The VAC National Mental Health Strategy is rooted in the following five principles:
1)Client-Centered:
Recognizing the uniqueness of each individual and the complexity of an OSI, VAC developed an interdisciplinary approach and case management model designed to address both the mental health and social needs of clients and support their transition into civilian life.
This client focus was further maintained through consultative forums and client focus groups conducted prior to the establishment of SAC. This strong client-centred experience led SAC to develop an expertise in understanding the complex nature of OSIs, which was consolidated by systematic client satisfaction surveys to evaluate its clinical programs. A survey process based on a sound methodology and established quality domains allowed a 75% client participation rate. This provided invaluable information to guide decisions about the future of the network
Such achievements led VAC to recognize the clinical leadership of SAC by creating the National Clinical Centre of Expertise, mandated to develop and promote best practices through ongoing education, collaborative research with universities and expert consultative services.
2)Accessibility and Continuity of Care:
Capitalizing on SAC’s clinical programs, VAC duplicated the SAC model by creating an OSI clinic network that met both clinical effectiveness and operational efficiency. In this context, agreements were reached with Provincial Health Authorities to build a geographically complementary network to that of DND. Today, the VAC network comprises five specialized clinics.
To further improve accessibility (including in remote areas) partnerships were created with local community services, peer support groups, professional associations and the piloting of telemental health services. Beyond enhanced accessibility, these partnerships also provide continuity of care from the acute phase to eventual follow up.
3)Seamless Transition:
VAC’s service delivery philosophy is founded on a seamless continuum of care approach. Its key innovation is the Transition Interview performed by VAC Transition Officers to identify early any impediments to successful transition towards civilian life. A comprehensive assessment by Area Counsellors, followed by referrals to appropriate services in the network completes this process.
The close coordination between VAC District Offices, regional clinics and community service providers is another strength of this approach. This coordination is provided by Mental Health and Rehabilitation Officers at regional and national levels.
4)Continuous Quality Improvement:
SAC was instrumental in defining the quality domains and indicators needed to evaluate clinical program outcomes. Several performance indicators were developed in six quality domains (accessibility, acceptability, appropriateness, continuity, safety and effectiveness). These are now shared by all clinics in the OSI network and at the DND OTSSC programs. This framework is consistent with the VAC Quality Management Program.
5)Shared Governance:
VAC’s governance sharing approach involved the establishment of a consistent and effective continuum of care across federal departments (VAC, DND, RCMP), various provincial health jurisdictions, community partners, public and private sectors. This was an innovative way for a federal department to build capacity while avoiding the duplication of existing services. This bottom-up vision of mental health service delivery is client driven and rooted in a response to their complex needs.
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