Transcript Court Outcomes Data Project Webinar - 2015-02-26

Court Outcomes Data Project
Thursday, February 26, 2015
Michael Dunn, Provincial HSJCC Co-Chair
Sarah Gauthier, Canadian Mental Health Association - Sudbury/ Manitoulin
Hélène Philbin-Wilkinson, North Bay Regional Health Centre
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HSJCC Webinar
Thank you to CMHA Ontario and the Evidence Exchange Network
(EENet) for providing support to host this webinar!
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Overview of Presentation
1. About the HSJCC
2. Northeast Regional Outcomes Project
3. Live Tour of Online Portal
4. Questions & Comments
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Presenters
• Michael Dunn, Director of Research, Evaluation & Quality Improvement, Canadian
Mental Health Association - Simcoe County Branch, Co-Chair of the Provincial HSJCC
• Sarah Gauthier, Justice Program Coordinator at CMHA - Sudbury/ Manitoulin Branch,
Chair of the Sudbury /Manitoulin District HSJCC and Co-chair of the Northeast Regional
HSJCC
• Hélène Philbin-Wilkinson, Director of Dual Diagnosis and Mental Health & the Law
Services at North Bay Regional Health Centre, Northeast Regional HSJCC Member
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HSJCC Network
• Established based on the Provincial Strategy to Coordinate Human Services and
Criminal Justice Systems in Ontario (1997)
• Responding to a recognized need in the province to coordinate resources and services, and
plan more effectively for people who are in conflict with the law
• Priority consideration is for people with a serious mental illness, developmental disability,
acquired brain injury, drug and alcohol addiction, and/or fetal alcohol syndrome
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HSJCC Network
HSJCC Network is comprised of
• 43 Local HSJCCs
• 14 Regional HSJCCs
• Provincial HSJCC
• Each HSJCC is a voluntary collaboration between health and social service organizations,
community mental health and addictions organizations and partners from the justice sector
including crown attorneys, judges, police services and correctional service providers
• Funded by the Ministry of Health and Long-Term Care
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Provincial HSJCC
Provincial HSJCC consists of
• Regional HSJCC Chairs representing their Regions
• Ex-officio members from important stakeholder groups such as Correctional Service of
Canada, Ontario Provincial Police and Ontario Association of Chiefs of Police, Legal Aid
Ontario, and Community Networks of Specialized Care
• Ex-officio representatives from 5 Provincial Ministries:
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Attorney General
Children and Youth Services
Community and Social Services
Community Safety and Correctional Services
Health and Long-Term Care
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Upcoming Webinars
1. March 26, 2015, 12 pm to 1 pm – Pre-Charge Diversion
2. April (date and time to be determined), 2015 – Hamilton Rapid Response Team
Stay tuned for further details on these webinars!
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Contact Information
For more information about the Provincial HSJCC, or to join the
mailing list visit: www.hsjcc.on.ca
For more information about CMHA Ontario, visit:
www.ontario.cmha.ca
For more information about EENet, visit: www.eenet.ca
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Northeast Regional
Outcomes Project
Sarah Gauthier BA
Hélène Philbin-Wilkinson BScN, Reg. N., MN
Agenda
• Background
• Development Process
• Measures
• Regional & District Trends
• Implications
• Lessons Learned
• Live Tour of Online Portal
Northeast Region
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Spans 400 000 square kilometers
Represents over 40% of Ontario’s land mass
With 4.2& of population
Compared to rest of the province we have higher rates of:
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Alcohol abuse, smoking
Chronic conditions
Unscheduled emergency department visits for mental health and substance abuse
Hospitalizations related to mental illness and self-injury (ages 15years and older)
• 25 hospitals (4 x Schedule 1, 1 x Regional Health Centre)
• 48 community mental health and addictions services
• 1 CCAC
• 8 Community agencies
• 24 Court locations
• NBRHC Mental Health & the Law
Partnerships with Purpose
• Service agreements since 2000
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Outlining roles and responsibilities
Timely access
Optimizing resource utilization
Track service trends
Inconsistent definitions and unclear rational for data collection
Inconsistent methods of reporting
Unclear understanding of the system demands in each area
Inability to validate trends and inform funding
How do we hold ourselves accountable?
