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Stage 1: Groundwork Stage 2: Workshop
Stage 3: E
valuation
March 24/25 2011
This workshoptook place
June/July 2011
3 month follow upquestionnaire
December2011
9 month follow upquestionnaires
September2011
6 month follow upquestionnaire &
focus groups
Planning, Funding,
EthicsApproval
Monitoring knowledge acquisition and EPIcapacity as compared to baseline (pretraining)
Stage 4: Knowledge Exchange
Feedback to participating agencies; results shared at national and international EPI conferences; results to
the development of training programs; FINAL REPORT RELEASED MARCH 2012
NORTHWESTERN O
NTARIO
SAMPLE SIZE: 19
on-site attendance
remote attendance
Southern Ontario
North
Eastern Ontario
North
Western Ontario
NORTHWESTERN O
NTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
Sioux Lookout First NationsHealth Authority (SLFNHA)
Kenora/Rainy River Child & Family Services (KRRCFS)
North of Superior Programs (NOSP)
Dilico AnishinabekFamily Care
PARTICIPATING COMMUNITY AGENCIES:
on-site attendance
remote attendance
NORTHWESTERN
ONTARIO
NORTH
EAST
SOUTHERN
ONTARIOONTARIOONTARIO }}
evaluation project
PSYCHOSIS 101EVALUATION OF A TRAINING PROGRAM FOR NORTHERN AND REMOTE YOUTH MENTAL HEALTH SERVICE PROVIDERS
setting
experience of training and evaluation
C. CHENG1 - A. HOWLETT2 - W. DERUITER3 - M. HANSON4 - C.S. DEWA3
1. Canadian Mental Health Association Thunder Bay2. University of Toronto, Department of Psychiatry3. Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health4. University of Toronto, Faculty of Medicine
• Mr. Maurice Fortin, Canadian Mental Health Association Thunder Bay• Managers and Participants from participating agencies in NW Ontario: Kenora Rainy River Child and Family Services; Dilico Anishnabek Family Care;
Sioux Lookout First Nations Health Authority; North of Superior Counselling Programs
FUNDERS:Canadian Psychiatric Association Foundation & Ontario Centre of Excellence in Child & Youth Mental Health
acknowledgements
Northwestern Ontario (NWO)• Size of France (525, 193)km2
• 45% of Ontario’s landmass• 2% of Ontario’s population• ~250, 000 people• Population Density of 0.6/km2
• One Early Psychosis Intervention (EPI) program for entire region
Participants spoke about how the training and evaluation process helped to strengthen their professional relationships not only with EPI services, but also with coworkers within their agency (who may not have participated in the workshop) and with other co-participants.
goals of training in epi
context outcomesparticipants
PARTICIPATING COMMUNITIES• Thunder Bay• Nipigon• Geraldton• Schreiber
• Fort Frances• Atikokan• Sioux Lookout• Sandy Lake
Participants’ comfort level with intervening in psychosis did not correlate with the years’ experience in mental health.
} KNOWLEDGE ACQUISITIONPre-intervention, the level of EPI knowledge was high, with average test scores of 84.5%.Changes in test scores were not statistically
significant over time, best described by a quadratic trend.
Participants spoke more about developing knowledge about EPI services than specific
EPI knowledge per sé.
} MODE OF TRAININGThe mode of knowledge acquisition on either onsite or remote via videoconferencing had no
statistically significant effect on test scores.
}REFERRAL TO EPI SERVICES
There was an increase in proportion of enrolled referrals from participating agencies
following the intervention.
