BC Patient Safety & Quality Council

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2018 Living with Illness Winner

Child & Youth Mental Health and Substance Use (CYMHSU) Collaborative

Shared Care Committee (Doctors of BC & Ministry of Health)

Research shows that receiving appropriate mental health and substance use care at the right time may enable a child or youth to return to good health or prevent the escalation of problems and symptoms into adulthood, staving off larger crises, and even saving young lives.

Child and Youth Mental Health and Substance Use Collaborative

 

In December 2012, a patient journey map was presented to the Deputy Minister of the Ministry of Children and Family Development, highlighting the delayed and fragmented care that children and youth with mental health and substance use challenges face in BC. As a result, in the spring of 2013, the Shared Care Committee committed to supporting the development of the Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative, with the understanding that children, youth and families, together with providers and communities across BC, would have the opportunity to work together to create meaningful, sustainable change. The Shared Care Committee is one of four collaborative committees representing a partnership of Doctors of BC and the BC government.

The Collaborative started in the Interior Health region, with eight Local Action Teams and 200 participants tackling work at the grassroots level. Thanks to the stewardship of three government ministries (Health, Children and Family Development, and Education), the Collaborative has grown to 64 Local Action Teams and 11 system-level Working Groups across seven health authorities, involving hundreds of physicians, school personnel, and numerous community partners. The Collaborative is the single largest change initiative in BC history, with over 2,600 active participants. Most importantly, youth and families have been at the centre of the Collaborative’s activities. The impact is evident in the stories and testimonials from BC youth themselves, many of which are available through Legacy Magazine.

Since 2013, the Collaborative has focused on values-based and community-driven change, supporting  Local Action Teams to identify local gaps in care and create grassroots solutions, in alignment with the Collaborative Charter. The Local Action Teams have brought together diverse providers, stakeholders and people with lived experience in their communities. Together they have developed care pathways, and strategies to increase awareness of signs and symptoms of mental health and substance use issues, and what to do about them.  There has been significant movement towards integrated care, crisis intervention, reduced waitlists for services, and linking youth and families to community resources. Local Action Teams continue to identify priority areas for change, most recently focusing on the impact of adverse childhood experiences and how families can be supported to mitigate the effects of trauma and toxic stress in childhood. The effectiveness of this grassroots approach, versus a top-down mandate, is evident by the rapid growth, wide-scale participation and important legacies of the Collaborative.

The 11 Working Groups tackled system-level issues that were identified as too large for Local Action Teams to address, such as poor emergency department experiences, lack of telehealth support, lack of capacity for mental health and substance use support in schools, and increased MHSU education for physicians and clinicians.

The CYMHSU Collaborative officially wraps up in December 2017, and work is underway to ensure the sustainability of its impact. Nearly all the Local Action Teams are continuing to plan for long-term sustainability of their collaboration. Additionally, the Shared Care Committee is supporting BC physicians to form a CYMHSU Community of Practice, with over 120 physicians already involved. The important legacy of continued CYMHSU action is strengthened by province-wide legacies including: Learning Links, pathways to care, an Emergency Room protocol, and telehealth expansion. Two legacy resources have also been produced to help document and sustain ongoing CYMHSU activities: Legacy Magazine and Collaborative Toolbox. After four years of shining a spotlight on mental health, the Collaborative can be confident that children and youth across the province will benefit from their dedication and tenacity.

At a Glance

Living with Illness Runner-Up

An End to Hallway Nursing
Hemodialysis Unit, St. Paul’s Hospital