We’ll post information here about promising practices from other jurisdictions, which are worth investigating to see if they could be applied here. If you have any suggestions for other practices worth noting, please let us know.

Triangle of Care (United Kingdom)

The Triangle of Care is a working collaboration, or therapeutic alliance between the service user, professional and carer (caregiver or family member) that promotes safety, supports recovery and sustains well-being. The Triangle of Care was initially developed to improve mental health acute services by adopting six principles:

• Carers and the essential role they play should be identified at first contact with services or as soon as possible thereafter.
• Staff should be aware of carers and trained to engage with carers more effectively.
• Policies and protocols should be in place to ensure confidentiality and improve information sharing with carers.
• Defined roles (Carer link workers), responsible for carers should be in place.
• Carers should be “introduced” to the service and provided with a range of information.
• A range of carer support services should be available to offer or signpost carers to.

Mental Health Ambulance – Stockholm Sweden

Stockholm debuted the world’s first ambulance dedicated solely to mental health services in March 2015.

The Psychiatric Emergency Response Team was introduced as a way to prevent the 1,500 suicides and 15,000 suicide attempts that occur in Sweden annually. Inside the ambulance is a warm, inviting area equipped with comfortable seats instead of medical equipment. It’s staffed by two mental health nurses and one paramedic.

PAM responds to over 130 calls a month in Stockholm, most of them relating to suicide risk.

Read news articles here and here, and download a research study on it here.

Trieste Department of Mental Health

Since 1980 the city of Trieste, Italy has closed psychiatric hospitals and set up a network of 24-hour community mental health centres capable of dealing with the most severe conditions and of supporting clients in their daily life, with a view towards recovery and social inclusion.

As a result of the Italian Mental Health Reform Law (1978), psychiatric total institutions (e.g., asylums, large psychiatric hospitals) were closed and replaced by regional Mental Health Departments over a period of two decades. The Trieste Mental Health Department is the  most successful example of this reform effort. Beneficiaries can now use services without losing any rights, such as community membership, employment, and the full respect of their human rights.

In 1987, the World Health Organization designated Trieste as its pilot collaborating centre for deinstitutionalization and community mental health care. It has continued in this capacity ever since and provides training and advice to centers around the world. The Trieste community-based is acting as an inspiring model for services in more than 30 countries –particularly in Europe, Asia, South America, Australia and New Zealand.

Family Support Services -Fraser Health, BC

This health district has a whole department dedicated to helping families of those with mental health and substance use conditions. Recognizing that “supportive family members are essential to a person’s recovery from mental illness and substance use problems,” Fraser Health offers education, support, respite and navigation assistance programs, as well as offering education programs to clinicians to help them include families when treating their loved ones.

Legislation Supporting Family Caregivers

Ontario’s Change Foundation advocates for legislation, policies and programs to support family caregivers. Through a review of existing legislation, policies, and programs designed to support family caregivers, they developed a paper that compares legislation supporting caregivers and related policies in Canadian provinces and a number of international jurisdictions such as the United States, the United Kingdom, Australia, and New Zealand. The international jurisdictions were chosen based on their notable initiatives to support family caregivers.

Download the paper here.

Improving Access and Coordination of Mental Health and Addiction Services in Manitoba

A May 2018 report on Manitoba’s mental health and addictions services made 130 recommendations, including Recommendation 2.4 (found on page 224), which encourages government to “design and implement a provincial program for facilitating consent to share information with family members and other loved ones, including education and training of… workers to allay fears about PHIA (Manitoba’s Personal Health Information Act).” 

B.C. Psychosocial Rehabilitation Advanced Practice

Psychosocial rehabilitation promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental illness or mental health concern. Psychosocial rehabilitation services and supports focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning and social environments of their choice and include a wide continuum of services and supports. Because of their demonstrated effectiveness and recovery orientation, these approaches should be widely available to people living with long term mental illness and/or substance use problems.

United Kingdom Care Act 2014

The Care Act brings those funding their own care into the care system with obligations on local authorities relating to information and advice, universal services, assessments and market shaping among others all applying to self-funders. It also sets out a new model of paying for care, putting in place a cap on the care costs which an individual is liable for. Importantly, the Act strengthens the rights and recognition of carers in the social care system, including, for the first time giving carers a clear right to receive services. These are by far the strongest rights for carers yet.

Download the Key Provisions for Carers document here.

The Problem with the Solution – Podcast

This episode of the Invisibilia podcast takes a deeper look at the unique approach to mental health care in Geel, Belgium. It raises thought-provoking questions about how we view mental illness as a problem to be solved, how the medical jargon and approach loses sight of individuals as persons, and whether or not families are helpful to someone recovering from mental illness. Listen to the episode here (jump to 6:00 minutes).

Best Advice Guide on Recovery-Oriented Mental Health and Addiction Care in the Patient’s Medical Home

Many family doctors aren’t equipped to deal with mental illness, and may not be aware of local resources or how to communicate appropriately with a patient living with mental illness. Developed in consultation with physicians and people with lived experience, the Best Advice Guide is a compendium of practical and easy-to-implement strategies and tools. It includes simple yet powerful tips on how to open the door to important conversations on mental health – from using non-stigmatizing language, to displaying signage in support of mental wellness, to incorporating at least one question in every patient visit that elicits a response about emotional health.

Home on the Hill Supportive Housing

This group in Richmond Hill Ontario came about when parents of adult children living with a serious mental illness joined to form Family Advocates for Mental Health. Their current focus is on supporting families with a member affected by serious mental illness. They practice a family-centered model of care that involves the individual with the illness and the family caregiver. Appropriate family-inclusive supportive housing based upon the needs of the individual with the illness is a long term goal.

Coast Mental Health

A Vancouver based non-profit that focuses on housing, support services and employment and education opportunities.