• Help youth reclaim lives• Eliminate the need for long-term mental health services/psychiatry through early detection and treatment
• Keep youth in their communities
GOALS:• To evaluate the effectiveness of EPI training using video vs. in-person comparison
• To increase the capacity of mental health workers to identify early psychosis and access care
• To increase awareness of and access to EPI services
INTERVENTION:• Training program specifically for Ontario Ministry of Child & Youth Services (MCYS) funded youth mental health service providers
• In NWO, a shortage of GP’s means we need to rely on more than primary care for early identification
• Large NWO geography necessitates a different model for training other than rounds
NORTHWESTERN ONTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
Sioux Lookout First NationsHealth Authority (SLFNHA)
Kenora/Rainy River Child & Family Services (KRRCFS)
North of Superior Programs (NOSP)
Dilico AnishinabekFamily Care
on-site attendance
PARTICIPATING COMMUNITY AGENCIES:
remote attendance
0 yrs
>0 - <3
3 - <5
5 - <10
>10
Comfort level with psychosisYears’ Experience in Mental Health
1
2
3
4
5 COM
FORT LEVEL W
ITH PSYCH
OSIS
TRENDS IN KNOWLEDGE ACQUISITION
PARTICIPATING AGENCY REFERRAL RATES
EXPERIENCE VS COMFORT LEVELS WITH PSYCHOSIS
MEN
TAL
HEA
LTH
EXP
ERIE
NCE
(YEA
RS)
% S
CORE
% S
CORE
VERY COMFORTABLE
COMFORTABLE
UNCOMFORTABLE
NEUTRAL
VERY UNCOMFORTABLE
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
POST-TRAININ
G:
KASQ
TRAININ
G
50
60
70
80
90
100
REFERRALSACCEPTED
REFERRALSRECEIVED
02010/11 2011/12
22
4
6
88
10
G
K
BAQKASQ
ON & OFF-SITE KNOWLEDGE ACQUISITION
3M POST
6M POST
9M POST
82
84
86
88
90
3M POST:
BAQ 6M POST:
KASQ 9M POST:
BAQ & KASQ
OFF-SITE
ON-SITE
KASQ: ON-SITE VS VIDEOCONFERENCING
PRE-WKSHP
6M POST
9M POST
VIDEOCONFERENCINGON-SITE
Training Workshop
TRENDS IN KNOWLEDGE ACQUISITION: KASQ
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
50
60
70
80
90
100
50
60
70
80
90
100
0 3 6 9TIME (MONTHS)
CONTENT OF TRAINING PROGRAMDay 1 Content & Learning Objectives
INTRODUCTION TO TREATMENT IN EARLY ONSET PSYCHOSIS1. To discuss treatment using case scenarios
PSYCHOLOGICAL INTERVENTIONS IN EARLY ONSET PSYCHOSIS
1. To provide introduction o family intervention2. To provide an introduction to coping strategy
enhancement3. To illustrate motivational interviewing
4. To provide examples of early warning signs and action planning
5. To provide an introduction to cognitive behavioural therapy
MEDICATION IN EARLY ONSET PSYCHOSIS1. To increase the awareness of major issues in the use of
antipsychotic medications2.To understand the processes involved in prescribing of
medication3.To present the advantages and side e�ects of medication and the issues of
compliance4.To provide an understanding of how and why medications work
DEPOT MEDICATIONS1. To provide an overview of depot antipsychotic medications
2. To understand the role of long-acting antipsychotics in early onset psychosis
3. To increase awareness of the population of youth who may consider depot antipsychotics
SUBSTANCE MISUSE AND MENTAL HEALTH1.To introduce di�erent substances and their e�ects2.To discuss how substances interact with psychosis
3.To understand the interaction between substances and young people with a vulnerability to psychosis
CASE DISCUSSIONS1.To provide opportunity to network, ask questions of each other, and discuss
case scenarios
INTRODUCTION TO WORKSHOPOverall workshop objectives:1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place
2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while building local capacity
3. To evaluate the established training content via face to face and videoconferencing opportunities
WHAT IS PSYCHOSIS?1. To provide an introduction to psychosis and associated signs and symptoms
2. To develop an awareness of how the signs of psychosis can be identi�ed
3. For participants to be aware of vulnerable groups4. To provide a baseline of knowledge concerning psychosis from which to develop
STRESS VULNERABILITY AND PSYCHOSIS1. To gain an understanding of the possible causes of schizophrenia2. To have an understanding of the relationship between vulnerability and stress
3. To begin to identify those young people who might be vulnerable to developing psychosis
4. To identify stress factors that might contribute to the onset of a mental health problem
AN INTRODUCTION TO EARLY PSYCHOSIS INTERVENTION1. To provide an overview of early intervention for psychosis2. To provide a background to concepts of early intervention and the phases of a severe mental illness
3. To enable recognition of the signs and symptoms that might develop in a young person
