Is it possible to ensure immediate access and timely intervention in mental health?
With this week’s article we will see how this is already possible in some parts of the world, particularly in Canada where immediate access to mental health services represents an ongoing challenge. Recall that Walk-In Therapy combined with Single Session Therapy (SSWI) is a service delivery model that improves access to care and ensures that people can get service when they need it most .
But how can such an efficient and innovative service be implemented in practice?
Sandy Harper-Jaques , Psychotherapist at Northwest Community Mental Health Center and Jacqueline Simms , Clinical Operations Manager at South Calgary Health Center , sharing a clinical case they supervised when they worked as Registered Nurses at South Calgary Walk-In Clinics Calgary Healt Center, will allow us to find out how we can provide these services.
What type of service does the South Calgary Healt Center Walk-In/SST offer?
The South Calgary Healt Center Walk-In/SST is a community-based service and is one of the few offered by Alberta Healt Services in the entire province. The intervention model is designed for individuals , couples and families , who seek timely help and who can access the service by simply logging in, filling out forms and being immediately seen by a qualified therapist (a nurse, a social worker, psychologist or doctor) for one hour of structured therapywhere they can meet their needs. To access the service there are no exclusion criteria or age limits and this form of therapy is suitable for those who have little time , but at the same time need help.
But let’s see in detail how the intervention is articulated!
Initially the client identifies one or two issues to focus on . The therapist interacts quickly with the client and during the interview the latter’s ideas regarding the desired changes are explored, to subsequently arrive together with new solutions for change. At the end of the interview, where the therapist deems it necessary to address further aspects of the problem, clients can also be provided with information from other agencies.
What results has the service achieved over time?
The South Calgary Healt Center’s Walk-In/SST , launched in 2004 has seen a steady increase in demand, thanks largely to people’s word of mouth. In recent years, the Center has evaluated and treated over a thousand clients , most of whom have turned to the service spontaneously, the others through referral from health professionals and school consultants.
How is the work team composed?
The clinical team is made up of professionals of different backgrounds such as nurses , social workers and psychologists , who also have different approaches to therapy. Furthermore, since the working group agrees that two conductors are better than one, the client forms are reviewed before and after the session by two specialists who consult before the client leaves the facility.
How is the service evaluated?
After the service is delivered clients are asked for feedback , first by measuring their level of difficulty before and after the session , then by asking them to complete satisfaction surveys at the end of the session . From September 2011 to February 2012, the team conducted a formal study to evaluate the effectiveness of the service, using four customer self-report tools, collecting information before and after the session and again after a month. The results showed that customers were generally satisfied and felt they had developed greater confidence in handling the problemfor which they sought help. 40% of clients indicated that only one therapy session was sufficient.
But now let’s see how a success story unfolded in practice!
A parent of eight-year-old Patrick approached the service after talking to a teacher who showed him three drawings her son had made in art class. One drawing showed an unhappy boy on a playground, far away from other children. In the second drawing, the child was crying and in the third he was holding a rope. The teacher had told the father that he had tried to talk to Patrick about his drawings of him, but the boy had refused to talk about it. After having also asked the father to interpret his son’s drawings, the teacher suggested that he contact the service.
When the father and the boy arrived at the center that same day, the father filled in the forms in the waiting room in which he described the situation with the boy and formulated his request for help. After a short wait, the two were met by a therapist. During the session Patrick talked about his problems with other children at school and how lonely he felt. The father then became involved in the intervention and told his son about some challenges he had with peers when he was a boy and how he overcame them. Together, father and son began to develop a plan to help Patrick solve his problems at school. At the end of the session, the therapist suggested that the father and son read two children’s books on how to make friends, which the two could read together, recognizing and valuing the father’s role.
From what has been reported in this article it can be deduced that such a Walk-In/SST service model can be very useful in reducing the pressure on other more complex and expensive services . In the feedback that the Center has received, for example in the year 2013-2014, 65% of clients reported that they should have sought other services where the service was not available, thus going to seek help from structures not necessarily suitable for responding to the problems presented. In particular, 7.5% declared that they would have asked for help in the emergency room and 4.6% would have sought medical assistance.
Team Psychotherapist of the Italian Center
for Single Session Therapy
Harper-Jaques, S., Simms, J., (2015). Single session walk-in therapy. Providing access and early intervention for people with mental health concerns. Canadian Nurse from https://www.canadian-nurse.com/en/articles/issues/2015/january-2015/single-session-walk-in-therapy
Harper-Jaques S., Mcelheran, N., Slive A., Leahey, M. (2008). A Comparison Of Two Approaches To The Delivery Of Walk-In Single Session Mental Health Therapy. Journal of Systemic Therapies, pp. 40–53