(dis)Connectedness

We are seeking youth for an upcoming ‘Photovoice’ project to explore the themes of connectedness and disconnectedness. Honoraria are available for 6-8 youth who are interested in taking a leadership role.

This is a youth-initiated project funded by the Child & Youth Health Network of the capital region.

Youth Leaders

Youth leaders will:

  1. Participate in a 3-hour youth-friendly working session on February 24th (date may be subject to change);
  2. Connect with other youth to encourage their participation in the project; and
  3. Help to prepare a presentation to share the results of the project.

An honorarium of $200 is available (in a few installments) to each youth leader.

Youth (and youth allies) who are interested or want more information can contact Petra at 250.208.2899.

Download the poster here.

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Measures of Connectedness

After reviewing the measures of connectedness that are in use worldwide, and the data that are available in our region, we have selected the following measures of connectedness as part of the shared measurement system for the Child & Youth Health Network.

This is a long-term project. We hope to be able to increase connectedness for children and youth over decades, and as one contribution to improved mental health for young people in our region.

Data Sources

The sources of available data are few and through this process we identified more data gaps than data. Currently available data sources include:

*The MDI data sets are incomplete. South Vancouver Island data available from SD61 only and BC data is available from just a subset of school districts in the province.

The Measures of Connectedness

Family Connectedness

  1. Family connectedness scale (AHS)
  2. How often did parent(s)/guardian(s) know what you were doing? (AHS)
  3. How often did parent(s)/guardian(s) eat an evening meal with you? (AHS)
  4. If you were having a serious problem, is there an adult in your family that you feel okay talking to? (AHS)
  5. The quality of relationships grade 7 students have with adults in their home (MDI)

School Connectedness

  1. School Connectedness Scale (AHS)
  2. School Connectedness Composite Measure (designed by the Ministry of Health using BCSS data)
  3. The quality of relationships students have with adults at school (MDI)

Measures School

Community Connectedness

  1. The quality of relationships students have with adults in the neighbourhood/community (MDI)
  2. In your neighbourhood /community, is there an adult who really cares about you? (AHS)
  3. How much you feel like you belong to your community? (AHS)
  4. If you were having a serious problem, is there an adult outside your family that you would feel okay talking to? (AHS)

Measures Community

Peer Connectedness

  1. Peer Belonging Scale (MDI)
  2. Friendship Intimacy Scale (MDI)

 

 

Youth Connectedness & Vital Signs

coverThe theme for the Victoria Foundation’s 2016 Vital Signs report (launched today!) is Belonging.

The report focuses on 4 profiles of belonging:

  1. Aboriginal Peoples;
  2. Newcomer;
  3. Youth; &
  4. Seniors.

Unsurprisingly, we had something to say when it came to youth belonging and connectedness. The following is an excerpt from the report:

As social animals, humans evolved to grow up and live in community. All the evidence points to increasing connectedness for youth as resulting in improved outcomes in all the important areas of life. “Youth who feel more connected to their community have lower rates of stress, feel less despair and are less likely to have self-harmed or attempted suicide,” says Petra ChambersSinclair, coordinator of the Child and Youth Health Network (CYHN) of the Capital Region.

Getting youth connected to place and community bolsters that sense of belonging, confers advantages in terms of educational outcomes and carries over long into their adult lives. But not all our children and youth experience that beneficial sense of social connectedness. “The experience of belonging varies enormously for children and youth in the Capital Region,” says Chambers-Sinclair. “All people need to feel that they belong, but there are enormous disparities in the degree of healthy social supports available to youth in our region.”

Young people need mentorship from adults, she asserts, because the health and resilience of the entire community depends on successful transition to adulthood by its young people. Chambers-Sinclair states, however, that nowadays mentors are scarce for many children and youth—and in many communities, the mentors they do have are overworked and burning out.

“Ultimately, we all need to work together to support the successful transition to adulthood for the next generation, and I believe creating resilient networks of social connectedness for young people is one of the best ways to approach that.” Adults increasingly feel that they don’t know how to support young people through the process of becoming successful adults, says Chambers-Sinclair. “We end up with a situation where adults feel alienated from youth, youth feel disconnected and abandoned by adults, and the successful transition to adulthood remains incomplete for many young people through their 20s, 30s and even longer,” she says. “All of these factors create fragmented and weak systems that lack resilience at the individual, family and community levels. At a time when we are facing some of the most complex challenges in human history. We need to wade into this space and work with young people to figure out how to help them.”

leverageThe CYHN has a mission of increasing connectedness to improve the wellbeing of young people in the Capital Region. In 2016, the CYHN began developing an Index of Connectedness as part of its shared measurement system. The index comprises a comprehensive review of indicators for measuring connectedness in young people, with the aim of creating a single composite index that will then identify gaps to be addressed as well as recommendations for using the results. 