ASSESSMENT IN FIRST EPISODE PSYCHOSIS1. To gain an understanding of the process and content of initial assessments2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment
3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives
Figure1: Content of training program Day 1 Content & Learning Objectives • Introduction to workshop
Overall workshop objectives: 1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place 2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while
building local capacity 3. To evaluate the established training content via face to face and videoconferencing opportunities
• What is psychosis? 1. To provide an introduction to psychosis and associated signs and symptoms 2. To develop an awareness of how the signs of psychosis can be identified3. For participants to be aware of vulnerable gropus 4. To provide a baseline of knowledge concerning psychosis from which to develop
• Stress vulnerability and psychosis 1. To gain an understanding of the possible causes of schizophrenia 2. To have an understanding of the relationship between vulnerability and stress3. To begin to identify those young people who might be vulnerable to developing psychosis 4. To identify stress factors that might contribute to the onset of a mental health problem
• An introduction to early psychosis intervention 1. To provide an overview of early intervention for psychosis 2. To provide a background to concepts of early intervention and the phases of a severe mental illness 3. To enable recognition of the signs and symptoms that might develop in a young person
• Assessment in first episode psychosis 1. To gain an understanding of the process and content of initial assessments 2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment 3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives • Introduction to treatment in early onset psychosis
1. To discuss treatment using case scenarios • Psychological interventions in early onset psychosis
1. To provide introduction o family intervention 2. To provide an introduction to coping strategy enhancement 3. To illustrate motivational interviewing 4. To provide examples of early warning signs and action planning 5. To provide an introduction to cognitive behavioural therapy
• Medication in early onset psychosis 1. To increase the awareness of major issues in the use of antipsychotic medications 2. To understand the processes involved in prescribing of medication 3. To present the advantages and side effects of medication and the issues of compliance 4. To provide an understanding of how and why medications work
• Depot medications 1. To provide an overview of depot antipsychotic medications 2. To understand the role of long-acting antipsychotics in early onset psychosis 3. To increase awareness of the population of youth who may consider depot antipsychotics
• Substance misuse and mental health 1. To introduce different substances and their effects 2. To discuss how substances interact with psychosis 3. To understand the interaction between substances and young people with a vulnerability to psychosis
• Case discussions 1. To provide opportunity to network, ask questions of each other, and discuss case scenarios
Stage 1: Groundwork Stage 2: Workshop
Stage 3: E
valuation
March 24/25 2011
This workshoptook place
June/July 2011
3 month follow upquestionnaire
December2011
9 month follow upquestionnaires
September2011
6 month follow upquestionnaire &
focus groups
Planning, Funding,
EthicsApproval
Monitoring knowledge acquisition and EPIcapacity as compared to baseline (pretraining)
Stage 4: Knowledge Exchange
Feedback to participating agencies; results shared at national and international EPI conferences; results to
the development of training programs; FINAL REPORT RELEASED MARCH 2012
NORTHWESTERN O
NTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
on-site attendance
remote attendance
NORTHWESTERN ONTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
Sioux Lookout First NationsHealth Authority (SLFNHA)
Kenora/Rainy River Child & Family Services (KRRCFS)
North of Superior Programs (NOSP)
Dilico AnishinabekFamily Care
on-site attendance
PARTICIPATING COMMUNITY AGENCIES:
remote attendance
0 yrs
>0 - <3
3 - <5
5 - <10
>10
Comfort level with psychosisYears’ Experience in Mental Health
1
2
3
4
5 COM
FORT LEVEL W
ITH PSYCH
OSIS
TRENDS IN KNOWLEDGE ACQUISITION
PARTICIPATING AGENCY REFERRAL RATES
EXPERIENCE VS COMFORT LEVELS WITH PSYCHOSIS
MEN
TAL
HEA
LTH
EXP
ERIE
NCE
(YEA
RS)
% S
CORE
% S
CORE
VERY COMFORTABLE
COMFORTABLE
UNCOMFORTABLE
NEUTRAL
VERY UNCOMFORTABLE
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
POST-TRAININ
G:
KASQ
TRAININ
G
50
60
70
80
90
100
REFERRALSACCEPTED
REFERRALSRECEIVED
02010/11 2011/12
22
4
6
88
10
G
K
BAQKASQ
ON & OFF-SITE KNOWLEDGE ACQUISITION
