The Need for Short, Medium and Long-term Systems of Mental Health Care
Typically, when feeling unwell physically, one can visit their doctor, a walk-in clinic or the hospital and have their issue tended to. Our healthcare system is set up well in this regard – while not perfect (waits, faster services for those who can afford private care) this model of someone being sick or injured and having resources they can readily access, works well: obtain medical treatment as and when needed, follow up as and when needed. If the need is more specialized, the doctor can refer to a specialist. Compared to other systems around the world, it is exemplary.
That same model exists for mental/emotional health and well-being: short-term immediate support and some short-term follow-up.
Examples of publicly funded immediate support include: crisis lines, ER at the hospital and services such as Fraser Health’s Urgent Care and Response Centre, Vancouver Coastal Health’s Access and Assessment Centre and MCFD’s Child and Youth Walk-in Mental Health.
Publicly funded short-term follow-up mental health and wellness services are intended to provide a limited number of sessions, with a limited focus (i.e. addictions, mental health, victims of violence, K-12 students, etc.) based on parameters set out by who funds the program. Examples of publicly funded short-term mental health follow-up services include: Health Authority Addictions and Mental Health services, MCFD Child and Youth Mental Health, School Counsellors and non-profits funded by MCFD, Health Authorities (the two largest funders of publicly funded mental health).
Longer-term supports are typically beyond the scope of publicly funded systems – only available through private therapists, either through a patient-pay or insurer pay system. Private insurers also tend to prefer short-term services as they are cost effective. The above described immediate and short-term publicly funded services model can work well for anyone needing immediate and short-term mental health care but these systems are not set up for medium and longer-term support and healing.
Moving Forward Family Services is able to provide short, medium and long-term therapy. While receiving some public funding, the vast majority of our services operates on philanthropic support, and thus we are able to operate to address not just the short term needs of clients, but also their medium and longer-term needs.
This public/private (philanthropy) model may not address all mental health and other social-emotional health issues, but it can be one way to address gaps (lack of affordable, accessible medium and long-term support) that exist within current models and contributes to our vision towards healthy, healing communities.
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I am reaching out to you regarding our efforts to develop more private and public partnerships and sponsorships.
Moving Forward Family Services (MFFS) is a mentorship agency – providing counselling and social work practice opportunities to interns and new graduates beginning private practice. We see ourselves as filling the gaps between limited public services (wait lists, restrictive eligibility criteria, a cap on sessions that limits long-term healing from trauma) and private services that many people cannot afford.
We receive funding for one clinical supervisor (Community Action Initiative, Ministry for Mental Health and Addictions), and through philanthropic support and nominal fees collected, we are able to subcontract with several more clinical supervisors. These supervisors in turn oversees an agency that has over 125 part-time counsellors, social workers and interns on post-secondary practicums, providing support to some of our most vulnerable communities. Community support also comes by way of donated space.
This unique, made-in-BC model allows the agency to offer timely, affordable (including free) short-term and long-term counselling and support without being bound by restrictions based on gender, age, geography or presenting issues. We are an extension of the student’s classroom, allowing them to practice holistically with these diverse range of clients. Our funding approach also allows MFFS to complement existing services (as opposed to competing with them for the same pools of traditional funding) thus reducing pressures on these services. The size of our team and the number of new and existing clients we see per week makes us one of the busiest agencies in the country – again this is all done with funding for one position, nominal fees collected and philanthropic support.
MFFS is committed to building and contributing to healthy, healing communities. We continue to build partnerships in the public and private sectors to further this mission. If interested in collaborations focused on mental health, substance use, intimate partner violence, child and youth mental health, wellness and healing, please feel free to contact me at 778-321-3054 or firstname.lastname@example.org Please also feel free to share this email with any of our contacts who may be interested in working with us.
Gary Thandi, MSW RSW
Founder and Executive Director
Moving Forward Family Services
Message to MFFS Donors and Supporting Agencies from Anne Harvey, President Board of Directors, Moving Forward Family Services Society
MFFS Continuing Support for Clients and Interns During Covid-19
When face to face counselling was banned in the mid-March provincial emergency announcement, Moving Forward Family Services was faced with the twin challenges of how to provide professional development for interns, and how to provide counselling for clients in the community.
The message on the MFFS access line was changed immediately after the announcement to explain that face to face counselling was no longer available but MFFS would provide telephone and on-line counselling. Almost fortuitously the first two weeks after the announcement the number
of calls to the Moving Forward Family Services access line from people wanting counselling, plummeted from 10-15 per day to one per day.
This gave Executive Director Gary Thandi, and the supervising counsellor team, time to research on-line counselling standards, and client consent forms and set up protocols for telephone and video conferencing options for
the interns to use to connect with clients. At the same time the group supervision sessions for interns were moved to Zoom. This was a great success and increased attendance from 10-12 interns a week to 50-60!
Group supervision sessions give interns the opportunity to discuss practice concerns with more experienced counsellors including, in the current situation, how to counsel clients on-line. These sessions are key to the quality of counselling MFFS provides to clients and during the Covid-19 outbreak, have given the MFFS counselling supervisors close contact with the interns and the challenges they face.
Direct supervision (one-on-one) has also moved on-line with interns sending recorded sessions with clients to their supervisor and then having a telephone or video meeting for comment and advice. For MFFS clients on-line and telephone counselling has been slower to achieve. After the first two weeks of the shut down, interns telephone their existing clients and asked if they would like to continue counselling on the telephone or video conferencing. Initially only about 25 per cent of the clients wanted this with the vast majority choosing telephone counselling. Electronic counselling means clients have to have their own phone (some share with a family member) or computer access, and equally important that there is a safe and private space in their home for the counselling session. With each announcement of the extension of stay at home measures, the number of new and existing clients prepared to accept electronic counselling, has increased. “People are adjusting to the ‘new normal’ and realizing it will be a long wait if they want face to face counselling,” said MFFS Executive Director Gary Thandi. Calls from new clients are back up to 7 or 8 per day.”
MFFS are planning for that number to rise substantially in June or July. “Social work theory tells us that a significant number of people generally ask for counselling about five or six months or longer after the crisis ends,” said Thandi.
When demand does increase, either for electronic counselling or face to face counselling in the Surrey offices, MFFS will be ready. “Moving Forward Family Services was created with the intention of being and remaining a grassroots agency, one that is nimble enough to adjust to whatever the emotional and social-emotional health needs are of the communities we all belong to,” said Thandi.
MFFS will soon be back to being one of the busiest counselling agencies in the province, while still operating on a shoe-string budget. We will gradually open up face to face counselling once we have met the regulations for the
May 19 provincial plan and we will continue with telephone and on-line counselling and definitely with Zoom group supervision sessions which have proved such a hit!