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Positive futures : optimizing mental health for Alberta's children & youth : a framework for action (2006-2016) PDF

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A F ramework for Action (2006 - 2 016) /dlberta September 2006 T ABLE OF CONTENTS Executive Summary 2 Facing Up to the Challenge 4 Background 5 A F ramework for Action 7 Vision 7 Beliefs and Principles 7 Conceptual Model 8 Strategic Directions 9 Expected Outcomes 10 Activities to Support the Strategic Directions 11 Looking Ahead 13 Glossary 14 References 15 APPENDIX Key Resources Considered in the Preparation of the Framework 16 Ww JH XECUTIVE SUMMARY A lberta is committed to supporting the The vision of Positive Futures is that “Alberta’s mental well-being of children, youth, and children and youth will have optimal mental their families, and to providing effective health”. Critical components of the framework are services for those who are experiencing mental the relationships between mental health, mental health problems and mental disorders in children health problems. Children’s mental health was identified as a p riority in Advancing the Mental and youth on a continuum from less than optimal Health Agenda: A P rovincial Mental Health Plan mental health to optimal mental health. Optimal for Alberta (2004) where the need to increase mental health for Alberta’s children, youth recognition, awareness and understanding of and their families will be achieved through the the needs of children and youth with mental following three strategic directions: illness, and the benefits of effective prevention, 1 . Building capacity to enhance/increase factors early intervention and treatment programs were that promote mental health and well-being; emphasized. The 10-year strategy Positive Futures 2. Removing or reducing risks to well-being and - O ptimizing Mental Health for Alberta’s Children mental health; and and Youth: A F ramework for Action (2 006-2016 ) supports a common and integrated approach 3. Providing support and treatment to children, to optimizing the mental health of children and youth and their families. youth ages zero to 24 and their families, and to align with the Provincial Mental Health Plan and Activities to support the three strategic other strategic government initiatives. directions include health promotion, prevention, early identification, crisis intervention and Positive Futures has been adapted from the draft stabilization, treatment interventions including document. Policy Framework: Mental Health for both basic and specialized services, community Alberta’s Children and Youth (2001) that was supports, and collaboration supports. developed by the cross-ministerial Children’s Expected outcomes indicating the successful Mental Health Framework Steering Committee implementation of the framework are as follows: within the context of the Alberta Children and Youth Initiative (ACYI) . T he policy framework Building Capacity received cross-ministry and cross-regional support in 2001. Vital to the development of the • Increased responsiveness of the infrastructure provincial framework was a comprehensive to meet the evolving needs of children, youth and families. review of background literature and key resources (see Appendix) , and a comprehensive • Increased capacity of individuals, families, provincial consultation with key stakeholders. communities and governments to recognize and contribute to the mental health of children and youth. EXECUTIVE SUMMARY • Enhanced range and accessibility of • Increased Albertans’ knowledge about the determinants of health (see Glossary) and community supports and services for their role in affecting mental health. children, youth and their caregivers. • Increased capacity of partners and • Increased early identification of children and stakeholders to collaborate effectively. youth at risk for mental health problems. • Increased awareness of the factors that build • Increased connection to appropriate mental and sustain mental wellness among service health resources for children, youth, families and communities. providers. Positive Futures outlines in broad terms what Reducing Risks needs to be done to address and optimize the • Increased prevention and early intervention mental health of Alberta’s children and youth strategies for children, youth, families and who will be Alberta’s adults in the future. communities. With the implementation of the framework, • Decreased risk factors that contribute to we are one step closer to the Alberta vision mental health problems in children, youth of a “ vibrant and prosperous province where and their families. Albertans enjoy a superior quality of life and are confident about the future for themselves • Increased knowledge and ability of individuals associated with children and and their children”. The next step is to develop a comprehensive implementation plan that includes youth to identify and connect those at risk an accountability framework; performance and for mental health problems to appropriate outcome measurement and evaluation strategies; resources. linkages to strategic initiatives such as the • Increased awareness of individuals, families ACYI, Student Health Initiative and Healthy Kids and caregivers about the warning signs of Alberta!; participation from key stakeholders such crisis, escalation of crisis, and the importance as the Alberta Mental Health Board (AMHB), of timely intervention for children and youth. Alberta Alcohol and Drug Abuse Commission (AADAC) , other ministries, and the regional Providing Support and Treatment health authorities; and priority strategies in areas • Increased