3M POST
6M POST
9M POST
82
84
86
88
90
3M POST:
BAQ 6M POST:
KASQ 9M POST:
BAQ & KASQ
OFF-SITE
ON-SITE
KASQ: ON-SITE VS VIDEOCONFERENCING
PRE-WKSHP
6M POST
9M POST
VIDEOCONFERENCINGON-SITE
Training Workshop
TRENDS IN KNOWLEDGE ACQUISITION: KASQ
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
50
60
70
80
90
100
50
60
70
80
90
100
0 3 6 9TIME (MONTHS)
CONTENT OF TRAINING PROGRAMDay 1 Content & Learning Objectives
INTRODUCTION TO TREATMENT IN EARLY ONSET PSYCHOSIS1. To discuss treatment using case scenarios
PSYCHOLOGICAL INTERVENTIONS IN EARLY ONSET PSYCHOSIS
1. To provide introduction o family intervention2. To provide an introduction to coping strategy
enhancement3. To illustrate motivational interviewing
4. To provide examples of early warning signs and action planning
5. To provide an introduction to cognitive behavioural therapy
MEDICATION IN EARLY ONSET PSYCHOSIS1. To increase the awareness of major issues in the use of
antipsychotic medications2.To understand the processes involved in prescribing of
medication3.To present the advantages and side e�ects of medication and the issues of
compliance4.To provide an understanding of how and why medications work
DEPOT MEDICATIONS1. To provide an overview of depot antipsychotic medications
2. To understand the role of long-acting antipsychotics in early onset psychosis
3. To increase awareness of the population of youth who may consider depot antipsychotics
SUBSTANCE MISUSE AND MENTAL HEALTH1.To introduce di�erent substances and their e�ects2.To discuss how substances interact with psychosis
3.To understand the interaction between substances and young people with a vulnerability to psychosis
CASE DISCUSSIONS1.To provide opportunity to network, ask questions of each other, and discuss
case scenarios
INTRODUCTION TO WORKSHOPOverall workshop objectives:1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place
2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while building local capacity
3. To evaluate the established training content via face to face and videoconferencing opportunities
WHAT IS PSYCHOSIS?1. To provide an introduction to psychosis and associated signs and symptoms
2. To develop an awareness of how the signs of psychosis can be identi�ed
3. For participants to be aware of vulnerable groups4. To provide a baseline of knowledge concerning psychosis from which to develop
STRESS VULNERABILITY AND PSYCHOSIS1. To gain an understanding of the possible causes of schizophrenia2. To have an understanding of the relationship between vulnerability and stress
3. To begin to identify those young people who might be vulnerable to developing psychosis
4. To identify stress factors that might contribute to the onset of a mental health problem
AN INTRODUCTION TO EARLY PSYCHOSIS INTERVENTION1. To provide an overview of early intervention for psychosis2. To provide a background to concepts of early intervention and the phases of a severe mental illness
3. To enable recognition of the signs and symptoms that might develop in a young person
ASSESSMENT IN FIRST EPISODE PSYCHOSIS1. To gain an understanding of the process and content of initial assessments2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment
3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives
Figure1: Content of training program Day 1 Content & Learning Objectives • Introduction to workshop
Overall workshop objectives: 1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place 2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while
building local capacity 3. To evaluate the established training content via face to face and videoconferencing opportunities
• What is psychosis? 1. To provide an introduction to psychosis and associated signs and symptoms 2. To develop an awareness of how the signs of psychosis can be identified3. For participants to be aware of vulnerable gropus 4. To provide a baseline of knowledge concerning psychosis from which to develop
• Stress vulnerability and psychosis 1. To gain an understanding of the possible causes of schizophrenia 2. To have an understanding of the relationship between vulnerability and stress3. To begin to identify those young people who might be vulnerable to developing psychosis 4. To identify stress factors that might contribute to the onset of a mental health problem
• An introduction to early psychosis intervention 1. To provide an overview of early intervention for psychosis 2. To provide a background to concepts of early intervention and the phases of a severe mental illness 3. To enable recognition of the signs and symptoms that might develop in a young person
