# Presentation: 468541

## Slide 1

## History of the program

- Locations in Canada
- Client Demographics
- Growing Pains
- Successes
- Data Collection mechanism
- New projects

## In 1994 media attention spurred a national survey to determine the extent of inhalant use on First Nation reserves across Canada. Health Canada had in mind a plan to open 3 First Nation Treatment Centres.

- Survey showed use was widespread, as a result 6 centres were developed.
- In 2000 Alberta and  Labrador opened centres.

## Nenqayni

- White Buffalo

- Whiteswan

- Sheshatshit

- Whiskyjack

- KaNaChi HIH

- Nimkee

- Walgwan

## Slide 5

## Limited scope to draw ideas for program design

-    Some Research said Inhalant Specific Treatment Centres rarely lasted more that 9 months
-   Centres worked in isolation of each other using a lot of trial and error
-  All but one centre started as co ed
- All but one  centre started as 6 months in duration
- Policies for client travel, family visitation, grievance procedures varied drastically across the country
- Remote locations made staff retention and recruitment difficult
- The research about the potential for clients was highly negative, extremely pathology focused, highlighted aggression, volatility, permanent brain damage creating an underlying hopelessness.
- Some centres experienced extreme behavior problems,  huge employee turn over, public scrutiny

## Started informally in 1998

- Centres verbalized the need to get together and share concerns
- Quarterly meetings with problem identification as the focus
- In 1999 focus changed to proactive response and shared projects
- Realization that for success we would have to look at 4 key areas
- Leadership and Governance of the Centres,
- Human Resources ( Hiring, training and retention)
- Client Specific programming ( gender,  program delivery, client load)
- Environment ( building design and policies)

## Development of a centre accreditation  program in partnership with CCHSA

- Development of standardized reporting templates so we could benchmark with each other
- Data collection of client background
- 2 centres sharing some outcome data
- Development of  10 National Partnership Protocols to even the playing field
- Developing meaningful linkages with support services ( CCSA, Nechi)
- Discussions and then formal research  ( with CCSA) about  optimal client length of stay
- Changes to length of stay ( from 6 to 4 months)

## Our focus is strength based using specific teachings from various positive Psychology models  key focus on emotional intelligence, resiliency and  traditional  models of stress reduction

- All but one centre are gender specific
-  One centre has 100 % client retention rate  3 years
- All centres participating in standardized data collection for  perceived resiliency ( pre/post), follow up data, motor coordination testing ( pre/post)
- YSAC has developed 4  Nationally certified Training courses specific to work with inhalant using clients.
- Buildings have been improved to allow for environments that are better suited to this type of programming.
- Client Restraints and damage by clients is rare rather than routine
- Staff retention and staff satisfaction surveys  are steadily improving
-   2 centres have reported between 75 and 85 % client success rate for 4 years in a row.
- YSAC has been  contracted to aid in the development of inhalant specific programs in  other countries. ( USA/Australia)
- Developed meaningful research and training partnerships
- All  but one centre received National Accreditation
-  changes to health sustaining behaviors such as re-entry in school (average of 55% return to school) , increased participation in positive social activities, recreation, connection to traditional culture are routinely reported by successful  graduates
- National Core competency assessments for all YSAC employees guide training and upgrading programs.
- Centres showing educational improvement of  up to 1.5 grade levels in 6 months.
- Development of  web based national data base to collect all this data
-  Utilizing of biofeedback system to monitor impact of stress reduction programs.

## Slide 10

## Depression Inventories

- Self Esteem Scales
- Emotional Intelligence scores
- Hand-eye Foot Coordination
- Perceived Resiliency
- Standardized education scores ( WRAT, etc)
- Heartmath Stress Monitoring software

## Centres close enough to major cities to draw trained  long term  staff members

- Centres that are gender specific
- Centres with a client load of 9-10
- Centres that incorporate a family component
- Centres with lower staff turnover
- Centres that have fully embraced the  holistic resiliency model into all parts of program design
- Centres utilizing traditional aboriginal healing methods in conjunction with other therapies ( i.e. traditional medicines, fasts, sweats and Elder teachings)

## Through partnership with Australian service providers

-  British Petroleum

## 
Over 250 fields collected
standard demographics
legal history
Suicide ideation history
family addiction
Inhalant by subgroup ( gas, paint etc)
Province of origin
Mental health functioning
 follow up questions at 3-6-12 months post treatment on all population health related areas, general health, living conditions, school attendance,  etc.

- Over 250 fields collected
- standard demographics
- legal history
- Suicide ideation history
- family addiction
- Inhalant by subgroup ( gas, paint etc)
- Province of origin
- Mental health functioning
-  follow up questions at 3-6-12 months post treatment on all population health related areas, general health, living conditions, school attendance,  etc.

##  examine the link between multiple instances of grief and subsequent inhalant use

-  examine the link between multiple instances of grief and subsequent inhalant use
- Hallucinations and seeking of family members.
- Brain function recovery post treatment/abstinence
- Exploratory regarding suicidal behavior and sniffing episodes
-  recognition in Canada that inhalant use is not exclusive to the aboriginal population and there is need for general population epidemiological data
- Unique International collaborative research opportunities that  will serve  to improve treatment outcomes.

-  Youth Solvent Addiction Commmitee
- Debra Dell
- ysac@shaw.ca