I am really interested in this thread. I especially appreciated the way you put it, Bill: "policy and how it gets operationalized"
Nipissing District has initiated a number of collaborative service models both within and outside of the mental illness and addictions sectors over the past 10 years. These have included everything from pooling resources to fulfill service needs in a rural community to the creation of a common referral triage system and community response process to address to homelessness issues. All of these initiatives came about because of grassroots initiatives and necessity. There was no money to be had and there were still clients who needed to be served so agencies and services worked together to fill the gaps.
I believe there are some outstanding, promising practices in existence that approach service gaps and service provision from a collaborative, needs-based perspective. I am, however, feeling more frustrated of late. I hear the words "partnering", "collaboration", and "integration" more and more, but what I see is more and more siloed planning and splitting between the mental health and addictions sectors and especially between the hospitals and treatment centres and community services. Maybe I'm too jaded after over 20 years working in the sectors. I just think we keep spending money on trying to develop new and better models rather than putting resources into the enhancement and development of proven models already in existence. If we all separately look only at ways to work with someone’s addictions or their mental illness symptoms or financial needs, we waste time and resources and will consistently set the service recipient up for failure. We would probably be more successful if we planned our collaborative efforts working from a model that uses Maslow’s hierarchy of needs as its vision. Someone who has no home or food is not likely to be able to spend a lot of time or effort working on beating an addiction.
Bill's comments about the challenges we are all going to face as social assistance is downloaded to municipalities are incredibly pertinent. Provincially provided social supports, no matter how convoluted with rules and regulations, provide consistency for recipients no matter where they live. All one has to do is look at all the inconsistencies that have always existed when looking at "discretionary" benefits. In some municipalities, dentures were covered and in others, they weren't. In some places people could get funding for bus passes or an honorarium each moth for volunteering, in others they couldn't. Rural areas, with no tax base can't afford what places that have expensive homes and large populations can afford but we are heading into a world where have and have-not is going to refer to what district we live in, and people will move from district to district to follow the benefits rather than the jobs. It's pretty scary. I learned this morning that the ODSP computer data system is being revamped again at who knows what cost for training and software. It has been changed at least three times within my memory, and each time its costs have been huge in both money and the stresses it cause to both service recipients and providers.
I believe one of the most important collaborations we can promote will be that of having one voice when it comes to advocating for the people we serve. We need a strong, comprehensive continuum of consistent, high quality services available to people when they need them and we need to work together to make that happen. Sorry. I didn’t mean to sermonize. It’s been a long day.