ANNUAL REPORT

ANNUAL REPORT 2015 1

TABLE OF CONTENTS Director s Message 4 Medical Director s Message 7 Child and Family-Centred Care 8 Our Vision for the Future: CPRI s Strategic Planning 10 interrai Child & Youth Suite of Assessments 12 Psychotropic Medication Monitoring Checklist and the Medwise App Project 15 Employee Engagement 16 CPRI Funding & Expenditures 17 Partners in the Journey 3

DIRECTOR S MESSAGE This is a time of exciting change in the Ministry of Children and Youth Services. The Moving on Mental Health Action Plan and the Special Needs Transformation are underway and the MCYS Operational Plan 2015/16 endorsed CPRI s future role as a provincial resource and a leader in knowledge and information management. CPRI is committed in our efforts to embrace this challenge. This year, CPRI has made significant strides in our plan to transform our services in order to meet the needs of Ontario s children, youth and their families. We provide specialized clinical services to children and youth with complex needs as well as offer education, organizational and operational capacity building to support the sector. We are an organization of passionate and highly skilled staff who are committed to taking a trauma-informed approach in the important work we do. We have improved our data collection and reporting practices to ensure accountability and proper data stewardship and are contributing to the sector in helping other agencies to use data to drive decision making. It is with great pride that I share that CPRI achieved an exemplary standing with an overall 99.3% of the accreditation standards met during our onsite review by Accreditation Canada. This status exemplifies our commitment to maintain and improve upon the level of quality of care we deliver to our clients. A focus on continuous quality improvement with the services we offer is additional evidence of the great work we continuously strive to deliver to Ontario s children and youth. Under the leadership of interrai fellow Dr. Shannon Stewart, we have received international recognition for our work developing the interrai child and youth suite of assessment tools and supporting other children s mental health agencies in implementation of these tools. This will offer the children s mental health system in Ontario the opportunity to measure outcomes at the client, agency and system level in a way that has never been possible before. We are humbled to share that CPRI s Applied Research and Education team, along with Dr. Stewart, were recipients of an Amethyst Award - one of the most significant honours in the Ontario Public Service - for this important work. We endeavour to offer enhanced consultation and training to build capacity in evidence based practices for those working with children and youth. This has included collaboration with Youth Justice Services to provide youth services officers training in child and youth mental health so that they are better equipped to identify issues and respond appropriately. I am pleased to share that this work was recognized through a Deputy Minister Pinnacle Award. We have also prioritized child and family centred care planning at CPRI, engaging family members and youth in care planning and service delivery to improve consistency, predictability, and a seamless service experience. Through our collaborative efforts and partnerships, we strive every day to make a difference. Anne Stark DIRECTOR, CPRI 4

Matthew has made such great progress. As a parent, that is a priceless gift you have given our entire family. Personally I have got to know all of you, admire your dedication, compassion, and joy you bring to your job. I will miss you all very much and please know that you have a special place in our hearts You have given our family hope again and the ability to move forward. CPRI parent of a residential youth 5

6 Excellence in child and youth mental health through research, education and practice.

MEDICAL DIRECTOR S MESSAGE Across our province, we are in the midst of monumental change in the system of mental health care for children and youth. It is a time of transformation. In anticipation of this shift, CPRI began years ago to think strategically about our contributions and role to the service system and ultimately our relationship with children, youth and families. We commenced a journey to embed trauma-informed care into every aspect of our organization, including clinical and non-clinical areas. We further challenged ourselves to support children on our residential units who are in crisis within a trauma-informed lens. Now in our third year of implementing the Sanctuary Model TM, we continue to shift our culture, establishing anchors of the model s seven pillars of nonviolence, emotional intelligence, social learning, open communication, democracy, social responsibility, and growth and change. Our entire organization prepared to undergo an accreditation review and emerged with high accolades. The journey of the interrai suite of instruments for children and youth, as well as our psychotropic medication monitoring checklists, are two notable examples of impactful work demonstrated by the committed professionals at CPRI. In strategically designing our future clinical service delivery model, we have begun to engage our stakeholders in an individual and family-centred approach to care that is flexible, responsive, individualized and collaborative. It is our ongoing commitment to support the system through consultation, clinical service, teaching and research. It is with the pride that I look back at the collective efforts of our community and marvel at what has been accomplished. This report will demonstrate evidence of our achievements and reveal opportunities for further growth and change. Enjoy the read. To every child, parent, clinician, non-clinician and contributing partner of CPRI, thank you for your tremendous efforts and ongoing pursuit of change. Clearly, we can anticipate a link from our year of exciting transformation to an upcoming year of more inspiring change. I ll end with a thought by American businessman and writer, Max De Pree, In the end, it is important to remember that we cannot become what we need to be by remaining what we are. Dr. Ajit Ninan MEDICAL DIRECTOR, CPRI 7

