Bill Dare explains – The network is taking on the complexity of the disjointed approaches to individual care and support to bring a “service user” driven foundation to community and neighborhood actions along with finding ways to align organizations and institutions.
I recently learned more about its efforts to strengthen social and health wellness after discussing with Dianne Urquhart of the Ottawa Social Planning Council https://www.spcottawa.on.ca/ and attending a community meeting, how: people are strengthening their own community, neighbourhood and work settings.
Individual practice – care and support can chip at at strengthening individual’s connections in multiple and various forms to their communities. How to embed, prioritize this approach in everyday practice beyond chipping, is not so easy as we negotiate layers of what is involved with Community Mental Health, Recovery practice but the formal framework and Community Development guidelines help.
Community Development Framework (CDF) brings together residents, community organizations, and city services in priority neighbourhoods across Ottawa. Together, we:
- Identify local community issues and strengths.
- Decide on the changes the community wants to make and set goals.
- Build on neighbourhood strengths, and develop skills and support to make the changes happen.
- Some goals require change at a level beyond the influence of the local community (for example traffic calming or access to affordable and nutritious food). An important aspect of the CDF approach is to support the “systems” level (i.e. community agencies and institutions) to address those concerns at a city-wide level.
Guiding Principles for
Community Development Practice
Coalition of Community Health and Resource Centres
Community Developers Network
II. Guiding Principles for Community Development Practice
The importance of clarity regarding guiding principles became increasingly evident as this work
unfolded. The overall connection is the resulting impact on community change. This work is
grounded in over-arching principles of social change and requires foundational supports to provide
the infrastructure capacity for CD practice.
The framework below highlights four core principles that define the work of CD.
Challenging Systemic Inequity & Power Dynamics & Supporting Empowerment
Responsive to Community
Partnership & Collaboration
These principles are strongly inter-related and as such are used in all CD activities. Depending on
the activity, one principle may have a greater focus, but the other principles are still considered
when planning the most appropriate approach.
The principles guideline for community developers can be found here: https://cdfcdc.ca/wp-content/uploads/2018/12/FINAL-Guiding-Principles-for-Comm-Dev-english-Nov-19.pdf
Learn more at the Community Development website: https://cdfcdc.ca/
A useful article to guide system reorganization that advances the recovery model – where acute care systems meet rehabilitation systems. This article which summarizes much of our talk of system change over recent years, will help put substance to new health group plans emerging here in Ontario,… I think, guess, … hope.
Remediation of functioning – reinstating a sense of possibility
…To ensure that the client’s investment of hope is well placed, it is essential that there is a full understanding of their strengths, protective factors and possible risks. As with physical rehabilitation, care needs to be exercised as the events and triggers that precipitated the relapse are brought into sharp focus by an approaching discharge. The need for care is also reinforced by the knowledge that a successful resolution of positive symptoms does not necessarily indicate a return to pre-episode functioning. A thorough assessment is required to develop a supportive, individually tailored, multi-modal skill building program, which may be provided in combination with other treatments; a point highlighted in a recent review by Lyman et al. .
The need for a holistic plan, which supports hope through a range of strategies that build confidence and competencies and addresses vulnerabilities, underscores the importance of the early involvement of rehabilitation specialists. While this phase will generally be led by acute MH services …
by: Barry G. Frost, Srinivasan Tirupati, Suzanne Johnston, Megan Turrell, Terry J. LewinEmail author, Ketrina A. Sly and Agatha M. ConradBMC PsychiatryBMC series – open, inclusive and trusted201717:22
The Income Security Advocacy Centre shares it’s analysis of the proposed ODSP admission criteria changes based on the federal CPP. This post builds from an earlier post I made. https://socialhealthpracticeottawa.wordpress.com/2018/11/27/ontarios-plan-for-social-assistance-reform-criteria-based-on-cpp-for-odsp-sets-back-our-earlier-efforts-to-support-people-living-with-a-disability/
This work by by ISAC can be utilized by us all as individuals and organizations to support further dialogue and perhaps advocacy with the Ontario government to maintain the gains and policy directions we had already established in mental health reform. For example, when we consider the Mental Health Commission’s foundational principle to implement reform, – the need for a whole system – inter-ministry – up and down the system of care of support for an integrated approach to ensure we address the Social Determinants of Health.
… On November 22, the Minister of Children, Community and Social Services announced proposed changes to the social assistance system in Ontario. One change would make the ODSP definition of disability more like definitions used in federal government benefit programs.