• Assessment in first episode psychosis 1. To gain an understanding of the process and content of initial assessments 2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment 3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives • Introduction to treatment in early onset psychosis
1. To discuss treatment using case scenarios • Psychological interventions in early onset psychosis
1. To provide introduction o family intervention 2. To provide an introduction to coping strategy enhancement 3. To illustrate motivational interviewing 4. To provide examples of early warning signs and action planning 5. To provide an introduction to cognitive behavioural therapy
• Medication in early onset psychosis 1. To increase the awareness of major issues in the use of antipsychotic medications 2. To understand the processes involved in prescribing of medication 3. To present the advantages and side effects of medication and the issues of compliance 4. To provide an understanding of how and why medications work
• Depot medications 1. To provide an overview of depot antipsychotic medications 2. To understand the role of long-acting antipsychotics in early onset psychosis 3. To increase awareness of the population of youth who may consider depot antipsychotics
• Substance misuse and mental health 1. To introduce different substances and their effects 2. To discuss how substances interact with psychosis 3. To understand the interaction between substances and young people with a vulnerability to psychosis
• Case discussions 1. To provide opportunity to network, ask questions of each other, and discuss case scenarios
Stage 1: Groundwork Stage 2: Workshop
Stage 3: E
valuation
March 24/25 2011
This workshoptook place
June/July 2011
3 month follow upquestionnaire
December2011
9 month follow upquestionnaires
September2011
6 month follow upquestionnaire &
focus groups
Planning, Funding,
EthicsApproval
Monitoring knowledge acquisition and EPIcapacity as compared to baseline (pretraining)
Stage 4: Knowledge Exchange
Feedback to participating agencies; results shared at national and international EPI conferences; results to
the development of training programs; FINAL REPORT RELEASED MARCH 2012
NORTHWESTERN O
NTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
on-site attendance
remote attendance
NORTHWESTERN ONTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
Sioux Lookout First NationsHealth Authority (SLFNHA)
Kenora/Rainy River Child & Family Services (KRRCFS)
North of Superior Programs (NOSP)
Dilico AnishinabekFamily Care
on-site attendance
PARTICIPATING COMMUNITY AGENCIES:
remote attendance
0 yrs
>0 - <3
3 - <5
5 - <10
>10
Comfort level with psychosisYears’ Experience in Mental Health
1
2
3
4
5 COM
FORT LEVEL W
ITH PSYCH
OSIS
TRENDS IN KNOWLEDGE ACQUISITION
PARTICIPATING AGENCY REFERRAL RATES
EXPERIENCE VS COMFORT LEVELS WITH PSYCHOSIS
MEN
TAL
HEA
LTH
EXP
ERIE
NCE
(YEA
RS)
% S
CORE
% S
CORE
VERY COMFORTABLE
COMFORTABLE
UNCOMFORTABLE
NEUTRAL
VERY UNCOMFORTABLE
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
POST-TRAININ
G:
KASQ
TRAININ
G
50
60
70
80
90
100
REFERRALSACCEPTED
REFERRALSRECEIVED
02010/11 2011/12
22
4
6
88
10
G
K
BAQKASQ
ON & OFF-SITE KNOWLEDGE ACQUISITION
3M POST
6M POST
9M POST
82
84
86
88
90
3M POST:
BAQ 6M POST:
KASQ 9M POST:
BAQ & KASQ
OFF-SITE
ON-SITE
KASQ: ON-SITE VS VIDEOCONFERENCING
PRE-WKSHP
6M POST
9M POST
VIDEOCONFERENCINGON-SITE
Training Workshop
TRENDS IN KNOWLEDGE ACQUISITION: KASQ
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
50
60
70
80
90
100
50
60
70
80
90
100
0 3 6 9TIME (MONTHS)
CONTENT OF TRAINING PROGRAMDay 1 Content & Learning Objectives
INTRODUCTION TO TREATMENT IN EARLY ONSET PSYCHOSIS1. To discuss treatment using case scenarios
PSYCHOLOGICAL INTERVENTIONS IN EARLY ONSET PSYCHOSIS
1. To provide introduction o family intervention2. To provide an introduction to coping strategy
enhancement3. To illustrate motivational interviewing
4. To provide examples of early warning signs and action planning
5. To provide an introduction to cognitive behavioural therapy
MEDICATION IN EARLY ONSET PSYCHOSIS1. To increase the awareness of major issues in the use of
antipsychotic medications2.To understand the processes involved in prescribing of
medication3.To present the advantages and side e�ects of medication and the issues of
compliance4.To provide an understanding of how and why medications work
DEPOT MEDICATIONS1. To provide an overview of depot antipsychotic medications
2. To understand the role of long-acting antipsychotics in early onset psychosis
3. To increase awareness of the population of youth who may consider depot antipsychotics
SUBSTANCE MISUSE AND MENTAL HEALTH1.To introduce di�erent substances and their e�ects2.To discuss how substances interact with psychosis
3.To understand the interaction between substances and young people with a vulnerability to psychosis