CHILD AND FAMILY-CENTRED CARE CPRI uses a Child and Family-Centred Care (CFCC) approach, which respects the important role of the family in a child/youth s life and makes sure the child/youth and their family are true partners on their care team. Family Advisory Committee The Family Advisory Committee (FAC) at CPRI was developed this year to advise and make recommendations to the Senior Management Team and staff to help to ensure CPRI services are child and family centred. Currently there are 23 family members on the committee, from across Ontario. The Family Advisory Committee gives children/youth and families the opportunity to: Give feedback and input on CPRI plans, policies, and initiatives. Be a part of other CPRI committees. Inform CPRI about what is most important for children and families. Find ways to share information about CPRI and its services with children and their families. TRAUMA INFORMED (SANCTUARY) COLLABORATION CPRI STAFF CLIENT & FAMILY/ COMMUNITY AGENCY Youth Engagement Youth engagement at CPRI is an active part of our culture. The input from CPRI s Youth Engagement Committee is invaluable in supporting program, policy and service changes. This past year our youth redesigned the Children s Rights Book to make the language more youth friendly, revamped the youth complaint process, and put forward ideas to change independent time while receiving residential care. 8

SHARED DECISION MAKING OUR COMMITTMENTS Continuous Feedback Loop POSITIVE CLIENT EXPERIENCE Transforms Service Delivery CPRI SERVICES CLIENT/FAMILY/ COMMUNITY FEEDBACK DRIVES QUALITY IMPROVEMENT POSITIVE CLIENT OUTCOMES CLIENT/FAMILY DRIVEN CHILDREN AND YOUTH HAVE A VOICE Residential Family Forum Our Residential Services Team hosts bi-monthly residential family forums. This provides an additional opportunity for families voices to be heard, and for families to ask questions, make suggestions, and connect with other families. 9

OUR VISION FOR THE FUTURE: CPRI S STRATEGIC PLANNING CPRI s Strategic Plan is built upon the principles and goals of the Ministry of Children and Youth Services Strategic Plan Growing Together and the ministry action plan Moving on Mental Health: A system that makes sense for children and youth. At a time of unprecendented system change, CPRI continues to be committed to ensuring that the children and youth of Ontario receive and experience high-quality and responsive services with a focus on continuous quality improvement. Highlights of our strategy and journey thus far include transforming our service delivery through: Service Deilvery CPRI is redefining our future service delivery approach to ensure timely and predictable, coordinated, client-centred, needs based service delivery. CPRI will be working closely in the year ahead with our families and system partners to ensure we get it right. Sanctuary TM CPRI is in year three of the Sanctuary TM implementation process and well on our way to receive certification. In 2015, we created an evaluation framework to support certification and embed the principles of trauma-informed care into practice. Once successful, CPRI will become the first Provincial and Canadian certified Sanctuary organization. Goals for 2016: Utilize monitoring tools and create a data framework to support ongoing cultural change using Sanctuary TM. Broaden the use of the SELF (Safety, Emotions, Loss and Future) language to include our clients and families. interrai CPRI is supporting agencies in Ontario to implement standardized, objective mental health assessments for children and youth. Research & Education CPRI is building capacity through education, with an increased focus on transferring expertise to the community. We are expanding our education catalogue and developing partnerships and web-based technology to deliver resources and expanding our reach within the province of Ontario and beyond. Last year, through our comprehensive education catalogue we delivered: 7 workshops with 650 participants 7 webinars with 385 particants Workshops via Ontario Telemedicine Network (OTN) with 20 provincial virtual sites participating Trauma-Informed Care Using recent interrai data on CPRI clients, we identified that 62% of all residential clients and 38% of all outpatient clients have triggered the interrai Child and Youth Traumatic Life Event CAP, further validating our decision to take a trauma-informed approach to care. Additionally, CPRI is building capacity though assessment, training and implementation of traumainformed care across the sector. CPRI provided an educational session Trauma-Informed - What you Need to Know to Children s Aid Societies via webinar and as a session at the 2015 Children s Mental Health Ontario Annual Conference. 10

