see what s possible & Annual Program Report 2016-17 About us Our and Services provide a community-based family care model of non-medical withdrawal management, and supported recovery in Vancouver to youth (13 to 21 years old) whose substance use is problematic. Youth accessing our services live with Family Caregivers who provide 24-hour support and supervision during their withdrawal process. Our team works closely with each youth to ensure that they receive the intensive one-to-one support they need and the services they require. They may stay for up to 10 days with extensions granted as needed. Priority is given to youth who are 16 years old and younger. Our services provide a safe and stable environment in the community for youth to continue their recovery process, and begin planning for their future by assessing their treatment options. Young people accessing these services live with Family Caregivers who provide support and assistance and our team works with them on a one-to-one basis to ensure they receive the services they require. Youth are able to stay for up to 28 days; services are flexible and based on individual circumstances. Both of these services are voluntary, funded by the Vancouver Coastal Health (VCH) and available to youth in the Vancouver Coastal Health region. Referrals to are made by contacting our office or through "D-Talks", a centralized intake telephone line operated by VCH. Referrals to our services are made by VCH addictions counsellors and other stakeholders in the continuum of care. We have been providing both of these services since 1995. Who we served Profile 2016-17 2015-16 2014-15 2013-14 2012-13 # of cases 1 69 112 144 126 152 # of youth 41 73 92 87 94 % young women 29 34 39 38 55 1 # of cases is greater than the # of youth because some youth received multiple services or were re-referred. www.plea.ca Charitable Registration # 10781 0467 RR0001
% young men 68 64 60 60 45 % self-identified as transgender 2 2 1 2 - % self-identified as Aboriginal 23 36 29 31 37 Average age when cases were opened 18 18 18 18 19 % reported they were homeless at intake 43 18 30 38 45 Average # of days in program by discharged cases (N= number of discharged cases) 8 (N=66) 8 (N=110) 6 (N=141) 7 (N=125) 6 (N=150) It is to be noted that there was a spike in youth that were reporting they were homeless at intake. There also has been a steady five year drop in youth who identify as aboriginal as well as a five year decline in females accessing the program. Primary drugs of choice as reported by youth by case 2016-17 2015-16 2014-15 2013-14 2012-13 Amphetamines 48% 26% 33% 25% 21% Heroin and other opiates 26% 28% 34% 24% 26% Cannabis 7% 10% 18% 13% 11% Alcohol 9% 9% 6% 21% 22% Cocaine/Crack 10% 14% 4% 10% 17% % of youth reporting intravenous substance use 32 42 36 39 38 % of youth reporting a second drug of choice 100 96 99 98 97 Heroin and amphetamines remain the most prominent drugs by percentage. It is worth noting that there was a significant spike over the past year with participants reporting Amphetamines. These substances continue to be highly accessible and relatively inexpensive. Cannabis and Alcohol remained consistent and youth continue to not identify marijuana to be their drug of choice but will report to using this substance frequently. Profile 2016-17 2015-16 2014-15 2013-14 2012-13 # of cases 2 27 44 50 70 75 # of youth 24 36 38 49 49 % young women 58 23 42 49 47 % young men 42 75 58 51 53 % self-identified as transgender 0 2 - - - % self-identified as Aboriginal 29 23 37 35 41 Average age when cases were opened 19 19 19 19 19 % reported they were homeless at intake 50 39 57 72 75 Average # of days in program by discharged cases (N= number of discharged cases) 23 (N=26) 17.93 (N=43) 20.23 (N=45) 20.71 (N=67) 17.61 (N=75) continues to struggle in its search for family homes for youth, which explains the continued decrease in cases and clients this year. The number of homeless youth had a significant increase in comparison from last year. There was also a significant shift in terms of the percentage of female and male participants with the number of females increasing and the number of males decreasing drastically. Primary drugs of choice as reported by youth by case 2016-17 2015-16 2014-15 2013-14 2012-13 Amphetamines 33% 30% 32% 24% 9% Heroin and other opiates 29% 37% 28% 31% 16% Cannabis 0% 5% 24% 4% 3% Cocaine/Crack 15% 12% 4% 10% 21% Alcohol 19% 5% 8% 21% 48% % of youth reporting intravenous substance use 22 44 44 40 25 % of youth reporting second drug of choice 100 98 96 96 96 PLEA p.2 of 7 2 # of cases is greater than the # of youth because some youth received multiple services or were re-referred.