CASE DISCUSSIONS1.To provide opportunity to network, ask questions of each other, and discuss
case scenarios
INTRODUCTION TO WORKSHOPOverall workshop objectives:1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place
2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while building local capacity
3. To evaluate the established training content via face to face and videoconferencing opportunities
WHAT IS PSYCHOSIS?1. To provide an introduction to psychosis and associated signs and symptoms
2. To develop an awareness of how the signs of psychosis can be identi�ed
3. For participants to be aware of vulnerable groups4. To provide a baseline of knowledge concerning psychosis from which to develop
STRESS VULNERABILITY AND PSYCHOSIS1. To gain an understanding of the possible causes of schizophrenia2. To have an understanding of the relationship between vulnerability and stress
3. To begin to identify those young people who might be vulnerable to developing psychosis
4. To identify stress factors that might contribute to the onset of a mental health problem
AN INTRODUCTION TO EARLY PSYCHOSIS INTERVENTION1. To provide an overview of early intervention for psychosis2. To provide a background to concepts of early intervention and the phases of a severe mental illness
3. To enable recognition of the signs and symptoms that might develop in a young person
ASSESSMENT IN FIRST EPISODE PSYCHOSIS1. To gain an understanding of the process and content of initial assessments2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment
3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives
Figure1: Content of training program Day 1 Content & Learning Objectives • Introduction to workshop
Overall workshop objectives: 1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place 2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while
building local capacity 3. To evaluate the established training content via face to face and videoconferencing opportunities
• What is psychosis? 1. To provide an introduction to psychosis and associated signs and symptoms 2. To develop an awareness of how the signs of psychosis can be identified3. For participants to be aware of vulnerable gropus 4. To provide a baseline of knowledge concerning psychosis from which to develop
• Stress vulnerability and psychosis 1. To gain an understanding of the possible causes of schizophrenia 2. To have an understanding of the relationship between vulnerability and stress3. To begin to identify those young people who might be vulnerable to developing psychosis 4. To identify stress factors that might contribute to the onset of a mental health problem
• An introduction to early psychosis intervention 1. To provide an overview of early intervention for psychosis 2. To provide a background to concepts of early intervention and the phases of a severe mental illness 3. To enable recognition of the signs and symptoms that might develop in a young person
• Assessment in first episode psychosis 1. To gain an understanding of the process and content of initial assessments 2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment 3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives • Introduction to treatment in early onset psychosis
1. To discuss treatment using case scenarios • Psychological interventions in early onset psychosis
1. To provide introduction o family intervention 2. To provide an introduction to coping strategy enhancement 3. To illustrate motivational interviewing 4. To provide examples of early warning signs and action planning 5. To provide an introduction to cognitive behavioural therapy
• Medication in early onset psychosis 1. To increase the awareness of major issues in the use of antipsychotic medications 2. To understand the processes involved in prescribing of medication 3. To present the advantages and side effects of medication and the issues of compliance 4. To provide an understanding of how and why medications work
• Depot medications 1. To provide an overview of depot antipsychotic medications 2. To understand the role of long-acting antipsychotics in early onset psychosis 3. To increase awareness of the population of youth who may consider depot antipsychotics
• Substance misuse and mental health 1. To introduce different substances and their effects 2. To discuss how substances interact with psychosis 3. To understand the interaction between substances and young people with a vulnerability to psychosis
• Case discussions 1. To provide opportunity to network, ask questions of each other, and discuss case scenarios
Stage 1: Groundwork Stage 2: Workshop
Stage 3: E
valuation
March 24/25 2011
This workshoptook place
June/July 2011
