The Strongest Families Institute
II. PROFILE OF THE STRONGEST FAMILIES INSTITUTE
3. Information about the Strongest Families Institute is spreading through pilot projects and partnerships across the world; stakeholders noted that additional dissemination on the initiative
could be achieved through partners, publications and at conferences.
The Strongest Families Institute design and program services have been adopted and planned for replication in other regions in Nova Scotia and across Canada (Ontario, Alberta, BC) and interest continues to expand (Finland, Singapore, UK, US Sweden and Spain have expressed interest).85 In addition, stakeholders noted that awareness about the initiative is being spread through its recognition as part of the MHCC Awards and its website. It was also noted that there could be more dissemination through other partners (e.g., Nova Scotia Department of Health and Wellness website), publications, or at conferences.
84 McGrath, P.J., Lingley-Pottie, P., Emberly, D.J., Thurston, C. & McLean, C. 2009. Integrated Knowledge translation in mental health:
family help as an example. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 18 (1), 30-7.
85 MHCC. 2012. National Mental Health Awards Application Form – Strongest Families Institute, p. 6.
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IV. CONCLUSIONS
1. The Strongest Families Institute has been very successful in providing high quality treatment to families with children with mild to moderate mental health problems in a timely, accessible, and cost-effective manner, while maintaining a high level of satisfaction and showing improvements in mental health and behavioural outcomes. Other impacts generated by the initiative are its expansion into other regions in Canada and the world, as well as the positive impact it has had on its staff. Factors that contributed to the success of the initiative include its basis in solid and ongoing research and evidence, its accessibility, and it’s family-centred approach.
2. Factors that have constrained or slowed the success of the project have included challenges in meeting the demand due to budget constraints, and the learning curve in determining where the program fits within the continuum of care. In addition, although there was some reluctance obtaining buy-in among clinicians and families at first, over time, they have come to value the service.
3. Best practices demonstrated by the initiative include:
The use of telephone and other technology to deliver distance mental health treatment services.
The technology and materials (i.e., telephone services, DVDs, booklets and website) facilitate the delivery of the services without requiring an in-person meeting. This creates a barrier free environment, which saves parents time and money.
The use of well-trained and highly monitored non-professional coaches. The coaches help parents learn and adopt skills to help address their child’s mental health issues. They are well trained and monitored, and able to deliver services to more families at a much lower cost than the formal system.
Ongoing evaluation, research, and quality assurance mechanisms. There are built-in mechanisms to track weekly progress on outcomes and parent satisfaction, as well as monitor coaching quality and effectiveness. This allows managers to identify early when a family is not responding to the treatment and to refer them to the formal system or other services.
4. The Strongest Families Institute advances the Mental Health Strategy for Canada by increasing the capacity of families to promote mental health and intervene early when problems first emerge, and by increasing the availability of mental health services in communities and remote areas.
5. The Strongest Families Institute engages various stakeholders in its design and implementation (e.g., clinicians, families, researchers, partners, and decision/policy makers) through a continuous feedback loop to strengthen program elements. The Strongest Families Institute tracks outcomes and parent satisfaction, and prepares mid-treatment and end of treatment reports for parents and referrers, as well as more compressive quarterly and year-end reports for partners and funding agencies.
6. Information about the Strongest Families Institute is spreading through pilot projects and partnerships across the world. Additional dissemination on the initiative could be achieved through partners, publications and at conferences. Ongoing research and development of new programs and delivery applications are being conducted through Dr. McGrath’s lab, the Centre for Research in Family Health at the IWK Health Centre in Halifax.
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APPENDIX I: EVALUATION QUESTIONS
The evaluation questions, presented in the following table, guided the data collection and analysis components of the evaluation. Data was gathered on each evaluation question through multiple lines of evidence. The data collection instruments were developed based on these questions and modified to suit the relevance of the information source or stakeholder group.
Evaluation Questions IMPACTS & SUCCESS
28. What are the intended impacts and objectives of the project? In what manner and to what extent have they been achieved?
29. What other impacts, whether positive or negative, have been generated by the project?
30. What factors contributed to the success of the project? What factors have served to constrain the success of the project?
PROJECT DESIGN
31. What are the best or promising practices that have been developed as part of the project?
32. What lessons have been learned with respect to the implementation of this project that can facilitate the implementation of other similar initiatives in the future?
33. In what manner and to what extent does the project advance the priorities of the Mental Health Strategy for Canada?
KNOWLEDGE EXCHANGE & EVALUATION
34. How have different stakeholders been involved in the design and implementation of the project?
35. How has knowledge generated by the project been shared with stakeholders? What are some ways in which these activities could be enhanced?
36. What mechanisms are in place to monitor and evaluate project impacts?
What are some ways in which these activities could be enhanced?
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APPENDIX II: LIST OF DOCUMENTS REVIEWED
Lingley-Pottie, P., & McGrath, P.J. 2006. A therapeutic alliance can exist without face-to-face contact. Journal of Telemedicine and Telecare, 12, 396-399.
Lingley-Pottie, P. & McGrath, P.J. 2007. Distance therapeutic alliance: the participant’s experience. Advances in Nursing Science, 30 (4), 353-366.
Lingley-Pottie, P., & McGrath, P.J. 2008. A paediatric therapeutic alliance occurs with distance intervention.
Journal of Telemedicine and Telecare, 14, 236-240.
Lingley-Pottie, P., Janz, T., McGrath, P.J, Charles Cunningham & MacLean, C. 2012. Outcome progress letter types: Parent and physician preferences for letters from pediatric mental health services. Canadian Family Physician, 57 (12), e473-481. Accessed February 13, 2012 from:
http://www.cfp.ca/content/57/12/e473.full.pdf+html.
McGrath, P.J., Lingley-Pottie, P., Emberly, D.J., Thurston, C. & McLean, C. 2009. Integrated Knowledge translation in mental health: family help as an example. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 18 (1), 30-7.
McGrath, P., Lingley-Pottie, P. et. al. 2011. “Telephone-Based Mental Health Interventions for Child Disruptive Behavior or Anxiety Disorders: Randomized Trials and Overall Analysis.” Journal of the American Academy of Child & Adolescent Psychiatry. Volume 50, Number 11, November 2011, p. 1162.
McGrath, P., and Lingley Pottie, P. 2012. “Strongest Families, an evidence based approach to helping families overcome mental health problems in children.” Psynopsis: Canada’s Psychology Magazine. Canadian Psychological Association. Spring 2012 – Volume 34 No. 2, p. 12.
http://www.cpa.ca/docs/File/Psynopsis/spring2012/index.html
MHCC. 2012. Mental Health Strategy for Canada: Changing Directions, Changing Lives.
http://strategy.mentalhealthcommission.ca/download/
MHCC. 2012. National Mental Health Awards Application Form – Strongest Families Institute.
Nova Scotia Department of Health and Wellness. 2012. Mental Health and Addictions Investments.
http://www.gov.ns.ca/health/mhs/reports/MHA_Investments.pdf
Nova Scotia Department of Health and Wellness. 2012. “Together We Can: The Plan to Improve Mental Health and Addictions Care for Nova Scotians” http://www.gov.ns.ca/health/mhs/mental-health-addiction-strategy.asp