awareness of and access to basic such as provincial standards for treatment and services in order to enable children, youth support, regional service delivery, and provincial and their families to obtain services within or and cross-regional mental health initiatives. close to their own community. • Availability of specialized services in strategic locations throughout the province to meet mental health needs of children, youth and their families. r ACING UP TO THE CHALLENGE Iberta is taking action on improving Positive Futures - O ptimizing Mental Health for the mental health and wellness of Alberta’s Children and Youth: A F ramework for Albertans and moving forward on mental Action (2 006-2016 ) i s a 1 0-year strategy that health innovation through the implementation aligns with the Healthy Kids Alberta! Strategy’s of Advancing the Mental Health Agenda: A expected outcome that, “more children, youth Provincial Mental Health Plan for Alberta and their families have strategies, skills and (2004) . T he Provincial Mental Health Plan tools to cope successfully with challenges, adjust positively to change, overcome obstacles, identified children’s mental health as a p riority and stressed the need to increase recognition, resolve problems and experience mental well- awareness and understanding of the needs being” (p. 3 ). The framework is action-oriented of children and youth with mental illness, and is a vital step towards addressing the and the benefits of effective prevention, early priorities set forth by the Provincial Mental intervention and treatment programs. Health Plan, namely supporting the mental well-being of children and youth, and providing The Alberta government has set a course for effective services for those children and youth the future with a 2 0-year vision: “A vibrant and who are experiencing mental health problems. prosperous province where Albertans enjoy a Cross-sector collaboration will be crucial in superior quality of life and are confident about the implementation of the framework because the future for themselves and their children”. Implementing strategies that address mental children’s mental health programs across the province are diverse with a multitude of service health needs of children, youth and their families will lead to a h ealthier adult population in providers delivering children’s mental health services in various locations including schools, the future. Treating mental illness in children, community mental health clinics, hospitals, and reducing risk, and supporting families and residential treatment programs. communities will also help to avoid the greater downstream costs resulting from the prevalence of mental illness in children. B ACKGROUND n 2 001, a d raft provincial policy Alberta Human Resources and Employment, framework to optimize the mental Alberta Health and Wellness, Alberta Children’s Services, Alberta Community Development, health of Alberta’s children and youth Alberta Learning, Alberta Aboriginal and Northern was prepared by a C hildren’s Mental Health Framework Steering Committee within the Affairs and Alberta Solicitor General. Vital to the context of the ACYI to serve as the foundation development of the provincial framework was a for strategic planning, investment priorities, and comprehensive review of background literature business and implementation planning. This and key resources (see Appendix) . Some trends steering committee was chaired by the AMHB, relating to the mental health of today’s children and included representatives from AADAC, and youth in Canada are described in Table 1 . Table 1. Trends and Risks Trend.. Risk... These numbers and ages of onset are In C anada, the face of depression is g etting younger, the average alarming and action needs to be taken age of onset being 23. The average age of onset is 1 2 in cases of to promote and protect the mental anxiety disorder and 18 for substance abuse (Wilkerson, 2005). health of children and youth. ► Suicide is a s erious problem in Alberta. In 2004, 440 people residing For every death by s uicide in Alberta, in Alberta died by s uicide, and 73 of t hese people were 24 y ears of there were nearly six hospitalizations age or younger (Alberta Vital Statistics - S upplied by t he Public Health and more than 15 emergency room Surveillance and Environmental Health Branch, AHW). Canada's rate visits for self-inflicted injuries in one of s uicide among adolescents aged 1 5 t o 1 9 i s 1 3 p er 1 00,000, the year alone (AMHB, 2005). third highest suicide rate in the world (Wilkerson, 2005). ► Family violence and bullying have a Thousands of Albertans are affected by f amily violence every year negative impact on the mental wellness and bullying affects many children and youth across the province of children and youth, and can lead to (Government of Alberta, May 2004). serious mental health problems. In t he 2003-2004 fiscal year, 7,400 per 100,000 children under the age of 18 in Alberta received physician services for a m ental health ► These numbers are alarming and action needs to be taken to ensure that service problem or concern. In t he 2004-2005 fiscal year, 3,123 per 100,000 children under the age of 1 8 i n A lberta received mental health delivery models are evidence-based services in other settings such as regional hospitals and community and leading practice. mental health clinics (AMHB). BACKGROUND In October 2001, the draft provincial policy In January 2002, A F ramework for Reform: framework was reviewed by selected stakeholders Report of the Premier’s Advisory Council on through focused conversations in Edmonton, Health (Mazankowski Report) was released. It Calgary, Medicine