Table Of ContentA F ramework for Action (2006 - 2 016)
/dlberta
September 2006
T
ABLE OF CONTENTS
Executive Summary 2
Facing Up to the Challenge 4
Background 5
A F ramework for Action 7
Vision 7
Beliefs and Principles 7
Conceptual Model 8
Strategic Directions 9
Expected Outcomes 10
Activities to Support the Strategic Directions 11
Looking Ahead 13
Glossary 14
References 15
APPENDIX
Key Resources Considered in the Preparation of the Framework 16
Ww JH
XECUTIVE SUMMARY
A
lberta is committed to supporting the The vision of Positive Futures is that “Alberta’s
mental well-being of children, youth, and children and youth will have optimal mental
their families, and to providing effective
health”. Critical components of the framework are
services for those who are experiencing mental the relationships between mental health, mental
health problems and mental disorders in children
health problems. Children’s mental health was
identified as a p riority in Advancing the Mental and youth on a continuum from less than optimal
Health Agenda: A P rovincial Mental Health Plan mental health to optimal mental health. Optimal
for Alberta (2004) where the need to increase mental health for Alberta’s children, youth
recognition, awareness and understanding of and their families will be achieved through the
the needs of children and youth with mental following three strategic directions:
illness, and the benefits of effective prevention,
1 . Building capacity to enhance/increase factors
early intervention and treatment programs were
that promote mental health and well-being;
emphasized. The 10-year strategy Positive Futures
2. Removing or reducing risks to well-being and
- O ptimizing Mental Health for Alberta’s Children mental health; and
and Youth: A F ramework for Action (2 006-2016 )
supports a common and integrated approach
3. Providing support and treatment to children,
to optimizing the mental health of children and
youth and their families.
youth ages zero to 24 and their families, and to
align with the Provincial Mental Health Plan and Activities to support the three strategic
other strategic government initiatives. directions include health promotion, prevention,
early identification, crisis intervention and
Positive Futures has been adapted from the draft
stabilization, treatment interventions including
document. Policy Framework: Mental Health for
both basic and specialized services, community
Alberta’s Children and Youth (2001) that was supports, and collaboration supports.
developed by the cross-ministerial Children’s Expected outcomes indicating the successful
Mental Health Framework Steering Committee
implementation of the framework are as follows:
within the context of the Alberta Children and
Youth Initiative (ACYI) . T he policy framework
Building Capacity
received cross-ministry and cross-regional
support in 2001. Vital to the development of the • Increased responsiveness of the infrastructure
provincial framework was a comprehensive to meet the evolving needs of children, youth
and families.
review of background literature and key
resources (see Appendix) , and a comprehensive • Increased capacity of individuals, families,
provincial consultation with key stakeholders. communities and governments to recognize
and contribute to the mental health of
children and youth.
EXECUTIVE SUMMARY
• Enhanced range and accessibility of
• Increased Albertans’ knowledge about the
determinants of health (see Glossary) and community supports and services for
their role in affecting mental health. children, youth and their caregivers.
• Increased capacity of partners and • Increased early identification of children and
stakeholders to collaborate effectively. youth at risk for mental health problems.
• Increased awareness of the factors that build • Increased connection to appropriate mental
and sustain mental wellness among service health resources for children, youth, families
and communities.
providers.
Positive Futures outlines in broad terms what
Reducing Risks
needs to be done to address and optimize the
• Increased prevention and early intervention mental health of Alberta’s children and youth
strategies for children, youth, families and who will be Alberta’s adults in the future.
communities. With the implementation of the framework,
• Decreased risk factors that contribute to we are one step closer to the Alberta vision
mental health problems in children, youth of a “ vibrant and prosperous province where
and their families. Albertans enjoy a superior quality of life and
are confident about the future for themselves
• Increased knowledge and ability of
individuals associated with children and and their children”. The next step is to develop a
comprehensive implementation plan that includes
youth to identify and connect those at risk
an accountability framework; performance and
for mental health problems to appropriate
outcome measurement and evaluation strategies;
resources.
linkages to strategic initiatives such as the
• Increased awareness of individuals, families ACYI, Student Health Initiative and Healthy Kids
and caregivers about the warning signs of Alberta!; participation from key stakeholders such
crisis, escalation of crisis, and the importance as the Alberta Mental Health Board (AMHB),
of timely intervention for children and youth. Alberta Alcohol and Drug Abuse Commission
(AADAC) , other ministries, and the regional
Providing Support and Treatment health authorities; and priority strategies in areas
• Increased awareness of and access to basic such as provincial standards for treatment and
services in order to enable children, youth support, regional service delivery, and provincial
and their families to obtain services within or and cross-regional mental health initiatives.
close to their own community.