Common goal of improving access and connections to service
Background
• How do we know we are making a difference?
• How do we measure program & system performance?
• Surveyed other programs across the province
• No provincial standard measures or common definitions
• Traditional data collection aka “ caseload statistics”
• Support from Northeast Regional HSJCC & North Bay Regional Health Centre
Timeline
• CMHA- Sudbury/ Manitoulin went live 2012 with three process
measures
• Demonstrated data after 6 months to HSJCC and partners
• Partners agreed to the development of a Regional portal building on
the three measures
• Agreement to engage consultant and financial commitment
• Northeast Regional Portal went live April 1, 2013
• Phase 2 was funded by the NE LHIN to enhance current measures and
further develop system outcomes measures
Development Process
Define
Control
Measure
Improvement
Improve
Analyze
Collaborative process guided by Brian Tramontini
Measures
• Phase 1
o Diversion Success Rate: How successfully are people diverted from the
criminal justice system and into the mental health system?
o Alternate Disposition (diversion) Success Rate:Are we successful in
advocating for improved dispositions?
o Admission Aversion Rate:How many clients inappropriate admissions to
forensic units are avoided?
Measures
• Phase 2
o Diversion Recidivism: How many people, while on a mental health diversion,
were known to reoffend within the diversion period?
o Fitness Recommendation Consistency Rate: Was the agency fitness
recommendation consistent with the physician assessment recommendation?
o Release from Custody Rate: How many clients are released on a recognizance
back to the community based on the involvement of the mental health court
worker?
Data Collection
• No unique identifiers
• Each agency utilizes their own client data base reference #
• Agency & Court
• Demographics: age category, sex, aboriginal, primary and secondary
diagnosis, needs
Data Collection
• Use of OCAN categories / language
• Data integrity – permissions, mandatory fields
age
gender
• Integrated into current practices
Dx
Outcomes
50
Diversion Counts
CMHA SudburyManitoulin
Diversion Counts by Age and Diagnosis
300
Dissociative Disorders
45
CMHA Sault Ste. Marie
40
_None
250
Acquired Brain Injury
CMHA Nipissing
35
200
30
CMHA Cochrane Temiskaming - Kirkland
Lake
25
Muskoka-Parry Sound
Community Mental
Health Service
20
15
CMHA CochraneTemiskaming Timmins
Office
10
5
0
2013 2014 2015 2013 2014 2015
Alternate
Diversion
Disorder of Childhood/
adolescence
Substance Related
Disorders
100
Unknown
Hearst Kapuskasing
Smooth Rock Falls
Counselling Services
50
Sudbury Community
Service Centre
0
Weeneebayko Area
Health Authority
Personality Disorders
150
Developmental
Disability
Schizophrenia and other
psychotic Disorders
Adult (18-64)
Youth (12-17)
Diversion
Senior (65+)
Anxiety disorder
Mood Disorder
District and Regional Trends
• Youth recidivism rates are higher in Sudbury & Nipissing
• Intervention increases success rate of release on bail for Dual
Diagnosis population
• Courts consistently follow recommendation of Justice Programs when
ordering Fitness to Stand Trial assessments
• Demographics: more males being diverted than females in most
districts, gap is narrowed with youth
Implications
• Combines qualitative and quantitative data
• Common language and measures to achieve our common goal
• Allows for flexibility in processes within the districts
• Outcome based accountability framework that informs service delivery
• Relevant evidence to identify system pressures
• Starting to understand cost savings at a program and system level
• Supports a culture of quality improvement in line with the Excellent Care for
All Act
• Despite barriers of geography and distance it fosters collaboration and a
supportive partnership
• Assists in determining allocations of funds and resources
Lessons learned
• Commitment at all levels
• Different levels of readiness
• Need a champion and evidence that it works
• Competing priorities and needs
• Common language early on to motivate engagement
• Essential to have expertise in outcome performance and data management
• Requires training and on-going support and involvement of all partners
• Utilizing partnership agreement
Future Directions
• Continued data collection & analysis
• Quality Improvement Planning
• Re-establishing the baseline and targets
• Setting the standard for an evaluative framework
Online Portal Tour
Thank you / Questions?