ADAPT CONCURRENT DISORDERS PROJECT REPORT

JUNE 2004



Prepared By:

Gates Consulting Inc

18359 McCowan Road

Mount Albert, Ontario

L0G 1M0

Tel: (905) 473-1662

Fax: (905) 473-3121

Email: janine.gates@sympatico.ca



Executive Summary



The ADAPT concurrent disorders program provides the only integrated concurrent disorders service in Halton Region. As such, the program’s Health and Hope groups are key resources for concurrent disorders services in Halton.



The program is made possible through partnerships between four area service providers: ADAPT (Halton Alcohol, Drug and Gambling Assessment, Prevention and Treatment), Joseph Brant Memorial Hospital, Halton Healthcare Services – Oakville Trafalgar Hospital, and North Halton Mental Health Clinic. Partners operate the program from within existing funding.



The program began in 1998, as a grass roots response to the needs of clients with co-occurring mental health and substance use problems. After 5 years of operation without dedicated funding, a need for program development and evaluation has been identified. The Concurrent Disorders Project was commissioned by ADAPT to answer that need. The over-aching goals of the Project are to improve the quality and responsiveness of the ADAPT concurrent disorders program, while also building awareness of concurrent disorders issues and services in the community.



Highlights of project activities include:



1. Evaluation of specific elements of the ADAPT concurrent disorders program was conducted, including a survey of client outcomes. Overall results of the evaluation were very positive in what they suggest about the effectiveness of Health and Hope I groups, for client who complete the group experience. Analysis of outcome data collected over the evaluation period indicates that the program achieves good matching, engagement and retention for the diagnostic group served. Clients found the group to be appropriate to their needs in terms of content and process, and helpful in terms of program goals. In the majority, clients reported gains in being able to cope with their problems, reductions in substance use, and improvement related to mental health problems.

2. A community workshop was convened and hosted by ADAPT, with the support of its mental health partners, as a capacity building event. The workshop was attended by 90 Halton area service providers from a wide range of agencies. Verbal and written feedback indicated that the community was genuinely appreciative of the opportunities for training, discussion, and information sharing provided by the workshop. Positive feedback about the workshop was also received from Ministry of Health and Long-Term Care regional and corporate staff. The workshop served as a vehicle to catalyze discussion of community strategies for working together collaboratively. Workshop participants collectively generated a comprehensive view of system strengths, barriers and resource needs in Halton.

3. The workshop provided an opportunity for positive visibility for the concurrent disorders program. Information about the program was disseminated to a wide range of community services through a panel presentation session at the workshop, and participants showed interest and enthusiasm for the concurrent disorders program. Additionally, written information about ADAPT and its programs was circulated to participants, and ADAPT staff were in attendance to connect and network with other service providers. Further program promotion and outreach activities will be generated out of the interest shown by participants in ADAPT services.

4. An assessment of community needs for concurrent disorders services was conducted within the framework of the workshop, as well as through interviews with a representative group of key informants. Community feedback identified the need for additional non-residential services (among a host of other service needs), and called for an expansion of ADAPT’s concurrent disorders groups. Feedback indicated that groups should be offered at greater frequency, at a greater variety of times, and in a greater range of geographical locations. Clearly, a range of concurrent disorders services is needed, in addition to concurrent disorders services provided by ADAPT. Health and Hope groups play an important role in the continuum of services, but timely access to other services (such as detoxification and concurrent disorders residential/day programs) is also needed for residents of Halton.

5. Best practices principles relative to the concurrent disorders program were identified through an analysis of Best Practices: Concurrent Mental Health and Substance Use Disorders (Health Canada, 2002). Recommendations were made for immediate and ongoing work within the concurrent disorders program to promote continuous quality improvement of the program.



Four key recommendations were made to support the stability and growth of the concurrent disorders program:

1) ADAPT should seek base funding to ensure sustainability and responsiveness of the concurrent disorders program. The ADAPT concurrent disorders program is the only concurrent disorders service in Halton. On that fact alone, it is a precious resource that should be protected and nurtured. Based on the strong track record of the program and the positive community response to the services offered, dedicated funding to stabilize and expand the program would result in a ‘quick win’ for the community and the program funder.



2) ADAPT and its partner agencies should develop formal written partnership agreements. Operational vulnerabilities can arise from the lack of formal commitments. The concurrent disorders program is an important resource that needs to be protected by its partner agencies, as well as by the support of funders. Formal service agreements may also add credibility and weight to requests for dedicated program funding made by ADAPT and/or its mental health partners.



3) The concurrent disorders program should develop program-specific policies and procedures, and should create and implement a sustainable evaluation framework to support the quality and credibility of the program.



4) ADAPT should continue to promote and market the program, not only as an important resource for the Halton area, but also as an innovative model of partnership, community collaboration and integrated services.