychological Assessment • Direct observation (in a variety of environments, specifically engaging with a caregiver in a play setting)

13. Psychiatry Access • Access to our psychiatrist is available when there is significant engagement with a mental health clinician or our intake team. • As such, psychiatry access is not available to the community at large. We expect that these clients would access their family doctors to obtain referrals to private psychiatrists or to paediatricians for this purpose.

14. Groups offered by CYMH • CONNECT parent group • Adolescent: 13 – 18 years • Child/Pre-adolescent: 9 – 12 years • Anxiety parent & child groups • Coping Skills for Anxiety Teen Groups • Clinical • School based • School based coping skills group for anxious teens

15. Some Interesting Stats An estimated 140,000 children and youth in the province are affected by mental health disorders serious enough to affect their functioning at home and at school (Review of Child and Youth Mental Health Plan, 2008) • ~23,000 children & youth (age 0-19) reside in Delta • Between 10 & 15 percent of them will experience some sort of mental illness • 13% of school age children have a parent with a mental health issue or an addiction A conservative estimate would suggest that at least 2,300 of the children in Delta have a CYMH issue but is most likely closer to 3,450. • Some of these children & youth are served privately, some by EAP companies. The rest are served by MCFD CYMH and our contracted agencies. As you can see our needs far outweigh our resources which calls on our strength and creativity as a CYMH office.

16. Waitlist & Intake Stats – Delta Mental Health Team Waitlist Info: South Delta: 20 North Delta: 27 Intake Stats: Total intakes for the month of November 2011: 22 Average intakes per month: ≈12

17. Waitlist & Referral Stats – Eating Disorders Clinic Total of approximately 20 children & youth receiving treatment. Waitlist Info: Currently no waitlist for service Referral Stats: • December 2011: 3 • November 2011: 2 • October 2011: 2 • September: 5 Average referrals per month: 3

18. High Priority Referrals • Immediately put to the top of the waitlist • Include the following: • Hospital referrals • A.C.R.P. referrals • EPI referrals • Moderate to severe suicide risk

19. Community Partnerships • Doctors/Paediatricians • Force Society for Kid’s Mental Health • Aboriginal Child & Youth Mental Health • REACH Child & Youth Development Society • Boys and Girls Club Community Services • Fraser Health Authority/A.C.R.P. • Deltassist • Early Psychosis Intervention • Delta Adult Mental Health • Delta School District • Diversecity • Winter House • Surrey Hospital Programs • Pacific Community Resource Services