The trend in remains consistent with. Heroin and Amphetamines continue to be accessible in most communities and, generally, youth accessing who need a transitional resource will utilize which could contribute to the consistency in percentages with primary drug of choice. How we did service delivery Measure 2016-17 2015-16 2014-15 2013-14 2012-13 % bed utilization 49 77 80 78 87 # of youth by case who completed final assessments 62 111 131 99 148 # of youth by case reporting a decrease in substance abuse 46 61 81 59 84 Measure 2016-17 2015-16 2014-15 2013-14 2012-13 % bed utilization 41 44 61 92 80 # of youth by case who completed final assessments 25 42 44 48 70 # of youth by case reporting a decrease in substance abuse 6 11 11 18 18 There is a consistent trend of lower bed utilization reported in due to an ongoing shortage of Family Caregivers. Both Detox and continue seeking new forums to recruit individuals who may be interested in applying to become caregivers with our programs. The program has also become more proactive by communicating with partnering programs to inform them about the need for family caregivers and we continue to communicate with other Vancouver Coastal Health Programs regarding the youth we serve to ensure that youth coming into our programs are appropriately referred in order for them to be successful. How we did against last year s goals i. To work with Vancouver Coastal Health to better connect to other Vancouver Coastal Health programs and resources. We continued to build our relationship with Vancouver Coastal Health and have developed a good working relationship with D-Talks as well as with several outreach clinics. This allowed us to access additional services for our youth such as Concurrent Disorder Clinicians. Continue to build relationships with addictions counsellors and other professionals by being on committees, organizing further 'meet and greets' and meeting them one-on-one. We continued to build our relationships with addictions counsellors and other professionals by being on committees, organizing further 'meet and greets' and meeting them one-on-one. This year, we attended several networking barbeques and open houses to talk about our services. i Seek to improve Family Caregiver retention rates by increasing the training opportunities and the amount of time our workers spend with the youth to give our Family Caregivers additional respite. PLEA p.3 of 7 We engaged our Family Caregivers in several training opportunities this year to further our ability to retain them. This included privacy, trauma and drug education. We also increased the amount of time spent in the home with the Family Caregiver as well as amount of time our workers spent with the youth to give our Family Caregivers additional respite. We were able to raise Family Caregiver rates and provide respite opportunities to ensure our caregivers are well-supported in their work with our participants.
iv. Update intake materials so they are consistent with Vancouver Coastal Health materials We worked with Vancouver Coastal Health and D-Talks to ensure our materials and processes are consistent and as easy to navigate as possible. This helped to minimize our waitlist. v. Incorporate new social detox health standards into practice, once available. We worked diligently with Vancouver Coastal Health to train staff and caregivers in the use of Naloxone.The program is still trying to incorporate other new social detox health standards into practice. Once available, these standards will be put into practice. i. The program, in consultation with Vancouver Coastal Health and other stakeholders, will make the referral process as low-barrier as possible. We continued to consult with Vancouver Coastal Health and other stakeholders to ensure the referral process was as low-barrier as possible. This goal continues to be a work in progress with VCH. Increase and improve Family Caregiver retention rates by increasing training opportunities and the amount of time our workers spend with the youth to give our Family Caregivers additional respite. We engaged our Family Caregivers in several training opportunities this year to further our ability to retain them this included privacy, trauma and drug education. We also increased the amount of time spent in the home with the Family Caregiver as well as amount of time our workers spent with the youth to give our Family Caregiver respite. i Incorporate respite into the contract. We have not yet been able to make significant progress on this goal. iv. Increase the number of family caregiver beds to meet required utilization rates. We had three available beds this year and have been working on securing two more. This year we reached capacity for program utilization however the Family Caregiver moved out of province and was no longer able to fulfill her commitment. Selected accomplishments i. We were able to retain three homes as well as offer training opportunities to our Family Caregivers to complement their existing skills. We also continued to provide service to a large number of youth even with reduced caregiver resources. We increased our Family Caregiver pay rates in to be more in line with the rates paid by other PLEA programs. i We trained all of our Family Caregivers and staff in the use of Naloxone and provided all caregivers with Naloxone kits. PLEA p.4 of 7
