First Steps to Success in Etobicoke

Prevention and Early Intervention
Written By rTraction

ETOBICOKE

This Service Collaborative focuses on infant mental health – the healthy social and emotional development of children from birth to age three.

 

What is the system challenge?

 

Infants and toddlers in Etobicoke, an area just west of Toronto’s downtown core, stand out as a vulnerable population when specific indicators of need are considered. Higher levels of risk are associated with key determinants of health including:

  • low income;

  • single mothers;

  • racialized populations;

  • recent immigrants;

  • young maternal age; and

  • low birth weight.

Families experiencing these vulnerabilities require a system that intentionally invests in care that meets their needs. Science shows that investing in healthy early social-emotional development, which refers to a child’s ability to express their emotions and form positive relationships, can have a significant positive impact in the mental health outcomes of children throughout their lives.

Etobicoke has a strong network of services committed to serving infants from birth to age three and their families. However, they have expressed that they are not using an intentional systematic approach to promoting social-emotional development and that this is a challenge.

 

What are we doing about it?

The goal of First Steps to Success in Etobicoke is to strengthen the capacity of the system to intervene early and prevent the development of mental health challenges in vulnerable infants. Enhancing the skills of service providers in a variety of settings, including child care centres and community-based family services, will help to build a workforce that more effectively provides social and emotional support for infants and reduces their risk of future mental health challenges.

Project partners chose the Pyramid Model for Supporting Social Emotional Competence in Infants and Young Children as the intervention needed to meet these goals. This model is evidence-based and designed to systematically enhance services across levels, including universal supports, prevention approaches for infants and toddlers who are more at risk, and intensive interventions for those who need the most support.

Benefits of implementing the Pyramid Model include:

  • increases in child social skills;

  • reductions in challenging behavior;

  • improved family satisfaction;

  • higher retention of children in programs; and

  • an increase in staff confidence levels.

 

Who is involved?

 

  • Toronto Public Health

  • Toronto Children's Services

  • Albion Early Learning and Child Care Centre

  • Delta Family Resource Centre

  • Ernestine’s Women’s Shelter

  • Humber College Child Development Centre

  • The Jean Tweed Centre

  • Kipling Early Learning and Child Care Centre

  • Rexdale Women’s Centre

  • Rowntree Early Learning and Child Care Centre

Informational Resources:

 
 

  • During the Exploration process, a series of interviews and focus groups were conducted with a wide range of service providers across different sectors who work with young children and their families in Etobicoke and Toronto, as well as with parents and families of young children connected to services. To date we have conducted 13 key informant interviews and four family focus groups. These consultations involved diverse stakeholders, including adult mental health and addictions, children’s mental health, child welfare, Etobicoke Brighter Futures Coalition, family members and primary care providers.

    Through these consultations, infant mental health system challenges and needs have been better identified and the 0-3 Service Collaborative has been able to define an area of focus for their work.

  • The Pyramid Model includes a series of trainings and a thorough coaching component designed to ensure uptake of new learning within the implementing sites. Project partners are currently setting up these training modules and recruiting staff to become coaches. Some settings are in the process of adapting elements of the intervention to best fit with their programs. An oversight committee is being formed to support implementation for the duration of the project.

  • The first weekend in February marked a significant milestone for First Steps to Success in Etobicoke, as more than 50 project members came together to participate in our first training series. A range of staff from each of our eight implementing sites joined their new coaches to learn about the importance of nurturing relationships, targeted social-emotional strategies, and building high-quality supportive environments.

    Thanks to Toronto Public Health and Toronto Children’s Services, public health nurses and Special Needs Resource Consultants will be playing the role of coaches for the duration of this project. These coaches have received two days of practice-based coaching training in order to best support implementing staff to achieve their skill development goals.

    Throughout the trainings, participants enjoyed getting to connect with their colleagues in the field and share their experiences with each other. Coaches and implementing staff formally began the partnership that will carry them through the rest of the project.

  • Individualized relationships between coaches and the eight site leads have continued over the past year. In pursuit of their professional development action goals, frontline staff have started seeing the impacts of the project. They’ve reported that the children in their care are calmer and more confident, and that they’ve built stronger relationships with the families they work with.

 

Next Steps

 

  • Continue ongoing conversations with community partners to ensure the project’s sustainability and transition to a new coordinating body.

  • STAY TUNED! for pilot results and more exciting news about the First Steps to Success Scale Out

 

For more information, please contact:

Nitali Tagger, Implementation Specialist

Swelen Andari, Implementation Specialist

 

References

 

Chung, D.T., Ryan C.J., Hadzi-Pavlovic, D., Singh, S.P., Stanton, C., Large, M.M. (2017). Suicide rates after discharge from psychiatric facilities: A systematic review and meta-analysis. Journal of the American Medical Association Psychiatry, 74(7):694-702

Donisi, V., Tedeschi, F., Wahlbeck, K., Haaramo, P., Amaddeo, F. (2016). Pre-discharge factors predicting readmissions of psychiatric patients: A systematic review of the literature. BMC Psychiatry, 16:449

Kalseth, J., Lassemo, E., Wahlbeck, K., Haaramo, P., Magnussen, J. (2016). Psychiatric readmissions and their association with environmental and health system characteristics: a systematic review of the literature. BMC Psychiatry, 16:376

Rahman, F., Guan, J., Glazier, R.H., Brown, A., Bierman, A.S., Croxford, R., Stukel, T.A. (2018). Association between quality domains and health care spending across physician networks. PLoS ONE, 13(4): e0195222.

Storm, M., Lunde Husebø, A.M., Thomas, E.C., Elwyn, G., Zisman-Ilani, Y. (2019). Coordinating mental health services for people with serious mental illness: A scoping review of transitions from psychiatric hospital to community. Administration and Policy in Mental Health and Mental Health Services Research, 46:352-367

rTraction
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