The (hidden secret) Youth Anxiety Epidemic

One of our youth partners just shared this post with me, because it describes their experience with anxiety.

Often the anxiety youth live with on a daily basis is invisible to adults. This post explains why.

High-functioning anxiety sounds like…

You’re not good enough. You’re a bad friend. You’re not good at your job. You’re wasting time. You’re a waste of time. Your boyfriend doesn’t love you. You’re so needy. What are you doing with yourself? Why would you say that? What if they hate it? Why can’t you have your shit together? You’re going to get anxious and because you’re going to get anxious, you’re going to mess everything up. You’re a fraud. Just good at faking it. You’re letting everybody down. No one here likes you.

All the while, it appears perfectly calm.

It’s always looking for the next outlet, something to channel the never-ending energy. Writing. Running. List-making. Mindless tasks (whatever keeps you busy). Doing jumping jacks in the kitchen. Dancing in the living room, pretending it’s for fun, when really it’s a choreographed routine of desperation, trying to tire out the thoughts stuck in your head. 

It’s silent anxiety attacks, hidden by smiles.

It’s always being busy but also always avoiding, so important things don’t get done. It’s letting things pile up rather than admitting you’re overwhelmed or in need of help.

It’s that sharp pang of saying the wrong thing, the one that starts the cycles of thoughts. Because you said too much, and nobody cares, and it makes you never want to speak up again.

Mental Health Rates for Youth in our Region

What is the state of youth mental health on Southern Vancouver Island and in BC?

  • “21% of local [Southern Vancouver Island] students had at least one mental health condition. Females were more likely than males to have at least one condition (25% vs. 16%) and to have multiple conditions (10% vs. 4%)” (South Vancouver Island Results of the 2013 BC Adolescent Health Survey, 2014, p. 4).
  • “Just under half of homeless or street-involved youth [in BC] rated their mental health as good or excellent (49%). Males were more likely than females to rate their mental health as excellent (23% vs. 10%), while females were more likely to rate it as poor (19% vs. 8%)” (Our Communities, Our Youth, 2015, p. 31).
  • “Among youth currently in care [in BC], females rated their mental health more poorly than males (36% vs. 23% of males rated their mental health as fair or poor), which was consistent with the gender difference among all youth who completed the BC AHS. Youth in care were more likely than their peers to report having a mental or emotional health condition (17% vs. 10% of youth not in care)” (We All Have A Role, 2015, p. 20).
  • “Youth [on Southern Vancouver Island] most commonly reported having Depression (10%), Anxiety Disorder (10%), Attention Deficit/Hyperactivity Disorder (ADHD; 7%), and/or an addiction to alcohol or other drugs (2%). Females were more likely to have Depression or Anxiety Disorder, whereas males were more likely to report ADHD. Most students (85%) reported feeling stressed in the past month. Females were three times as likely as males to experience extreme stress that prevented them from functioning properly. Students were also asked the extent to which they felt so sad, discouraged or hopeless that they wondered if anything was worthwhile. Fifty percent reported feeling some level of despair in the past month” (South Vancouver Island Results of the 2013 BC Adolescent Health Survey, 2014, p. 15).
  • “When [Southern Vancouver Island youth] were asked about specific mental health conditions such as depression and anxiety, a higher percentage reported having such a condition than recognized that they had a mental or emotional health condition” (South Vancouver Island Results of the 2013 BC Adolescent Health Survey, 2014, p. 11).
  • “More than two thirds of [homeless and street-involved youth (68%; 62% of males vs. 72% of females) reported having at least one specific mental health condition. Also, 24% reported having a behavioural condition (19% of males vs. 29% of females), and 26% indicated having problems with anger. Youth most commonly reported having been told by a health professional that they had Depression (31% of males vs. 60% of females). Females were also more likely to have Chronic Anxiety Disorder or panic attacks (38% vs.13% of males), Bipolar Disorder (20% vs. 7%), Post-Traumatic Stress Disorder (PTSD; 24% vs. 8%), and an eating disorder (28% vs. 9%). Males were more likely than females to report having Attention Deficit Hyperactivity Disorder (ADHD; 31% vs. 20%). Compared to 2006, a greater percentage of youth reported having Depression (47% vs. 23% in 2006), Chronic Anxiety Disorder or panic attacks (27% vs. 10%), and Schizophrenia (6% vs. 4%). Increases among female youth were also seen in PTSD (24% in 2014 vs. 8% in 2006) and Bipolar Disorder (20% vs. 8%)” (Our Communities, Our Youth, 2015, p. 32).
  • “Males and females with care experience [in BC] were more likely than their peers who were never in care to report extreme levels of stress (20% vs. 9%) and despair (19% vs. 7%) in the past month, to the point where they could not function properly. Youth previously in care were more likely than those currently in care to report these extreme levels” (We All Have A Role, 2015, p. 21).
  • “Most [homeless and street-involved] youth (88%) felt some level of stress in the past month, with 15% of males and 24% of females feeling so stressed that they could not work or deal with things. Youth were also asked the extent to which they felt so sad, discouraged, or hopeless that they wondered if anything was worthwhile. More than 7 in 10 youth (72%) felt this way at least sometimes in the past month, with 1 in 10 reporting feeling so much despair that they could not function properly” (Our Communities, Our Youth, 2015, p. 33).
  • “Youth with [government] care experience [in BC] were more likely than their peers to rate their mental health as fair or poor (as opposed to good or excellent). Those previously in care were more likely than those currently in care to rate their mental health this way.” (We All Have A Role, 2015, p. 19).