Hat and Peace River. included a recommendation to “Integrate mental Participants were selected by the partnering health services with the work of regional health ministries and included service providers from authorities” and noted that provincial leadership various sectors including education, health, is required to anticipate the growing needs mental health, addictions, and other community for mental health services for specific groups agencies. including children and adolescents. In April 2003, responsibility for most mental health services Following the provincial consultation, an action transferred from the Alberta Mental Health Board plan was developed and an implementation to regional health authorities. strategy was put forward at the end of 2001 . The draft policy framework was accepted as a first step in the development of an integrated approach to mental health for children, youth and their families but was not formally approved as other provincial and national mental health initiatives were underway. The model on optimizing mental health, which includes building capacity, reducing risk, and providing support and treatment, featured prominently in the Provincial Mental Health Plan. FRAMEWORK FOR ACTION ositive Futures is a 1 0-year strategy The determinants of health (see Glossary) designed to support a common and influence the optimal development of children, integrated approach to optimize the youth, families and communities. mental health of children and youth. For the Individuals, families, community service purpose of this framework, “child” is defined as providers and governments share responsibility children from the ages of zero to 12 and “youth” and accountability for achieving optimal mental is defined as youth from the ages of 13 to 24, health. recognizing that young persons from the ages The severity and duration of mental of 18 to 24 face a major transition to adulthood health problems are reduced through early which can be impacted significantly when they identification and intervention. suffer from a major mental disorder. Some children and youth are seriously impaired VISION by mental health problems and disorders. Children, youth and their families who have The vision of Positive Futures - O ptimizing mental health disorders or mental health Mental Health for Alberta’s Children and Youth: problems should have access to timely and A F ramework for Action (2006-2016) is: appropriate support and treatment. “Alberta’s children and youth will Principles have optimal mental health.” The mental health of children and youth will be This vision compliments the Alberta positively impacted in environments where they Government’s vision of “a vibrant and are safe, well nourished, stimulated, loved and prosperous province where Albertans enjoy a have opportunities to learn and play. superior quality of life and are confident about the future for themselves and their children”. Respect for autonomy, dignity, culture, spirituality and diversity of all children, youth BELIEFS AND PRINCIPLES and their families shall be demonstrated. There is a need for programs and services The framework is based on the following beliefs specifically designed for children and youth to and principles: optimize their mental health. Beliefs There is a need for services to be available, Mental health is more than the absence of accessible and reflect community requirements. mental health disorders or freedom from Optimal mental health for children and youth psychiatric symptoms. will be achieved through effective collaborative action based on common goals. Children, youth and families have strengths and potential. Children, youth and their families will have Children and youth have unique mental health opportunities to influence the processes that needs that are different from those of adults. impact their mental health. Children and youth benefit when they are involved with positive role models. A FRAMEWORK FOR ACTION :ONCEPTUAL MODE! Critical components of Positive Futures are the health problems and mental disorders in children definitions of mental health, mental health and youth are graphically presented, reflecting problem and mental disorder (see Glossary) . movement back and forth along the continuum: The relationships between mental health, mental Figure 1. Mental Health Continuum Positive health determinants are evident and the child/youth is w ell-adjusted and is coping and adapting well. The child/youth has: Basic needs met; Safety and security; Opportunities for learning, work and play; Meaningful attachments and relationships with family or others; Opportunities to pursue goals and create a p ositive future; Knowledge and decision-making skills; Positive self-esteem; and Controlled mental disorder (if a pplicable). s o f one or more of the factors above and presence of such factors as: Harsh social conditions; Family breakdown; Discriminatory attitudes; Bullying and/or relational aggression; Crisis and/or periodic states of crisis; VPioovleerntcye;, abuse and neglect, trauma; Substance abuse; and Physical or mental illness. Recognizable medically diagnosable illness that results in a s ignificant impairment of an individual's cognitive, affective and relational abilities including but not limited to: Mood and anxiety disorders; Schizophrenia and other psychotic disorders; Personality disorders (in y outh ages 18 to 24); Eating disorders; Substance-related disorders; Pervasive developmental disorders; Attention-deficit and disruptive behaviour disorders; and Suicidal behaviour (while not a m ental illness, suicide is h ighly correlated with mental illness).

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