100% of eligible full time and part time CPRI staff and students are trained in the Sanctuary Model and all 23 parents on our Family Advisory Council were trained in Being Trauma Informed: What You Need to Know. Sanctuary TM interrai Service Delivery Research & Education Trauma-Informed Care 11

interrai CHILD AND YOUTH SUITE OF ASSESSMENTS We understand that better health information equals better results for kids, families and caregivers. That s why at CPRI we partnered with Western University and interrai to create the Child & Youth Suite of Assessments. interrai assessments represent a global standard of assessment that provide high quality information for clinical, organizational and system-level decision making. CPRI supports community partners across Ontario in maximizing the benefits of using these assessments. 11,000+ Unique Individuals Assessed 650+ Child & Youth Mental Health- Dual Diagnosis Assessments Completed 900+ Assessors Trained Across Ontario 14,000+ Child & Youth interrai Assessments Completed 3500+ Child & Youth Mental Health Assessments Completed 10,000+ Child & Youth Mental Health Screeners Completed 12

interrai Goals for 2016: Create a Negative Life Events Scale to inform treatment using the interrai assessments. Continued partnership with interrai, a research network comprised of investigators in more than 30 countries, to lead the implementation support for the use of the child and youth suite of assessments. Currently 64 agencies in total, including 16 Lead Agencies across Ontario, are implementing interrai child and youth suite tools. CPRI S QUIET ROOM CPRI opened a Quiet Room for clients, staff, and families to use for reflection, contemplation, meditation or personal prayer during the day. HIGHLIGHTED AWARDS 2014-2015 Leading Practice Designation: Accreditation Canada interrai Self-Report Quality of Life Child and Youth Mental Health Self-Report Quality of Life - Child & Youth Mental Health It is the mission of CPRI to enhance the quality of life of the children and youth we serve. In collaboration with interrai, with a focus on creating quality assessment tools (www.interrai.org), CPRI developed the SQoL- ChYMH with the vision that the results will be used for client-centred care and to inform improvement initiatives. Both the Child and Youth and Family versions focus on well-being and service satisfaction. This enables the respondent to provide additional feedback around information on their life circumstances and what would have improved their experience with CPRI. DEPUTY MINISTER PINNACLE AWARD PARTNERSHIP Mental Health Training for Youth Justice DEPUTY MINISTER PINNACLE AWARD PARTNERSHIP Fetal Alcohol Spectrum Disorder (FASD) London Region Assessment Clinic DEPUTY MINISTER PINNACLE AWARD PARTNERSHIP Development of interrai Child & Youth Suite of Assessments Applied Research & Education Department 13

CPRI DATA FACTS: 170 STUDENT QUARTERLY PLACEMENT SESSIONS PROVIDED 2015/2016 *Note individuals may be in multiple placement sessions 2,148 CLIENTS SERVED 589 COMMUNITY PRESENTATIONS 6,851 COMMUNITY PARTICIPANTS REACHED THROUGH PRESENTATIONS 14

PSYCHOTROPIC MEDICATION MONITORING CHECKLIST AND THE MEDWISE APP PROJECT The Psychotropic Medication Monitoring Checklist (PMMC) was developed by a physician-pharmacist team led by CPRI s Medical Director, Dr. Ajit Ninan. It is an evidence-based medication monitoring tool which helps track potential side effects of commonly prescribed classes of psychotropic medications for children and youth. The next phase of this project is the creation of MedWise, a digital tool transforming the current paperbased PMMC into a responsive, web and mobile App which supports increased availability and utility for children, youth, guardians and care providers throughout the province. The goal is to develop a technology-based tool to improve quality of life for children and youth who are experiencing mental health challenges and prescribed psychotropic medications. PMMC Achievements Best Poster Presentation - PSYCHOTROPIC MEDICATION MONITORING CHECKLIST Canadian Academy of Child and Adolescent Psychiatry (CACAP) conference Vancouver, BC (Related publication: JCACAP; Volume 23, Issue 3, pages 218-225). KEY INDICATORS: 10,000+ PUBLICATIONS analyzed in a comprehensive evidence-based literature review of potential medication side effects 11 ENGAGEMENT SESSIONS held including prescribers and caregivers 53 PSYCHOTROPIC MEDICATIONS included in literature review for App Best Poster Award - PSYCHOTROPIC MEDICATION MONITORING APP PROJECT Western University Annual Child and Adolescent Psychiatry Research Half Day 15

EMPLOYEE ENGAGEMENT Making CPRI a better workplace starts with staff engagement. The implementation of an employee engagement workplan identified 6 Key Priority Areas and we have begun to identify the means to achieve these: Hiring Process Support & Tools Organizational Communication Recognition Career Advancement Safe & Healthy Workplace 16 I feel so good about the work we do here. I am very proud to work at CPRI. - CPRI Staff

CPRI FUNDING & EXPENDITURES APRIL 1, 2015 TO MARCH 31, 2016 TOTAL EXPENDITURES % OF TOTAL SPENDING Clinical Services 20,443,203 72% Operations & Utilities 2,596,747 9% IT & Communications 1,092,345 4% Research & Education 924,258 3% Quality Improvement 653,812 2% Homeshare 1,692,744 6% Administration 910,148 3% Tele-Mental Health 415,457 1% 72% Clinical Services 9% Operations & Utilities 4% IT & Communications 3% Research & Education 2% Quality Improvement 6% Homeshare 3% Administration 1% Tele-Mental Health 17

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