Self-harm & Suicidality

  • “In the past year, 8% of local males and 22% of females reported cutting or injuring themselves on purpose without trying to kill themselves” (South Vancouver Island Results of the 2013 BC Adolescent Health Survey, 2014, p. 16).
  • Among Southern Vancouver Island youth, “eight percent of males and 15% of females seriously thought about killing themselves in the past year…, 4% of males and 7% of females reported attempting suicide in the past year” (South Vancouver Island Results of the 2013 BC Adolescent Health Survey, 2014, p. 16).
  • “Males and females in care [in BC] in the past year were more likely than their peers without this experience to have cut or injured themselves on purpose without trying to kill themselves during that time period (31% vs,. 15%) and to have done so multiple times (24% vs. 10%). They were also more likely to have seriously thought about suicide in the past year (19% vs. 6%).” (We All Have A Role, 2015, p. 22).
  • “Youth who had previously been in care [in BC] were more likely than those currently in care to have self-harmed, seriously thought about killing themselves, or to have attempted suicide in the past 12 months” (We All Have A Role, 2015, p. 22).
  • “Forty-five percent of [homeless or street-involved] youth (23% of males vs. 61% of females) cut or injured themselves on purpose without trying to kill themselves (self-harmed) in the past year. The percentage of males who had ever self-harmed was similar to 2006, while females were more likely to have done so (75% in 2014 vs. 55% in 2006)” (Our Communities, Our Youth, 2015, p. 33).
  • Homeless or street-involved “youth most commonly reported that they most recently self-harmed because they felt lonely or depressed. Among youth who self-harmed, females were more likely to indicate self-harming because they felt lonely or depressed (80% vs. 53% of males), stressed (62% vs. 40%), or because they wanted to feel in control (34% vs. 12%)” (Our Communities, Our Youth, 2015, p. 34).
  • Among homeless and street-involved youth 68% “(62% of males vs. 72% of females) reported having at least one mental health condition, 42% had seriously considered suicide in the past year, and almost a third (31%) had attempted suicide” (Our Communities, Our Youth, 2015, p. 8).

Sources

 

Sustaining Collective Impact

BB_MapIn the summer of 2016, the Collective Impact Forum published seven interviews with experienced backbone leaders from the US.

David Phillips then summarized the key takeaways from these seven interviews for us in this post. Here’s the short version of his summary:

Keys to sustaining a CI initiative:

  • Evolve scope
  • Diversify funding sources
  • Build capacity of others
  • Know how to speak the language of different types of funders
  • Share credit
  • Build trust
  • Engage the community in authentic ways to foster community ownership
  • Focus on the benefits of partnerships
  • Produce convenings that people want to attend

Character traits and skills we observed about our interviewees (all experienced backbone leaders):

  • Celebrate successes while embodying urgency to do more
  • Have exceptional instinct for managing interpersonal dynamics
  • Are open about their personal and organizational shortcomings

Ideas worth considering:

  • Given the size of their key roles, compensate working group chairs for their time
  • Compensate community members for their participation, but in a thoughtful way.
  • Create an Equity & Inclusion Workgroup to help the whole initiative embed equity in its work
  • Support programs and system-level reforms
  • Reinforce a collaborative culture through communication protocols and high-quality deliverables

Additional thought-provoking comments from our interviewees:

  • To reinforce a collaborative culture, don’t have every organization on the Steering Committee
  • We live in a unique moment where the time is ripe to push for equity. If we don’t push, the moment may be lost
  • To build relationships, you have to sincerely care about people
  • Backbones are not “neutral facilitators,” but “transparent facilitators”
  • Acting together can create just as much (or more) alignment than planning together

Using Evidence for Impact

Ariadne Labs is one example of an organization that is translating evidence into practice for impact.

The Child & Youth Health Network similarly seeks to align and initiate cost-effective evidence-based practices in the capital region of British Columbia to help us meet our goal of increasing the mental health of children and youth in our region by 10% or more within 20 years.

