How we can work together to help mothers with mental health problems in the SIPPE program?

Over the past year, the FEJ[1] and mental health teams of the CSSS Dorval-Lachine-Lasalle wrote a document entitled, “Arrimage entre les services FEJ-DI-TED-DP3[2], accueil psychosocial et santé mentale” (Connecting the FEJ-DI-TED-DP3, Psycho-social and Mental Health Services). This document was a response to concerns the SIPPE[3] program felt regarding its collaboration with the mental health team. It presents a framework for practice aiming to increase teamwork and collaboration between various services. Since implementing this framework last fall, we have noticed improvements in communication between health care providers on the FEJ and mental health teams. Because we are dealing with two programs with two distinct mandates, collaboration remains complex and great challenges lie ahead.

One of the main difficulties exists in the fact that mental health care providers remain largely uninformed on the reality faced by the SIPPE. Often mothers followed by the SIPPE are unreliable and do not collaborate with service providers. SIPPE care providers must invest time and energy in order to create and maintain trusting relationships. When a mother shows symptoms of mental health problems, they must put forth extra effort to encourage and persuade them to consult specialized services. Despite this, it is common for mental health care providers to end follow-up care requested by the SIPPE program because the client fails to come to her appointment. This is a frequent problem observed in SIPPE cases. Mental health care providers manage long waiting lists that don’t allow them to wait for a client who doesn’t maintain her commitments, an attitude that opposes the SIPPE’s approach.

Another difference lies in the fact that the SIPPE program recommends home visits. In contrast, one of the objectives of mental health is to encourage the client to leave her house to improve her state of mind and escape isolation. If mental health care providers wish to adapt to the SIPPE program, making home visits would mean a change in their approach. For this and other changes to occur, both sides need to get to know one another and understand where everyone is coming from. The presence and support of leaders alongside care providers will prove to be essential to the success of this collaboration.

Health care providers are also asking questions about their roles and responsibilities within this continuum of services. These are relevant questions, stimulating the discussions that need to be had in order to better clarify and define these roles and responsibilities.

We have envisioned some solutions, including the possibility that health care providers switch to common evaluation and follow-up procedures. This would bring them to a shared understanding of facts and consistent approach to intervention. The Individualized Service Plan (ISP) would be one of many key tools to help facilitate dialogue and cohesion within interventions.

This collaboration is an opportunity to improve client services. We need to take the time to invest in this process which must become a departmental priority and acquire senior levels of government support.

[1] FEJ: Services Famille enfance jeunesse (Family, Child and Youth Services)

[2] FEJ-DI-TED-DP: Famille enfance jeunes-déficience intellectuelle-troubles d’envahissement de développement-déficience physique (Family, youth, child-intellectual disability-autism spectrum disorders-physical disability)

[3] SIPPE: Service intégré en périnatalité et pour la petite enfance (Integrated Services for Prenatal and Early Childhood). To learn more about this program, see Quintessence “For the optimal development of children living in vulnerable conditions: early intervention and parental support