This proposed change would result in many low-income people with disabilities in Ontario who would qualify for ODSP today not being eligible. They would instead have to rely on the Ontario Works program, which provides a lot less money in benefits. They will also be subject to Ontario Works rules, which are much stricter around work requirements and other expectations, and it is unclear whether they would have access to critically important disability-related health benefits. …
CPP-D definition ODSP definition Level of disability Severe Substantial – more moderate than severe, and provides assistance to those with “significant” but not “severe” functional barriers How long the disability has to last Prolonged – i.e., long continued and indefinite Recurrent or continuous and expected to last at least one year The impacts of the disability In employment only – person must be incapable of regularly pursuing any substantial gainful occupation In any of three activities of daily living – personal care, community and workplace
Please go to the ISAC background document here: https://incomesecurity.org/public-education/changing-the-odsp-definition-of-disability/
From Income Security Advocacy Centre http://incomesecurity.org/
Helping people with mental health disabilities access ODSP: An expert report on the complexity of mental health treatment in Ontario
… The report explains why many people with mental health conditions do not seek treatment and, if they do, are mainly managed by primary care health care providers (such as family doctors) who are trained to treat a broad range of mental health conditions. The report notes, for example, that the absence of a specialist referral does not reflect the severity of a patient’s mental health condition.
The report also explains why treatment history can be an unreliable predictor of the severity of a person’s disability. The treatment of mental illness and addictions is complex and influenced by many factors such as: limited availability and access to specialized treatment and outpatient care, especially for those who are low income and disadvantaged; the stigma of treatment; intolerance to the side effects of medication; limits to the effectiveness of medication; and variations in prescribing medication. …
See the report here: http://incomesecurity.org/liti…reatment-in-ontario/
A thoughtful article by Megan Marrelli from This Magazine https://this.org/.
It would be easy to simply slam down how things are in domiciliary hostels (Homes for Special Care (HSC) and other municipal residences, now called Residential Support Services). Instead it brings to light the complexity, including the dynamics of a business that can sometimes impact on the directions residents are able to go to advance in their recovery, participation in community, along with owners/carer’s daily efforts of care along with the role of mental health service providers outside of the residence.
On a rainy Thursday in April, I arrive at a yellow brick, split-level house in London, Ont. People are doing word searches at a large dining table. Some help themselves to a container of freshly baked peanut butter cookies, and CBC News is playing on a television in the living room. This house, tucked away in a quiet, tree-lined neighbourhood a few kilometres from London’s gritty city centre, feels almost like a family home. “You’ve come right in time for morning break,” says Sarah Dutsch, the homeowner, as I take off my shoes. This is one of Ontario’s Homes for Special Care: a controversial custodial housing program for people living with severe psychiatric challenges. Sarah and dozens of other Homes for Special Care operators are now in talks with the Ministry of Health and Long-Term Care about the future of mental health housing in Ontario. …
I hope that local communities and mental health planners bridge the issue to our broader directions in mental health reform, guided by the Recovery Model/Housing First.
The Mental Health Commission’s foundational report on housing and mental illness “Turning the Key” is a useful guide for us. https://www.mentalhealthcom…
The role of social enterprise to support people to enter employment, employment calibrated to a person’s- need, skills is unique in the continuum of Vocational Program development. In my own practice I’ve found greater potential to actually find the best fit for an individual is through a social enterprise approach. Maybe it is because of the structure and values in play where, while there always is a boss and a job to do, there are bigger outcomes and expectations involved. This brief video gives a taste of such an approach.
BTW, they are always looking for bike donations.
See the video here: http://rogerstv.com/media?lid=237&rid=4&gid=283391
Learn more about Causeway’s social enterprise efforts here: http://www.causewayworkcentre.org/social-business/
Sean Kidd, Kwame McKenzie, and Gursharan Virdee, bridge our community based and recovery focused care to the hospital context. As a front line worker I found it a refreshing relook at the challenge of
“…situate this very large care sector with a dialogue that, to date, has focused almost exclusively on outpatient and community practices. …”
Mental Health Reform at a Systems Level: Widening the Lens on Recovery-Oriented Care Sean A Kidd, PhD, CPsych, CPRP,1 Kwame J McKenzie, MD, MRCPsych,2 and Gursharan Virdee, MSc (PsyD Candidate)3
…However, should hospitals more effectively engage in efforts toward mental health reform, the challenges of transition out of hospital may be considerably reduced. First, there would be a less radical shift in the model of care, with recovery-oriented hospital care more seamlessly merging with outpatient and community care. …