Mental Health and/or Substance Use Services (CA-MHSU) 4: Service Planning and Monitoring
Individuals and their families, as appropriate to the program model and the age and expressed wishes of the person, participate in the development and ongoing review of a service plan that is the basis for delivery of appropriate services and support.
Due to the importance of family involvement in achieving positive outcomes for children, all aspects of service delivery should be family-driven when working with this population, accounting for the dynamics of the family as well as the needs of the child. Family should be defined in partnership with the child.
NAThe organization provides Diagnosis, Assessment, and Referral Services only.
Currently viewing: MENTAL HEALTH AND/OR SUBSTANCE USE SERVICES (CA-MHSU)
Examples: Family involvement has been emphasized due to the significant impact family engagement can have on resilience and recovery. However, the level of family involvement can vary given the age and expressed wishes of the person and as permitted by law.
Program model and structure can also impact family involvement. For example, detoxification treatment programs are short-term and primarily focused on withdrawal management; therefore, persons served have limited opportunities to involve family members in the service planning and monitoring process. Furthermore, it may not be appropriate to engage family members due to the service recipient's physical and mental state and treatment progress.
Examples: Treatment outcomes for adults may include the ability to live independently or obtain employment, while outcomes for children and youth may focus on school performance and social and emotional well-being.
The organization determines whether a crisis plan is necessary and, when indicated, engages persons served and involved family members in crisis and/or safety planning that:
is individualized and centered around strengths;
identifies individualized warning signs of a crisis;
identifies coping strategies and sources of support that individuals can implement during a suicidal crisis, as appropriate; and
specifies interventions that may or may not be implemented in order to help the individual de-escalate and promote stabilisation.
A safety plan includes a prioritized written list of coping strategies and sources of support that individuals who have been deemed to be at high risk for suicide can use. Individuals can implement these strategies before or during a suicidal crisis. A personalized safety plan and appropriate follow-up can help suicidal individuals cope with suicidal feelings in order to prevent a suicide attempt or possibly death. The safety plan should be developed once it has been determined that no immediate emergency intervention is required.
“No-suicide contracts,” also known as “no-harm contracts” and other similar terms, should never be used. No-suicide contracts are based on a verbal or written agreement by the service recipient to not engage in self-harm or suicidal acts during a specific timeframe. Research does not support this practise or show that these agreements are effective at preventing suicides, nor have they been found to provide protection against malpractise lawsuits.
Examples: Depending on the needs of the individual, crisis plans may reference advanced mental health directives, also known as advanced psychiatric directives.
Examples: Components of a safety plan can also include: internal coping strategies, socialization strategies for distraction and support, family and social contacts for assistance, professional and agency contacts, and lethal means restriction.
Examples: Warning signs for individuals assessed as being at high risk for suicide can include a missed appointment, or significant change in status, and personnel may conduct active outreach and service engagement strategies such as phone calls, text messages, or home visits until contact is made.
Examples: Safety plans may look different depending on the specific needs of the service recipient. For example, safety plans for survivors of domestic violence may focus on helping individuals prepare for immediate escape, while safety plans for individuals at risk for suicide may address coping strategies and sources of support, such as socialization strategies for distraction and support, family and social contacts for assistance, professional and agency contacts, and lethal means restriction. Organizations may also provide family members with information on crisis prevention. For example, Mental Health First Aid is a one-day training that can prepare someone to recognize, understand, and respond to a person’s mental health crisis.
The worker and a supervisor, or a clinical, service, or peer team, review the case quarterly, or more frequently depending on the needs of persons served, to assess:
service plan implementation;
progress toward achieving service goals and desired outcomes; and
the continuing appropriateness of the agreed upon service goals.
When experienced workers are conducting reviews of their own cases, the worker’s supervisor must review a sample of the worker’s evaluations as per the requirements of the standard.
Examples: Individuals with higher level of care needs require frequent review. For example, weekly review is recommended for individuals with substance use disorders at high risk for relapse. Individuals with acute or complex needs (e.g., individuals receiving medications for diagnosed symptoms and conditions) may require that their service plan be reviewed and updated every 30 days.
The worker and individual, and his or her family when appropriate:
review progress toward achievement of agreed upon service goals; and