Download OPUS 55

CLINICAL APPLICABILITY AND
COMMUNITY CAPACITY BUILDING IN SUBSTANCE USE AND
MENTAL HEALTH EDUCATION
Presented by:
Debora Steele, RN BScN C.P.M.H.N.(C) GNC(C),
Providence Care Mental Health Services
Jennifer Barr, B.A., CAMH Healthy Aging Project Lead
Centre for Addiction and Mental Health
Conflict of Interest
Declaration
• CAMH led project – quantitative and
qualitative evaluation results
• Collaborative agreement with
P.I.E.C.E.S. Consult Group
Developing Training and
Education Resources
“Making the Connection Work:
Identification and Support for
Older Adults with Substance Use
and/or Mental Health Problems”
• A one-day community based workshop
Training Description
• Developed and piloted by the Centre for
Addiction and Mental Health in partnership
with P.I.E.C.E.S. Consult Group
• Target audience for this training is Ontario
professionals working with older adults in a
variety of roles, as well as those in the
addiction and mental health fields.
Training Team
• Integral to this training is the
model of an older adult
addiction specialist teaming up
with a Psychogeriatric
Resource Consultant as cofacilitators.
Ontario older persons specific
addiction programs
• COPA (Toronto)
• LESA (Ottawa)
• Sister Margaret Smith (Thunder
Bay)
Content of the Workshop
• Information on older adults with
mental health issues &/or
substance use
• Integrates a P.I.E.C.E.S. approach
• Community capacity building
component
Alcohol Issues
• Alcohol is still most common problem
substance
• As people get older they become more
sensitive to the effects of alcohol and may be
more vulnerable to alcohol’s negative effects
• Injuries due to falls
• Liver disease
• Can worsen:
– Diabetes
– Heart disease or elevated BP
– Stomach problems
– Mental Health Issues
Illicit Drugs - The Next Generation
• 44.5% of Canadian have tried marijuana in
their lifetime.
• Important fact is that drug use as a whole
has increased in the last decade.
• Are we screening for it? Older Adults are
still largely not seen as users.
• Beginning to see use of drugs
like crack cocaine in men 55+
-- homeless and marginally housed
Prescription Medication Misuse
• Benzodiazepines
• Sedatives/Sleep
• Analgesics/Opiates
Signs of Aging
or an Alcohol/Drug Problem?
• Confusion
• Loss of interest in
activities
• Depression
• Social isolation
• Disorientation
• Tremors
• Unsteady gait/falls
• Irregular heart rate
• Recent memory loss
• Poor appetite
• Stomach complaints
Barriers to Treatment
• Personal Barriers:
– Shame
– Guilt
– Stigma
– Uncertainty about
the process
• Attitudes:
– Societal
– Family
– Health
– Cultural
– Health Prof.
• Accessibility
• Health Status
Best Practices
• Recognizes that isolation and on-going
losses are risk factors for addictions
• Is client-centred & older adult specific
• Utilizes outreach services
• Takes a harm reduction approach
• Is flexible, non-threatening, unhurried
• Addresses basic living needs
Best Practices
• Addresses socio-cultural differences
• Demands collaboration among treatment and
health care professionals
Key Approaches
• Go to where the client is at physically,
mentally and emotionally
• Assess stage of change
• Employ principles of harm reduction
Putting the P.I.E.C.E.S.
...Together
Physical
Intellectual
Emotional
Capabilities
Environment
Social/ Cultural
Cornerstones
of the
P.I.E.C.E.S.
philosophy
of care
Goals of P.I.E.C.E.S.
Learning Initiative:
To provide:
 a common vision and set of values
 a common language and knowledge for
communicating across the system
 a common yet comprehensive approach
for thinking through problems
3-Question P.I.E.C.E.S. Template
Q. 1 What has changed?
Avoid assumptions; think atypical.
Q. 2 What are the RISKS and possible causes?
Think P.I.E.C.E.S.
Q. 3 What is the action?
Investigations
Interactions
Information
Community Capacity Building
• Understanding the Problems and
Identifying Stakeholders
• Building Community Capacity
• Leveraging Resources
• Follow-Up
Evaluation
• Three-month post-event evaluation of first
pilot training has shown that participants are
able to recall and have applied concepts that
they have learned in the training to their
clinical practice.
• Of 43 participants tested after the second
pilot 15 reported they were “quite likely to”
and 21 “definitely will” implement some of
the things they learned in the workshop into
their work/practice.
Promotion and Roll Out
• To all Ontario Communities (Fr & Eng)
• Promoted to PRC’s and CAMH Project
Consultants
• Presentation Kit includes
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Sample Agenda
Presentation Slides
Training exercises and case studies
Promotional flyer
Budget template
Letter of Agreement
For more information:
Jennifer Barr
CAMH Healthy Aging Project
Centre for Addiction and Mental Health
Tel. 613 256 1397
[email protected]