Component: Young Parent Services

Legislation:  Child, Youth and Family Services Act, 2017

Service description

Intensive treatment services focus on reducing the severity of and/or remedying the mental health problems of children and youth that are psychological, emotional, social and behavioural- related. These services differ from counselling and therapy with respect to the intensity of the service needed to meet the child/youth’s identified needs.

People served

The target population is children and youth under 18 years of age with treatment needs requiring highly intensive services due to needs that impair their functioning at home, school and/or in the community.

Program/service features

The intensive treatment service categories include

  1. intensive community-based/day treatment services
  2. intensive in-home services
  3. intensive out-of-home services

Specific service provided

Intensive community-based/day treatment

Intensive community-based treatment and day treatment services are provided to children and youth who have mental health needs (e.g., psychological, behavioural, social, emotional, and self-regulation) that require intensive therapeutic services. The delivery of intensive community- based/day treatment service may occur through various settings within the community (e.g., community agency or school environment).

Intensive community-based treatment services are provided within the context of the family, culture, and community. A range of treatments can be provided through intensive community - based treatment services (e.g., wraparound services and family therapy). In addition, services may be supported by respite care, where it is part of an integrated service plan to meet the intensive service needs of a client and used to promote positive family functioning, avert or delay crises, reduce the need for or risk of longer out-of-home placement or to avoid placement breakdown when a child or youth is involved with a children’s aid society and/or to support the continuity of a youth justice order/placement.

Day treatment services offer an intensive therapeutic approach that can provide children and youth with treatment and the necessary skills to successfully function in school settings. As with the delivery of other core services, within this category there are a variety of elements that may be delivered either as stand-alone services, or as part of an integrated service plan with a range of strategies (e.g., individualized supports and family/group therapy). In general, the delivery of day treatment services requires an environment where psychiatric, psychosocial, and academic problems are addressed by multi-disciplinary teams. Some models approach service delivery on a graduated plan, slowly reducing the focus on therapy and increasing linkages with the school system – as the child/youth’s mental health needs diminish and their functioning improves.

Children/youth receiving day treatment services may continue to reside with their families and receive treatment throughout the day (e.g., an 8 a.m. to 8 p.m. program) or the service may be provided in conjunction with out-of-home services (e.g., residential treatment).

Intensive in-home services

Intensive in-home services provide therapeutic support and treatment for children and youth who have been identified as having mental health needs (e.g., psychological, behavioural, social, emotional and self-regulation) that require an intensive level of intervention, and which are best addressed through flexible services specifically tailored to meet their individual needs. Depending on the needs of the child/youth, intensive therapeutic services can be appropriately delivered in the home environment rather than in conventional treatment settings (e.g., clinical environments).

A range of treatments can be provided through intensive in-home services (e.g., wraparound services, intensive behaviour management support and family therapy). In addition, it may be supported by respite care, where it is part of an integrated service plan to meet intensive service needs and used to promote positive family functioning, avert or delay crises, reduce the need for or risk of longer out-of-home placement or to avoid placement breakdown when a child or youth is involved with a children’s aid society and/or to support the continuity of a youth justice order/placement.

Intensive out-of-home services

Intensive out-of-home services provide treatment in external settings (e.g., residential treatment settings) for children or youth who are dealing with mental health problems that impair their functioning at home, school and/or in the community, and who require an intensive level of intervention. This may include children and youth who may require longer-term treatment (e.g., children and youth with complex mental health needs).

A range of treatment can be provided through intensive out-of-home services (e.g., individual, group and family therapy, day treatment services, milieu therapy and behaviour management programming).

Intensive treatment services include a suite of services. How these services are delivered will vary based on the needs of the child or youth, and their family. Intensive treatment services are delivered in variety of settings.

Program goals

Intensive treatment services are designed to

  • reduce the severity of mental health problems
  • strengthen coping and resilience
  • enhance awareness and understanding of the problem
  • improve functioning at home, school and in the community, and
  • stabilize and transition the individual to less intensive or intrusive treatment services

Ministry expectations

Services are child and family-centered and support the diverse needs of families in a way that is culturally safe, promotes equity, anti-racism, and anti-oppression.

The following minimum expectations apply to intensive out-of-home services:

  • residential treatment settings must meet all applicable legislative and regulatory requirements
  • admission to and discharge / transition from out-of-home service occurs on a planned basis where possible, in a manner that promotes continuity of services and is managed with sensitivity, transparency and, as far as possible, respects the preferences of the child or youth and families

Individual planning and goal setting

Each individual will have a current Plan of Care (POC) that reflects an assessment of his/her needs and preferences. The POC will identify the specific services/supports received by the individual, the expected outcomes and be based on the principles of person-centered planning, self-determination, and choice.

Intensive treatment services are targeted to children and youth who have been diagnosed/identified with mental health problems that impair their functioning in some or many areas. Many of these children/youth will require intensive intervention either for a defined period or periodically throughout their life span, to maintain functioning in their home, school and/or community.

Intensive treatment services include a suite of services. How these services are delivered will vary based on the needs of the child or youth, and their family. Intensive treatment services are delivered in variety of settings.

Intensive treatment services should be provided in the least restrictive settings, in local communities and as close to home as possible (e.g., community, school, or licensed residential setting such as a core service provider setting, group home or foster home). Services should be delivered with minimal disruption to the continuity of family, school, and community life. These services should be customized to meet the individual needs of each child, youth, and family, matching the level of need with the appropriate intensity of service. There should be flexibility in the provision of Intensive treatment services. This will help ensure smooth and timely transitions for children and youth to less intensive and disruptive forms of treatment and support as their needs fluctuate.