3 month follow upquestionnaire
December2011
9 month follow upquestionnaires
September2011
6 month follow upquestionnaire &
focus groups
Planning, Funding,
EthicsApproval
Monitoring knowledge acquisition and EPIcapacity as compared to baseline (pretraining)
Stage 4: Knowledge Exchange
Feedback to participating agencies; results shared at national and international EPI conferences; results to
the development of training programs; FINAL REPORT RELEASED MARCH 2012
NORTHWESTERN O
NTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
on-site attendance
remote attendance
NORTHWESTERN ONTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
Sioux Lookout First NationsHealth Authority (SLFNHA)
Kenora/Rainy River Child & Family Services (KRRCFS)
North of Superior Programs (NOSP)
Dilico AnishinabekFamily Care
on-site attendance
PARTICIPATING COMMUNITY AGENCIES:
remote attendance
0 yrs
>0 - <3
3 - <5
5 - <10
>10
Comfort level with psychosisYears’ Experience in Mental Health
1
2
3
4
5 COM
FORT LEVEL W
ITH PSYCH
OSIS
TRENDS IN KNOWLEDGE ACQUISITION
PARTICIPATING AGENCY REFERRAL RATES
EXPERIENCE VS COMFORT LEVELS WITH PSYCHOSIS
MEN
TAL
HEA
LTH
EXP
ERIE
NCE
(YEA
RS)
% S
CORE
% S
CORE
VERY COMFORTABLE
COMFORTABLE
UNCOMFORTABLE
NEUTRAL
VERY UNCOMFORTABLE
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
POST-TRAININ
G:
KASQ
TRAININ
G
50
60
70
80
90
100
REFERRALSACCEPTED
REFERRALSRECEIVED
02010/11 2011/12
22
4
6
88
10
G
K
BAQKASQ
ON & OFF-SITE KNOWLEDGE ACQUISITION
3M POST
6M POST
9M POST
82
84
86
88
90
3M POST:
BAQ 6M POST:
KASQ 9M POST:
BAQ & KASQ
OFF-SITE
ON-SITE
KASQ: ON-SITE VS VIDEOCONFERENCING
PRE-WKSHP
6M POST
9M POST
VIDEOCONFERENCINGON-SITE
Training Workshop
TRENDS IN KNOWLEDGE ACQUISITION: KASQ
POST-WKSHP
3M POST
6M POST
9M POST
PRE-WKSHP
50
60
70
80
90
100
50
60
70
80
90
100
0 3 6 9TIME (MONTHS)
CONTENT OF TRAINING PROGRAMDay 1 Content & Learning Objectives
INTRODUCTION TO TREATMENT IN EARLY ONSET PSYCHOSIS1. To discuss treatment using case scenarios
PSYCHOLOGICAL INTERVENTIONS IN EARLY ONSET PSYCHOSIS
1. To provide introduction o family intervention2. To provide an introduction to coping strategy
enhancement3. To illustrate motivational interviewing
4. To provide examples of early warning signs and action planning
5. To provide an introduction to cognitive behavioural therapy
MEDICATION IN EARLY ONSET PSYCHOSIS1. To increase the awareness of major issues in the use of
antipsychotic medications2.To understand the processes involved in prescribing of
medication3.To present the advantages and side e�ects of medication and the issues of
compliance4.To provide an understanding of how and why medications work
DEPOT MEDICATIONS1. To provide an overview of depot antipsychotic medications
2. To understand the role of long-acting antipsychotics in early onset psychosis
3. To increase awareness of the population of youth who may consider depot antipsychotics
SUBSTANCE MISUSE AND MENTAL HEALTH1.To introduce di�erent substances and their e�ects2.To discuss how substances interact with psychosis
3.To understand the interaction between substances and young people with a vulnerability to psychosis
CASE DISCUSSIONS1.To provide opportunity to network, ask questions of each other, and discuss
case scenarios
INTRODUCTION TO WORKSHOPOverall workshop objectives:1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place
2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while building local capacity
3. To evaluate the established training content via face to face and videoconferencing opportunities
WHAT IS PSYCHOSIS?1. To provide an introduction to psychosis and associated signs and symptoms
2. To develop an awareness of how the signs of psychosis can be identi�ed
3. For participants to be aware of vulnerable groups4. To provide a baseline of knowledge concerning psychosis from which to develop
STRESS VULNERABILITY AND PSYCHOSIS1. To gain an understanding of the possible causes of schizophrenia2. To have an understanding of the relationship between vulnerability and stress
3. To begin to identify those young people who might be vulnerable to developing psychosis
4. To identify stress factors that might contribute to the onset of a mental health problem
AN INTRODUCTION TO EARLY PSYCHOSIS INTERVENTION1. To provide an overview of early intervention for psychosis2. To provide a background to concepts of early intervention and the phases of a severe mental illness
3. To enable recognition of the signs and symptoms that might develop in a young person
ASSESSMENT IN FIRST EPISODE PSYCHOSIS1. To gain an understanding of the process and content of initial assessments2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment
3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives
Figure1: Content of training program Day 1 Content & Learning Objectives • Introduction to workshop
Overall workshop objectives: 1. To increase detection of early psychosis symptoms in youth so that earlier intervention can take place 2. To increase the reach of limited early psychosis (EPI) specialist services in northwestern Ontario while
building local capacity 3. To evaluate the established training content via face to face and videoconferencing opportunities
• What is psychosis? 1. To provide an introduction to psychosis and associated signs and symptoms 2. To develop an awareness of how the signs of psychosis can be identified3. For participants to be aware of vulnerable gropus 4. To provide a baseline of knowledge concerning psychosis from which to develop
• Stress vulnerability and psychosis 1. To gain an understanding of the possible causes of schizophrenia 2. To have an understanding of the relationship between vulnerability and stress3. To begin to identify those young people who might be vulnerable to developing psychosis 4. To identify stress factors that might contribute to the onset of a mental health problem
• An introduction to early psychosis intervention 1. To provide an overview of early intervention for psychosis 2. To provide a background to concepts of early intervention and the phases of a severe mental illness 3. To enable recognition of the signs and symptoms that might develop in a young person
• Assessment in first episode psychosis 1. To gain an understanding of the process and content of initial assessments 2. To develop an awareness of the components of a comprehensive multi-disciplinary assessment 3. To provide an overview of additional assessments which might be conducted during the assessment process
Day 2 Content & Learning Objectives • Introduction to treatment in early onset psychosis
1. To discuss treatment using case scenarios • Psychological interventions in early onset psychosis
1. To provide introduction o family intervention 2. To provide an introduction to coping strategy enhancement 3. To illustrate motivational interviewing 4. To provide examples of early warning signs and action planning 5. To provide an introduction to cognitive behavioural therapy
• Medication in early onset psychosis 1. To increase the awareness of major issues in the use of antipsychotic medications 2. To understand the processes involved in prescribing of medication 3. To present the advantages and side effects of medication and the issues of compliance 4. To provide an understanding of how and why medications work
• Depot medications 1. To provide an overview of depot antipsychotic medications 2. To understand the role of long-acting antipsychotics in early onset psychosis 3. To increase awareness of the population of youth who may consider depot antipsychotics
• Substance misuse and mental health 1. To introduce different substances and their effects 2. To discuss how substances interact with psychosis 3. To understand the interaction between substances and young people with a vulnerability to psychosis
• Case discussions 1. To provide opportunity to network, ask questions of each other, and discuss case scenarios
Stage 1: Groundwork Stage 2: Workshop
Stage 3: E
valuation
March 24/25 2011
This workshoptook place
June/July 2011
3 month follow upquestionnaire
December2011
9 month follow upquestionnaires
September2011
6 month follow upquestionnaire &
focus groups
Planning, Funding,
EthicsApproval
Monitoring knowledge acquisition and EPIcapacity as compared to baseline (pretraining)
Stage 4: Knowledge Exchange
Feedback to participating agencies; results shared at national and international EPI conferences; results to
the development of training programs; FINAL REPORT RELEASED MARCH 2012
NORTHWESTERN O
NTARIO
Atikokan: 3Fort Frances: 4
Sandy Lake: 1Sioux Lookout: 2
Geraldton: 1Nipigon: 1
Thunder Bay: 7
SAMPLE SIZE: 19
on-site attendance
remote attendance
“Videoconference allowed me to attend the
workshop, whereas i likely would not have been
able to attend... i guess technology is technology
and i guess [glitches] just come with it.”
“it was important to hear [about the epi
program] and get a clear understanding
of how to access the services... after this
training i feel a lot more comfortable to call
[child & adolescent psychiatrist/facilitator]”
“as a worker, it gives you more
confidence in being able to assist
somebody and knowing that you’re not
alone in this... now you debrief with
other people if you’ve got challenges.”
“what i found was nice was that
we were invested in our learning. but
with the evaluations and the follow
up... lets us know that you guys
were invested in our learning, too.”
}Sample Size: 19
On-Site (n=7)Remote (n=12)