An article in the Stanford Social Innovation Review describes the approach taken by Ariadne Labs: “Instead of developing new treatments, people at Ariadne work to identify areas where health-care workers and institutions could be—but aren’t—deploying proven interventions. Then they develop programs that can bridge the gap between knowing what works and doing what works.”

“A crucial element of Ariadne’s work is its emphasis on evidence-based assessment and adaptation of specific interventions.”

One example is the Safe Childbirth Checklist, “a 30-item list of best practices that have been clinically proven to decrease the primary causes of maternal and neonatal death.”

2016 Healthy Schools Forum

The 2nd annual Healthy Schools Forum for the capital region of British Columbia occurred on May 27, 2016. This day-long event was co-hosted by School Districts 61, 62, 63 and 64, Island Health, and the Child and Youth Health Network.

285 people, including a large contingent of youth, gathered at the University of Victoria in Lekwungen, and W̱SÁNEĆ territory to foster collaboration and share knowledge about evidence-informed and school-centred approaches to promoting mental health for young people in the capital region.

The day included dialogue between local thought leaders called From Evidence to Action, in which Maureen Dockendorf  from the Ministry of Education), Dr. Kim Schonert-Reichl from the Human Early Learning Partnership University of British Columbia, and Scott Stinson, from the Saanich School District discussed ‘what we know makes a difference and opportunities to strengthen our efforts’ as people who care about the health and well-being of children and youth.

Dr Richard Stanwick, Cheif Medical Health Officer for Island Health also spoke on the subject of Connectedness Across our Communities.

Each participant was also able to attend 4 of 12 Roundtable sessions that each illustrated a promising practice in the promotion of mental health and resiliency in children and youth in our region.

The following documents provide more information about the forum:

 

Cultural Safety and Humility

In 2015, all Health Authorities committed to advancing cultural safety and cultural humility in health services in British Columbia.

What does ‘cultural safety’ and ‘cultural humility’ mean?

CULTURAL SAFETY

Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.

CULTURAL HUMILITY

Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.

Declaration-of-Commitment-on-Cultural-Safety-and-Humility-in-Health-Services

Cultural Safety and Cultural Humility in the Child & Youth Health Network

What does ‘cultural safety’ and ‘cultural humility’ mean for the Child & Youth Health Network?

Child Rights. How’s Canada doing?

The Kid’s Rights Index is the annual global index which ranks how all UN member countries adhere to (and are equipped to improve) children’s rights.

This Index ranks all 163 countries that have ratified the UN Convention on the Rights of the Child for which sufficient data is available.

How is Canada doing?

In 2015 we placed #57 out of 163.

In 2016 we slipped to 72.

What area are we failing in?

Child Rights Environment

Though we score relatively high in the area of ‘life‘ , which relates to mortality and life expectancy, and the area of ‘health‘, and moderately high in the area of ‘protection‘, Canada has a shockingly low score (130-135 out of 163) in the area of ‘Child Rights Environment’.

Child Rights Environment‘ includes:

  • Non-discrimination
  • Best interest of the child
  • Respect for the views of the child/child participation
  • Enabling legislation
  • Best available budget
  • Collection and analysis of disaggregate data
  • State-civil society cooperation for child rights

Using Data (for measurement and intervention)

Shared Measurement is at the heart of Collective Impact.

According to Jeff Raderstrong in his recent blog post at Living Cities, “Without continuously tracking and managing progress with data, it is highly unlikely that a collective impact initiative, or any large-scale change initiative, can achieve its goals.”

Measurement only one of the reasons we are developing an Index of Connectedness through the Child & Youth Health Network. We also intend to use data as a core element of our intervention strategy.

In an earlier post, Jeff outlined five steps to using data in Collective Impact:

Step 1: Agree on the Data

This is what we are currently doing as we build the Index of Connectedness with a panel of experts in the area of measurement from around British Columbia.

Step 2: Find the Data

The Index will use existing data sources, such as the EDI and the Adolescent Health Survey, but we know that there may be data gaps that we will also need to fill in order to create a truly useful index.

Step 3: Present the Data

We are currently working with data science students to create data visualization for the index so that it will be easy for everyone (not just data geeks!) to interpret. Data visualization will also aid comparison between communities and over time.

Step 4: Discuss the Data

Once the index is complete (we are planning to launch the Index in 2017, it will provide information that we hope will provoke discussion at multiple system levels throughout our region.

Step 5: Change Behavior and Share Responsibility

The Index of Connectedness will be at the core of our shared measurement system, but it is also intended to function as an intervention for change. Through the index we hope to:

  1. Mobilize knowledge, to help everyone in our communities understand that increased connectedness for children and youth improves their health, as well as their academic performance, future productivity, and future parenting capacity.  Increased connectedness for children and youth results in improved overall community health in the long-term.
  2. Support all community members in seeing that they have a role, and helping them to  take steps to increase connectedness for children and youth in their families, schools and communities.