Core service providers are encouraged to continue exploring innovative models of intensive treatment that allow children and youth to function to their best potential. It is not the expectation that all types of intensive intervention must be offered within each service (e.g., not all areas may require intensive out-of-home treatment or services may be delivered through cross-sectoral partners). Some clients may also require intensive treatment over and above these services (e.g., hospital-based inpatient care or secure treatment). These determinations should be informed locally with the support of data and information, and services adjusted as needs change and new evidence on best practices emerges.

Maintaining education is important for child and youth mental health and wellbeing. Every effort should be made to minimize school transfers and maintain education programming. Within Intensive treatment services, there may also be a Care, Treatment, Custody and Corrections (CTCC) Section 23 educational program attached to the core service (e.g., day treatment services and intensive out-of-home services) and delivered as part of an integrated service plan. CTCC programs provide educational programming and treatment to students who cannot attend regular classrooms because of their need for care, treatment, or rehabilitation. These services are intensive full- or part-time Services delivered jointly by core service providers and district school boards. CTTC educational programs are often provided in a classroom setting, which can be in a core service provider setting, school, custody facility or other settings.

The treatment component is delivered in collaboration and coordination with the education component, and both are provided intensively (three to six hours daily). These services require formal partnerships between district school boards and core service providers. The educational programming is delivered by school board- employed teachers and in some boards by educational assistants. Treatment is delivered by core service provider staff.

Reflecting the significant needs of children / youth accessing these services, Intensive treatment services may be accessed singularly or combined to form an integrated service that is responsive to the changing needs of the child/youth. Given the nature of these services, they are likely to be supported by a multidisciplinary team and/or a collaborative team of service providers, including cross-sectoral partners (e.g., health and education). Intensive treatment services may also be supported by special needs coordinated service planning, intensive case management and service resolution.

Specific elements available in a particular community will vary based on local conditions and the needs of children/youth in that service area.

Availability of service

While Intensive treatment services are available in every service area, out-of-home and day treatment services may not be appropriate for all communities. Where it is determined that the needs of their community can be sufficiently met without out-of-home or day treatment services, or where the level of need for the services in the community does not support sustainable out-of-home or day treatment services, they are responsible for establishing relationships with neighbouring or provincial programs to maintain clear pathways to these services if a child or youth requires a service that is not available within their community.

Some children and youth may require Intensive treatment services for the duration of their adolescence; it is expected that there is a smooth transition of these clients to the adult system.

Reporting requirements

The following service data will be reported on at an Interim and Final period. Please refer to your final agreement for report back due dates and targets.

Service data name Definition
# of children/youth with complex assessed needs: Former CYMH Intensive treatment services Number of children/youth receiving service having more than one priority need requiring multiple services/treatments and/or multiple service providers based on assessed needs using a standardized tool. Children/youth will be counted only once per fiscal year in this data element.
# of children/youth: out-of-home: Former CYMH Intensive treatment services: CSN The number of children/youth that received intensive treatment respite services out-of-home at some time during the fiscal year.
# of days children/youth waited for service: Former CYMH Intensive treatment services The number of days between the initial contact date and the start date for service provided to the child/youth in the reporting period. The initial contact date is the date the child/youth and/or family member contacted the agency for service/treatment. The start date is defined as the date of first contact between the specialist providing the consultation/assessment and the child/youth and/or family member.
# of days: residential care: Former CYMH Intensive treatment services The number of 24-hour periods for which people were provided residential care during the fiscal year. The day on which a person arrives is included as one day of service. The day a person leaves is excluded.
# of elapsed days service received by child/youth: Former CYMH Intensive treatment services The number of days elapsed between start and end dates for a core service provided to children/youth in the reporting period. Start date is defined as the date of first contact between the worker/therapist delivering a service and the child/youth to focus on the goals identified for treatment. End date is defined as the date of last contact between the worker/therapist delivering a particular service and the child/youth, and/or the date when the particular service is determined to have ended based on client preference (i.e., opting out), goal attainment, change in eligibility.
# of hours of direct service: CYMH Intensive treatment services Number of hours of direct service. The total number of hours of "Direct" service provided by staff to individuals during the fiscal year for a service. "Direct" Hours: The hours spent interacting, whether in a group or individually; face to face or on the phone. It does not include work done "on behalf of" clients, such as telephone calls, advocacy, etc. Administrative support to the service is not to be included. For group service, one hour of service equals one hour of service for the entire group. For example: one hour of group service with five participants equals one Hour of Direct Service. (Note: each individual in the group is recorded under ’number of individuals served’ where there is a record).
# of hours of indirect service: Former CYMH Intensive treatment services The total number of hours of service provided by staff "on behalf of" clients, such as telephone calls, advocacy, and administrative support to the service.
# of individuals: day treatment service: Former CYMH Intensive treatment services The number of individuals for whom a record has been created and who were recipients of Day Treatment service(s) at some point during the fiscal year.
# of individuals: residential service: Former CYMH Intensive treatment services The number of individuals for whom a record has been created and who were recipients of residential service(s) at some point during the fiscal year.
# of spaces available: Former CYMH Intensive treatment services The total number of spaces available at the end of the reporting period in the Intensive treatment services program including a) residential beds, and b) day treatment placements.
# of spaces occupied: CYMH Intensive treatment services The total Number of spaces occupied at the end of the reporting period in the Intensive treatment services program including a) residential beds, and b) day treatment placements.
CSN: Intensive treatment services: Ministry-funded agency expenditures Total ministry-funded expenses for the Transfer Payment Recipient to administer and/or deliver this service in the reporting year (cumulative). 
# of individuals: CYMH Intensive treatment services Report the unique/unduplicated number of individuals that received services in the reporting year. An individual is counted only once per year for each service delivered where they received service. The same individual may be counted in more than one service delivered if they are receiving services from more than one service delivered.