• Availability of specialized services in strategic
locations throughout the province to meet
mental health needs of children, youth and
their families.
r
ACING UP TO THE CHALLENGE
Iberta is taking action on improving Positive Futures - O ptimizing Mental Health for
the mental health and wellness of
Alberta’s Children and Youth: A F ramework for
Albertans and moving forward on mental Action (2 006-2016 ) i s a 1 0-year strategy that
health innovation through the implementation
aligns with the Healthy Kids Alberta! Strategy’s
of Advancing the Mental Health Agenda: A
expected outcome that, “more children, youth
Provincial Mental Health Plan for Alberta and their families have strategies, skills and
(2004) . T he Provincial Mental Health Plan tools to cope successfully with challenges,
adjust positively to change, overcome obstacles,
identified children’s mental health as a p riority
and stressed the need to increase recognition, resolve problems and experience mental well-
awareness and understanding of the needs
being” (p. 3 ). The framework is action-oriented
of children and youth with mental illness, and is a vital step towards addressing the
and the benefits of effective prevention, early priorities set forth by the Provincial Mental
intervention and treatment programs. Health Plan, namely supporting the mental
well-being of children and youth, and providing
The Alberta government has set a course for
effective services for those children and youth
the future with a 2 0-year vision: “A vibrant and who are experiencing mental health problems.
prosperous province where Albertans enjoy a
Cross-sector collaboration will be crucial in
superior quality of life and are confident about
the implementation of the framework because
the future for themselves and their children”.
Implementing strategies that address mental children’s mental health programs across the
province are diverse with a multitude of service
health needs of children, youth and their families
will lead to a h ealthier adult population in providers delivering children’s mental health
services in various locations including schools,
the future. Treating mental illness in children,
community mental health clinics, hospitals, and
reducing risk, and supporting families and
residential treatment programs.
communities will also help to avoid the greater
downstream costs resulting from the prevalence
of mental illness in children.
B
ACKGROUND
n 2 001, a d raft provincial policy Alberta Human Resources and Employment,
framework to optimize the mental
Alberta Health and Wellness, Alberta Children’s
Services, Alberta Community Development,
health of Alberta’s children and youth
Alberta Learning, Alberta Aboriginal and Northern
was prepared by a C hildren’s Mental Health
Framework Steering Committee within the Affairs and Alberta Solicitor General. Vital to the
context of the ACYI to serve as the foundation development of the provincial framework was a
for strategic planning, investment priorities, and comprehensive review of background literature
business and implementation planning. This and key resources (see Appendix) . Some trends
steering committee was chaired by the AMHB,
relating to the mental health of today’s children
and included representatives from AADAC, and youth in Canada are described in Table 1 .
Table 1. Trends and Risks
Trend.. Risk...
These numbers and ages of onset are
In C anada, the face of depression is g etting younger, the average
alarming and action needs to be taken
age of onset being 23. The average age of onset is 1 2 in cases of
to promote and protect the mental
anxiety disorder and 18 for substance abuse (Wilkerson, 2005).
health of children and youth.
►
Suicide is a s erious problem in Alberta. In 2004, 440 people residing
For every death by s uicide in Alberta,
in Alberta died by s uicide, and 73 of t hese people were 24 y ears of
there were nearly six hospitalizations
age or younger (Alberta Vital Statistics - S upplied by t he Public Health and more than 15 emergency room
Surveillance and Environmental Health Branch, AHW). Canada's rate
visits for self-inflicted injuries in one
of s uicide among adolescents aged 1 5 t o 1 9 i s 1 3 p er 1 00,000, the
year alone (AMHB, 2005).
third highest suicide rate in the world (Wilkerson, 2005).
► Family violence and bullying have a
Thousands of Albertans are affected by f amily violence every year
negative impact on the mental wellness
and bullying affects many children and youth across the province
of children and youth, and can lead to
(Government of Alberta, May 2004).
serious mental health problems.
In t he 2003-2004 fiscal year, 7,400 per 100,000 children under the
age of 18 in Alberta received physician services for a m ental health ► These numbers are alarming and action
needs to be taken to ensure that service
problem or concern. In t he 2004-2005 fiscal year, 3,123 per 100,000
children under the age of 1 8 i n A lberta received mental health
delivery models are evidence-based
services in other settings such as regional hospitals and community and leading practice.
mental health clinics (AMHB).