Selected stories i. Alex s Story Prior to entering our program, Alex had completed 2.5 months of treatment and attended daily meetings. They received a month extension to help them with their continuum of care, ie. find housing, receive support in conflict resolution and triggering situations, build confidence in self and transitioning to independence. During their stay, Alex made a disclosure that they had previously reported to their family and social worker but had resisted making a police report until now. This self-reflection had allowed them to have more selfawareness in establishing healthy boundaries. Alex was receptive to being connected to a PLEA Onyx worker to continue working on exploitation concerns. Alex s ability to confide in staff shows their level of trust in their workers. They thrive with encouragement and frequently requests staff support when attending meetings that are new to them or could potentially be overwhelming. Our team helped Alex advocate their needs to their social worker and school, return to their passion in acting, and make a safe and structured visit back home. Alex was able to receive a mental health diagnosis and our team reminds them to be kind to themselves, especially while undergoing adjustments in their life. Greg s Story Greg utilized the Detox program over a dozen times within the past year. He had no prior connections with any addictions or mental health professionals and was looking for short-term housing. He just wanted to play video games and sleep, and he thought his substance use was not problematic. With our assistance, Greg was able to establish a strong relationship with a drug and alcohol counsellor from Vancouver Coastal Health. He was also connected with other professionals, such as a concurrent disorders counsellor and a psychiatrist. In order to stay consistent with his medications, Greg agreed to visit the same medical clinic for clearance and prescriptions each time he entered Detox or. After a few stays in Detox, he scheduled eye appointments and purchased prescription glasses; a task which he had previously resisted. Eventually, Greg recognized that his substance use had significantly impacted his life and so decided to enter a treatment facility. i A Youth Worker Shares a Story One young person who stands out to me in particular is one who accessed both Detox and Supported Recovery on numerous occasions. We walked alongside him through many highs and lows. During our time together, we often discussed self-worth in connection with his substance use, and he shared with me that no matter how much his support networks tell him he s worthy, years of trauma and adverse experiences have led him to believe otherwise. During his last stay in Detox, we were successful in transitioning him into a one year residential treatment program. Over the past year, I often thought of him and wondered what his life looked like now. Recently, I received a text message from him. He told me that he had completed his treatment and was doing well. He asked that we reconnect as he wanted to share with me all that has changed for him over the past year. I reminded him that I have and always will feel that he deserved to lead a good, fulfilling life. His response to this was something I will never forget: he said he finally believed he did too. In a job where we PLEA p.5 of 7
often don t get to see the seeds that we plant blossom, or perhaps even more importantly, grow roots this story reminds me why we do the work that we do here at PLEA. Biggest challenges i. Our biggest challenge continues to be the recruitment of Family Caregivers. We were unable to attract any new caregivers into our Detox Program. We were also unable to attract any new caregivers to Supported Recovery and we, in fact, lost one home due to the lack of fit for the program need. Managing the Fentanyl crisis meant that we needed to adapt by training our staff and Family Caregivers as well as make sure that we had all the resources in place to support our youth. i We had a challenging year with there being so much uncertainty with regards to our existing contract. The team is small so balancing the needs of providing service with impending changes has been difficult. Our team staffing 3 1 Program Director 1 Residential Services Coodinator 2 Youth Support Workers 41 youth () and 24 youth (Supported Recovery) 1 Family Caregivers (Youth Detox) 1 Respite Workers (both programs) 2 Family Caregivers (Supported Recovery) Our team learning undertaken i. The team engaged in training including suicide prevention, boundaries, trauma informed practice, verbal deescalation, strengths-based approach and working with transgender youth, on-going drug education, CAMS Casenote Training, and attended the Gangs and Guns Conference. We also participated in the agency s learning modules, including Ethics and Conduct; PLEA s Core Principles; Developing Sensitivity; Person & Family Centred Service Delivery; Self-Care; Emergency Response & Preventing Communicable Diseases; Unravelling your Worldview; Identifying & Reporting Critical Incidents and Engaging Program Participants, Medical Issues, and The Power of Language. PLEA p.6 of 7 3 # of individuals as opposed to FTEs as per March 31st, 2016
Our team new relationships i. We continued to work on building new relationships with stakeholders outside of the Vancouver Coastal Health region in recognition that the youth in need of our services are becoming more transient. i We continued to increase our connection with existing partners over the last year by visiting their sites and sharing referral information so that they are more aware of our program and referral process. We continued to present at schools as well as other community forums with the goal of increasing the number of referrals. iv. We also attended several community events such as Recovery Day and post-secondary institutions to promote our Family Caregiving opportunities. Next year s goals i. Work with Vancouver Coastal Health to better connect to other Vancouver Coastal Health programs and resources so we can achieve 85% utilization. i Continue to build relationships with addictions counsellors and other professionals by being on committees, organizing further 'meet and greets' and meeting them one-on-one. Improve Family Caregiver retention rates by increasing the training opportunities and the amount of time our workers spend with the youth to give our Family Caregivers additional respite. i. In consultation with Vancouver Coastal Health and other stakeholders, make the referral process as low-barrier as possible and work to better connect to other Vancouver Coastal Health programs and resources so we can achieve 85% utilization. Improve Family Caregiver retention rates by increasing training opportunities and the amount of time our workers spend with the youth to give our Family Caregivers additional respite. i Increase the number of Family Caregiver beds to meet required utilization rates. For more information Contact Paul Gordon, Program Director at 604-506-0504 or email pgordon@plea.bc.ca PLEA p.7 of 7