In response to the changing profile of youth admitted to Kinark’s Forensic Mental Health and Youth Justice Program, the Syl Apps Youth Centre (SAYC) team focused on consolidating its inter-professional approach to treatment last year. Investments were also made in staff training to share best practices and actively engage staff in fostering a more diverse and inclusive culture, one that is both welcoming and respectful.
As a provincial resource for youth, SAYC is a secure forensic mental health facility located in Oakville, Ontario that serves a diverse population with highly complex mental health and other needs. Youth from across the province are referred here by the courts, hospitals, and other community service providers. Some are at risk youth who, due to mental health and other life issues, need a safe and secure place where they can get the treatment they require. Others have had multiple encounters with the law. They, too, often have mental health conditions that require intensive inter-professional intervention.
Gerry Watson, Administrative Director and Dr. Janelle Hawes, Clinical Director,
Forensic Mental Health and Youth Justice
According to psychologist and Clinical Director Dr. Janelle Hawes, “we complete a comprehensive inter-professional assessment, one that includes both psychiatric and psychological assessments, of all youth upon admission. The results provide the team with the clinical information and diagnostic clarification it needs to generate clinical formulations and inform individual treatment plans, which include the youth’s goals and are developed in collaboration with the youth, their family members and community stakeholders who may be involved in their care.”
Members of the inter-professional team which, in addition to outside case workers and family members, may include a psychiatrist, psychologist, social worker, nurse practitioner, registered nurse, child and youth workers, art and recreational therapists, a clinical case coordinator and transitional worker, all contribute to the treatment plan, using their own specialized skills, in a manner that is consistent with the youth’s treatment needs and goals.
“When the entire team knows that a youth is prone to anger and aggression, for example, they can be on the lookout for what triggers this behaviour and intervene when necessary to help the youth identify situations or scenarios that elicit these reactions, understand the reasons for them and the function this type of behaviour serves for the youth,” explains Dr. Hawes. “Then we focus on teaching them more adaptive coping strategies to shape appropriate and positive behaviour.”
According to Syl Apps’ Administrative Director Gerry Watson, child and youth workers, who are with the youth 24/7, play a pivotal role in coaching them in-the-moment to reinforce the new skills and strategies they learn during individual and group therapy, which is evidence-based and often trauma-informed.
“Over the past year,” Watson says, “we have engaged our frontline staff more in operationalizing treatment plans. Because they’re with the kids around the clock, what they see happening at school, in the gym, and on the units where youth reside and interact with one another, and the way in which they engage with the youth is important. Their interactions and observations are logged and fed back to the clinical team at monthly case conferences. The clinicians can then advise staff how to address new symptoms or developments.”
What sets Kinark’s secure mental health programs apart, say Dr. Hawes and Watson, is the depth and breadth of clinical expertise at SAYC, engagement with child and youth workers, and the unique environment in which youth are treated for periods ranging from 3 to 12 months.
“The youth have increased access to treatment and therapeutic programming options here,” says Dr. Hawes. Although it’s a secure facility, youth at Syl Apps can move around more freely and engage in different activities. They go to school on site, participate in structured recreational activities and, when not in school or therapy, can explore special interests like art, music, yoga, woodworking, poetry or gardening. Many of these extracurricular programs are offered by volunteers from the community so the youth have an opportunity to engage with people outside of the treatment team.
If youth need to work off steam, they can head to the gym, join a pet therapy session or go for a walk outside in a secure enclosure. They can also take part in other programs designed for youth of diverse gender, spiritual and cultural orientations.
“We try to normalize the experiences adolescents have here as much as possible,” says Dr. Hawes. “Recreating the life of a typical teenager within a therapeutic environment is critical to their treatment,” and to their successful reintegration into the community, adds Watson.
Preparing to return to life in the community is something that starts soon after youth arrive at SAYC although where they go upon discharge varies depending on their individual circumstances and goals. Regardless, reintegrating youth into the community is often a primary goal of treatment and developing a plan to help them make the transition successfully is also a team effort, involving all members of the Syl Apps treatment team, and in many cases, family members as well as other community service providers.
“In preparation for discharge, all members of our inter-professional team explain to those who will be working with the youth in the community, the treatment plan, goals, strategies and progress to date as well as recommendations for what needs to happen next,” Dr. Hawes says. “We do our best to set up each youth for success when they leave, and to connect them with the community resources and supports they will need to maintain the gains they’ve made here and to help them achieve their long-term goals.