BACKGROUND
In October 2001, the draft provincial policy In January 2002, A F ramework for Reform:
framework was reviewed by selected stakeholders
Report of the Premier’s Advisory Council on
through focused conversations in Edmonton, Health (Mazankowski Report) was released. It
Calgary, Medicine Hat and Peace River.
included a recommendation to “Integrate mental
Participants were selected by the partnering health services with the work of regional health
ministries and included service providers from
authorities” and noted that provincial leadership
various sectors including education, health, is required to anticipate the growing needs
mental health, addictions, and other community for mental health services for specific groups
agencies. including children and adolescents. In April 2003,
responsibility for most mental health services
Following the provincial consultation, an action
transferred from the Alberta Mental Health Board
plan was developed and an implementation
to regional health authorities.
strategy was put forward at the end of 2001 .
The draft policy framework was accepted as a
first step in the development of an integrated
approach to mental health for children, youth
and their families but was not formally approved
as other provincial and national mental health
initiatives were underway. The model on
optimizing mental health, which includes
building capacity, reducing risk, and providing
support and treatment, featured prominently in
the Provincial Mental Health Plan.
FRAMEWORK FOR ACTION
ositive Futures is a 1 0-year strategy The determinants of health (see Glossary)
designed to support a common and influence the optimal development of children,
integrated approach to optimize the youth, families and communities.
mental health of children and youth. For the
Individuals, families, community service
purpose of this framework, “child” is defined as providers and governments share responsibility
children from the ages of zero to 12 and “youth” and accountability for achieving optimal mental
is defined as youth from the ages of 13 to 24, health.
recognizing that young persons from the ages
The severity and duration of mental
of 18 to 24 face a major transition to adulthood
health problems are reduced through early
which can be impacted significantly when they
identification and intervention.
suffer from a major mental disorder.
Some children and youth are seriously impaired
VISION by mental health problems and disorders.
Children, youth and their families who have
The vision of Positive Futures - O ptimizing mental health disorders or mental health
Mental Health for Alberta’s Children and Youth: problems should have access to timely and
A F ramework for Action (2006-2016) is:
appropriate support and treatment.
“Alberta’s children and youth will Principles
have optimal mental health.”
The mental health of children and youth will be
This vision compliments the Alberta
positively impacted in environments where they
Government’s vision of “a vibrant and
are safe, well nourished, stimulated, loved and
prosperous province where Albertans enjoy a
have opportunities to learn and play.
superior quality of life and are confident about
the future for themselves and their children”. Respect for autonomy, dignity, culture,
spirituality and diversity of all children, youth
BELIEFS AND PRINCIPLES and their families shall be demonstrated.
There is a need for programs and services
The framework is based on the following beliefs
specifically designed for children and youth to
and principles:
optimize their mental health.
Beliefs There is a need for services to be available,
Mental health is more than the absence of accessible and reflect community requirements.
mental health disorders or freedom from Optimal mental health for children and youth
psychiatric symptoms. will be achieved through effective collaborative
action based on common goals.
Children, youth and families have strengths and
potential. Children, youth and their families will have
Children and youth have unique mental health opportunities to influence the processes that
needs that are different from those of adults. impact their mental health.
Children and youth benefit when they are
involved with positive role models.
A FRAMEWORK FOR ACTION
:ONCEPTUAL MODE!
Critical components of Positive Futures are the health problems and mental disorders in children
definitions of mental health, mental health and youth are graphically presented, reflecting
problem and mental disorder (see Glossary) . movement back and forth along the continuum:
The relationships between mental health, mental
Figure 1. Mental Health Continuum
Positive health determinants are evident and the child/youth is w ell-adjusted
and is coping and adapting well. The child/youth has:
Basic needs met;
Safety and security;
Opportunities for learning, work and play;
Meaningful attachments and relationships with family or others;
Opportunities to pursue goals and create a p ositive future;
Knowledge and decision-making skills;
Positive self-esteem; and
Controlled mental disorder (if a pplicable).
s o f one or more of the factors above and presence of such factors as:
Harsh social conditions;
Family breakdown;
Discriminatory attitudes;
Bullying and/or relational aggression;
Crisis and/or periodic states of crisis;
VPioovleerntcye;, abuse and neglect, trauma;
Substance abuse; and
Physical or mental illness.
Recognizable medically diagnosable illness that results in a s ignificant
impairment of an individual's cognitive, affective and relational abilities
including but not limited to:
Mood and anxiety disorders;
Schizophrenia and other psychotic disorders;
Personality disorders (in y outh ages 18 to 24);
Eating disorders;
Substance-related disorders;
Pervasive developmental disorders;
Attention-deficit and disruptive behaviour disorders; and
Suicidal behaviour (while not a m ental illness, suicide is h ighly correlated
with mental illness).
