The Children’s Hospital of Eastern Ontario (CHEO) and the Royal Ottawa Mental Health Centre (The Royal) are launching a new model for outpatient mental health services that is designed to reduce wait times and improve access to mental health care for our region’s children and youth. The initiative is part of the Young Minds Partnership, a five-year strategy launched by CHEO and The Royal last fall.
The Choice and Partnership Approach (CAPA), developed in the UK, is a flexible model that gives patients and families a stronger voice in their care. CAPA provides a structure for mental health clinicians and patients to work in close partnership, focusing on the patient’s individual strengths, defining clear goals, and working together to determine the right care plan.
In the past, children and youth referred for mental health services spent many months waiting for an in-depth assessment, then could spend more time on a waiting list for treatment. The ideal target in the CAPA model is that no referred child or youth wait more than six weeks for an initial “Choice” appointment.
“The demand for mental health services has outgrown our capacity, and we need a brand new approach to make sure that every child and youth gets the right help at the right time,” says Alex Munter, President and CEO of CHEO. “Because of CAPA, we will be able to help the people currently on our outpatient waiting list faster, and over the next year, transition towards a more sustainable model.”
“We need to do better for the young people in our community who are living with mental illness. Long wait times need to be replaced with a system that is more responsive to their individual needs and able to get them back on track faster, living the lives they want. CAPA is a fresh approach that allows us to do just that by working collaboratively with young clients and their families, using the skills of every member of our clinical team more efficiently,” says George Weber, President and CEO of The Royal.
Using the CAPA model, psychologists, psychiatrists, social workers and counsellors will work as one clinical team, focused less on formal assessment and more on problem solving and offering choices to patients. So, rather than waiting an extended period of time for a psychiatric assessment, a patient’s initial appointment – called the Choice Appointment – will focus on understanding the problems the patient is facing, their strengths and supports, their goals, and the help they hope to receive – such as counselling, a group program, or community services. Together, the clinician, patient and family will make a plan to meet the patient’s goals and the appropriate follow up appointments will be booked or community resources suggested.
Due to a backlog of several hundred referred patients, CHEO’s initial target is to reduce the wait for a first appointment to four months or less by the end of 2016, then continue working towards a six-week target. Through the implementation of CAPA in its Youth Psychiatry Program, The Royal is targeting for wait times to be reduced to four weeks from the time of referral to first appointment (the wait time prior to CAPA was three to five months).
CHEO and The Royal’s Young Minds Partnership is a five-year strategy to address the rapidly growing need for mental health services among children and youth in Eastern Ontario. Along with implementing CAPA, the Young Minds Partnership is planning other new initiatives such as increased Telehealth care, identifying youth who have co-occurring substance abuse and helping them get care.
“As a community, we are working together to make sure children and youth get help faster and from the provider best suited to meet their needs. We congratulate CHEO and The Royal on adopting the CAPA model to improve access to mental health support for families and young people,” says Joanne Lowe, Executive Director, Youth Services Bureau of Ottawa (YSB).
[NOTE: The Royal is also in the process of implementing CAPA in the outpatient service of its Mood and Anxiety Disorders Program for adults. For more information, contact Karen Monaghan.]
CHEO is one of the largest providers of child and youth mental health services in Ontario. It offers a broad range of both hospital and community-based services for children and youth (ages 0-18) and their families – spanning prevention and early intervention to more intensive diagnostic and treatment services. CHEO is also home to internationally-recognized researchers in the field of mental health, eating disorders and outcomes management. Their research has helped shape clinical programs at CHEO and beyond.
About The Royal
The Royal is one of Canada’s foremost mental health care and academic health science centres. Its mandate is simple: to help more people living with mental illness into recovery faster. The Royal combines the delivery of specialized mental health care, advocacy, research and education to transform the lives of people with complex and treatment resistant mental illness. The Royal places a sharp focus on awareness building through the You Know Who I Am campaign and public education initiatives like Conversations at The Royal and Is It Just Me? Conversations about Youth Mental Health.