Adictions and Mental HealthNetwork of Champlain

January 2013

Denis BoileauPaul Welsh

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Project S.T.E.P.

School based program evaluation

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A community response

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S.T.E.P stands for

Support Treatment Education Prevention

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o Community’s response to addressing the need for residential substance abuse treatment, education and prevention for young people.

o Support of community partners, local champions and leaders,

o GOAL:

o Campaign will raise the funds needed to support the development of a comprehensive substance abuse education and prevention program in our high schools

o and provide specialized treatment and counselling in a 24-hour

residential setting.

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Project S.T.E.P. partners include Premier McGuinty’s office and the Province of Ontario, the Champlain Local Health Integration Network, Health Canada, the Sens Foundation, the Cowan Foundation, Ottawa’s four school boards, Ottawa Police Service, Ottawa Public Health, the Royal Ottawa Hospital, Maison Fraternité ( Club Richelieu is also a partner) in the buildingDave Smith Youth Treatment CentreRideauwood Addiction and Family Services

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Paul Welsh, Rideauwood/Addictions Ontario -Federation Transitional Board Member

Denis Boileau, Maison Fraternité

OPDI, OAPC & OFCMHAP Joint Conference & AGM

multi-sector community partnership, brought together to address the issue of substance abuse among students in Ottawa.

Substance Abuse and Youth in School (SAYS) Coalition. Coalition members include all four local school boards, youth-serving addiction agencies, Ottawa Public Health, United Way / Centraide Ottawa, enforcement and allied professionals.

2011 Ontario Student Drug Use and Health Survey, 1 in 8 Ontario students (Grades 7 – 12) may have a drug use problem, but only a small fraction of students have received treatment.

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OverviewSchool trained to understand, recognize, refer, support;Multi Disciplinary Team (Rideauwood/Maison Fraternité Counsellor, Vice Principal, Guidance Counsellor, Social Worker, Special Education);School refers to Counsellor;Counsellor coaches school on referral, M.I., etc.; Counsellor does Screening, Engagement, Assessment;Counsellor provides individual counselling; flexible length - 1, 2, maybe 3 times weekly;Groups provided – “Moderation” or “Recovery”.

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Rideauwood Began School Programs in 1986.

In 49 English Catholic & Public Schools 2-4 days weekly; each school – 52 weeks a year;

Grades 7-12 – all Catholic Schools + 2 Sr. Elementary;

Critical Mass: 14 hours weekly per school X 52 weeks;

Maison Fraternité began in 1993. Now in 17 French Language Catholic & Public

Schools;

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Client Profile 60% Grade 9 & 10; 55% Male Students are in difficulty, substance abuse known; Cannabis use 20 days out of 30; Binge drinking 8 days of 30; 1 in 5 students are failing; 48% “High Risk for Dropout”, Many have identified related Mental Health Problems;

– Depression, Anxiety, Trauma, Eating Disorder, Anger.

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ParentsAbout 30% have Substance Use Disorders;Other Mental Health Problems also;Parents are served in schools;Provided counselling, education, address their distress;Why? THEY ARE CLIENTS TOO. Service is accessible.

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Assessment Tool – Basis 32

The MOH approved assessment tool, the Basis 32, was used to assess changes in the well-being of students, between the beginning and end of the academic year.

The Basis 32 is a five point scale from where:0 = No difficulty, 1 = A little difficulty, 2 = Moderate

difficulty, 3 = Quite a bit of difficulty, and 4 = Extreme difficulty.

Overall improvements were most pronounced in those clients with the more severe problems.

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OutcomesThe largest improvements in well-being were observed in those clients which exhibited signs of moderate to extreme difficulty in various aspects of their life on the Basis 32.

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Basis 32 n Baseline Reassessment

Change

Relation to self/Others 34 2.67 1.87 0.8

Daily Living/Role Functioning 34 2.66 1.87 0.79

Depression/Anxiety 34 2.58 1.75 0.84

Impulsive/Addictive 34 2.26 1.41 0.85

Psychosis 34 1.25 0.74 0.51

Overall Average 34 2.32 1.55 0.77

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OutcomesA typical client uses both alcohol and cannabis – using cannabis 19 days a month and using alcohol 8 days a month;At the end of the school year, clients reduced in both the amounts and frequency of their use.

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Changes in Drug Use NBaselin

eReassessme

nt

Average Reductio

n

% Reductio

n

Average Cannabis Use Per Month(in Grams)

164 43.67 22.01 21.66 ↓ 50%

Average Alcohol Use Per Month(in Standard Drinks)

142 54.67 35.32 19.35 ↓ 35%

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Outcomes> 10% of clients are also using “other” drugs, most commonly cocaine, hallucinogens, and/or ecstasy The greatest reductions in use were found with these drugs. More than 70% of clients completely ceased using, and more than 85% showed marked reductions.

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Became Abstinent

Cannabis 18%

Alcohol 19%

Cocaine 71%

Hallucinogens 80%

Ecstasy 73%

Reduced Use

Cannabis 38%

Alcohol 21%

Cocaine 14%

Hallucinogens 13%

Ecstasy 13%

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During 2011/12 school year, 1500 students served through school-based counselling across all four school boards,

additional 5400 high school students participating in prevention and education programming,

to better support students referred to counselling, 500 of their parents were also offered counselling support during the year

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2011/12, 900+ new students referred to the counselling program.

Estimated that 75% of the students who meet with a school-based addiction

counsellor engage in ongoing counselling.

Also, many students continue receiving counselling services for multiple years; (42% of the clients who were seen in 2010/11 continued with services in 2011/12).

“Ongoing counselling” implies that the student has attended at least three sessions, after which a client is formally admitted to counselling.

Variety of reasons why a student may not be admitted, including lack of readiness/motivation or referral to other services.

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For many students, a few months of counselling is not sufficient time to overcome their substance use issues and develop the necessary positive behaviours and skills, so this high proportion of returning clients is seen to be an important outcome.

High rate of student engagement and commitment is one of the hallmarks of this school-based model, and differentiates this program from other types of service delivery models.

Getting adolescents to act on a referral and engage in ongoing counselling is one of the most challenging aspects of intervention and treatment.

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The program’s success is because of the close partnership between school staff and the service providers, including the physical presence of the counsellors in the school building.

Each counsellor makes an effort to visit as many classes as possible early in the school year to introduce themselves to new students, and to be a visible part of the school community.

The counsellors have earned the trust of students to the point where some students have self-referred or have brought friends to see a counsellor.

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From the sample group of students participating in this program: 7 out of every 10 students were able to reduce or stop using one or

more drugs during the evaluation period 56% of the 150 cannabis-using students in the group reported that

they decreased or stopped their use of this drug. Overall alcohol consumption decreased by 35%.

Over 70% of the clients who previously used cocaine and/or ecstasy reported that they achieved abstinence from these drugs. For clients who used hallucinogens, 80% had stopped use.

Students who were experiencing the most difficulty upon entering the program showed the biggest improvements in health and wellbeing (as measured by the BASIS 32 assessment tool).

89% of the students admitted to the counselling program completed the school year.

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“An excellent, collaborative program which works very well in our school community.”

“They [the counsellors] are extremely professional and work with the students in a kind, and caring manner. I would hope that the time increases at each school for the number of days a counsellor visits to better address the number of students requiring support. This time could also be used to educate and visit Gr. 7/8 classes for preventative measures.”

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Denis Boileau Executive Director, Maison Fraternité 613-741-2523 dboileau@maisonfraternite.ca

Paul Welsh Execive Director, Rideauwood Addiction and Family

Services 613-724-4881 paulwelsh@rideauwood.org

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