Standards for Canadian organizations

2020 Edition

Mental Health and/or Substance Use Services (CA-MHSU) 2: Personnel

Program personnel have the competency and support needed to provide services and meet the needs of the target population.

Interpretation

Competency can be demonstrated through education, training, experience, or licensure. Support can be provided through supervision or other learning activities to improve understanding or skill development in specific areas.
2020 Edition

Currently viewing: MENTAL HEALTH AND/OR SUBSTANCE USE SERVICES (CA-MHSU)

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Purpose

Individuals and families who receive Mental Health and/or Substance Use Services improve social, emotional, psychological, cognitive, and family functioning to attain recovery and wellness.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,  
  • With some exceptions, staff (direct service providers, supervisors, and program managers) possess the required qualifications, including education, experience, training, skills, temperament, etc., but the integrity of the service is not compromised; or
  • Supervisors provide additional support and oversight, as needed, to the few staff without the listed qualifications; or 
  • Most staff who do not meet educational requirements are seeking to obtain them; or 
  • With few exceptions, staff have received required training, including applicable specialized training; or
  • Training curricula are not fully developed or lack depth; or
  • Training documentation is consistently maintained and kept up-to-date with some exceptions; or
  • A substantial number of supervisors meet the requirements of the standard, and the organization provides training and/or consultation to improve competencies when needed; or
  • With few exceptions, caseload sizes are consistently maintained as required by the standards or as required by internal policy when caseload has not been set by a standard; or
  • Workloads are such that staff can effectively accomplish their assigned tasks and provide quality services and are adjusted as necessary; or
  • Specialized services are obtained as required by the standards.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards.  Service quality or program functioning may be compromised; e.g.,
  • A significant number of staff (direct service providers, supervisors, and program managers) do not possess the required qualifications, including education, experience, training, skills, temperament, etc.; and as a result, the integrity of the service may be compromised; or
  • Job descriptions typically do not reflect the requirements of the standards, and/or hiring practices do not document efforts to hire staff with required qualifications when vacancies occur; or 
  • Supervisors do not typically provide additional support and oversight to staff without the listed qualifications; or
  • A significant number of staff have not received required training, including applicable specialized training; or
  • Training documentation is poorly maintained; or
  • A significant number of supervisors do not meet the requirements of the standard, and the organization makes little effort to provide training and/or consultation to improve competencies; or
  • There are numerous instances where caseload sizes exceed the standards' requirements or the requirements of internal policy when a caseload size is not set by the standard; or
  • Workloads are excessive, and the integrity of the service may be compromised; or 
  • Specialized staff are typically not retained as required and/or many do not possess the required qualifications; or
  • Specialized services are infrequently obtained as required by the standards.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Table of contents of training curricula
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Sample job descriptions from across relevant job categories
  • Documentation tracking staff completion of required trainings and/or competencies
  • Training curricula
  • Caseload size requirements set by policy, regulation, or contract, when applicable
  • Documentation of current caseload size per worker
  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files

CA-MHSU 2.01

Clinical personnel are qualified by education, training, supervised experience, and licensure or the equivalent as appropriate to the services provided and program design.

Interpretation

Clinical personnel may also include individuals who are license-eligible and supervised by experienced, licensed staff.

CA-MHSU 2.02

Supervisor qualifications are tailored to the services provided and program design, and include: 
  1. an advanced degree in a human services field and a minimum of two years professional experience;
  2. specialized training in supervision; and
  3. certification and/or licensure by the designated authority in their province, as appropriate.

Interpretation

Regarding element (a), supervisors in detoxification treatment programs may have an advanced degree in a medical field.
Examples: Qualifications for supervisors in substance use treatment programs may include training and experience in alcohol and other drug use, diagnosis, and treatment, and/or certification by the designated authority in their province as approved alcohol and/or drug counselling supervisors.

CA-MHSU 2.03

Clinical personnel are trained on, or demonstrate competence in: 
  1. evidence-based practices and other relevant emerging bodies of knowledge;
  2. psychosocial and ecological or person-in-environment perspectives;
  3. criteria to determine the need for more intensive services;
  4. methods of crisis prevention and intervention, including assessing for and responding to signs of suicide risk;
  5. understanding child development and individual and family functioning;
  6. working with difficult to reach or disengaged individuals and families;
  7. recognizing and working with individuals with co-occurring physical health, mental health, and substance use conditions; and
  8. collaborating with other disciplines and services.

Interpretation

Element (e) is not applicable to detoxification treatment programs.
Examples: Ecological or person-in-environment perspectives view social, economic, and environmental factors as critical in the development and resolution of personal and family problems. Factors may include: 
  1. poverty and lack of employment opportunities;
  2. local mores;
  3. language and cultural differences; and
  4. alternative medicine and traditional healing processes.

CA-MHSU 2.04

Clinical personnel are trained on, or demonstrate competence in the latest information, theories, and proven practices related to the treatment of alcohol and other drug use disorders, including: 
  1. the signs and symptoms of withdrawal;
  2. addiction as a disease;
  3. relapse prevention; and
  4. interventions that demonstrate respect for sociocultural values, personal goals, life style choices, and complex family interactions.
NA The organization provides mental health services only.

CA-MHSU 2.05

Individuals who provide peer support:
  1. obtain certification, as defined by their province; 
  2. are willing to share their personal recovery stories; 
  3. have a job description and clearly understand the role of a peer support worker; and
  4. have adequate support and appropriate supervision.
NA The organization does not utilize peer support workers.

CA-MHSU 2.06

Individuals who provide peer support receive pre- and in-service training on: 
  1. how to recognize the need for more intensive services and how to make an appropriate referral;
  2. established ethical guidelines, including setting appropriate boundaries and understanding confidentiality; 
  3. wellness support methods, trauma-informed care practices, and recovery resources; and
  4. skills, concepts, and philosophies related to recovery and peer support.
NA The organization does not utilize peer support workers.

CA-MHSU 2.07

The organization minimizes the number of workers assigned to persons served over the course of their contact with the organization by:
  1. assigning a worker at intake or early in the contact; and
  2. avoiding the arbitrary or indiscriminate reassignment of direct service personnel.
NA The organization provides Diagnosis, Assessment, and Referral Services only.

CA-MHSU 2.08

Employee workloads support the achievement of client outcomes and are regularly reviewed.
Examples: Factors that may be considered when determining employee workloads include, but are not limited to:
  1. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
  2. the work and time required to accomplish assigned tasks and job responsibilities; and
  3. service volume, accounting for assessed level of needs of clients.