Improving Access to Care: Go-To Educator Program
Approximately 70% of mental illnesses can be diagnosed before the age of 25 which makes adolescence a critical time for addressing all aspects of mental health and mental illness. Unfortunately, many young people with a mental disorder do not have the opportunity to rapidly access effective mental health care, often because their needs are not recognized and the type of support they require is not made available. Given that most young people spend a significant amount of time in schools, these institutions can become an ideal location for recognizing and addressing the mental health needs of youth. At present however, schools and healthcare systems exist as separate systems. This innovation works to help address these challenges.
This intervention is based on the observation that in every school there are educators (teachers, student services providers, and primary care providers) that students naturally form good relationships with and go to for help. We call them “Go-To Educators”. The “Go-To” Educator Training enhances the help-providing capacities of these individuals by improving their competencies in the early identification of youth with mental health problems and mental disorders. Additionally, as it improves mental health literacy for these educators, it also enhances within school capacity for triage, referral and ongoing support for students who require those interventions – creating stronger links with appropriate health care/mental health care providers. Taken together, these training inputs frugally build substantial and sustained mental health capacity within existing educational systems and promote better integration between education and health care systems that results in earlier identification and access to care for those who require it.
This approach uses a train the trainer model with the provision of a three-day Core Trainer professional education session. The core trainers then apply a one-day educational experience to “Go-To Educators” that have been selected by school administrators (junior high and secondary schools). As the one-day intervention can be delivered in a single professional development day or spread over two half days, implementation costs are minimal. The Core Trainer groups provide ongoing support to educators who have received the one-day intervention in whatever manner best suits the jurisdiction in which this is being implemented.
Each school then develops a cadre of educators that learn how to identify, triage, refer and support young people who are at risk of a mental disorder or who are exhibiting substantial mental health problems. It frugally facilitates earlier identification and referral of students who require mental health services without adding additional or undue burden on either education or health systems.
Substantial evidence of the positive impact of this intervention is available. A number of published papers and numerous evaluations (http://teenmentalhealth.org/product-tag/evaluations-and-reports/ ) have clearly demonstrated significant, substantial and sustained improvements in educator’s mental health literacy and their comfort in addressing the mental health needs of students. Additional research demonstrates multiple long term positive impacts on the outcomes of the Go-To Educator’s themselves, including improved help-seeking and better support for their families and friends (http://teenmentalhealth.org/product/report-evaluation-go-educator-traini...). A cluster controlled study has demonstrated that schools in which the intervention took place have lower rates of referral to specialty mental health services but youth referred are younger (demonstrating earlier identification), score higher on independent severity assessment (demonstrating clinical need) and a provided with more intensive treatment (demonstrating greater treatment needs).
In the Province of Alberta alone, more than 4,000 educators have been trained with a reach capacity of over 30,000 students and with positive mental health care access results (Baxter et al. in press).