Integrated Service Delivery

Brief Description

Integrated Service Delivery (ISD) is a local and regional governance and service delivery framework that enables partners to better work together, using a coordinated and integrated approach to meet the needs of children and youth at risk. ISD is intended to address service gaps in early assessment and intervention services for children, youth and their families. In the provision of ISD assessment and intervention supports, core areas of functioning and needs related to the positive development of children, youth and their families provide a specific focus of intervention services. The goal of ISD is to enhance the system capacity to respond in a timely, effective and integrated manner to the strengths, risks and needs profiles of children, youth and their families (right service intensity at the right time).

Goals

The main goals of the ISD framework are to:

• Eliminate service gaps currently found in early intervention and assessment services currently available for children, youth, and their families;
• Ensure positive growth and development in children with multiple needs through the access to partnering services and programs; and
• Develop suitable interventions based on the strengths, specific risks and needs of the identified children.

Clientele

ISD specifically targets a client base of children and youth (no older than 18—up to 21 if still in the public school system) with multiple needs. These needs are defined by the core areas of development and include physical health and wellness, emotional and behavioral functioning, educational development, family relationships, and mental health.

Children must have the presence of moderate to severe internalizing and externalizing (emotional or behavioral) features, in addition to significant impairment or disruption in functioning in one of the four other areas of adaptation (physical health and wellness; emotional and behavioural functioning; family relationships; educational development; mental health challenges; and addictions).

Core Components

ISD centers around one common plan: a process of cooperation between all service providers for a child, youth, and/or his or her family. ISD is designed to mobilize all the skills and competencies required to ensure a collaborative and cooperative assessment of strengths, needs, and risks to be addressed. Efforts are focused on agreeing on priorities that must be addressed in order to meet needs and on the degree of services to be provided, in accordance with the mandates and responsibilities of each organization concerned. While there are provincial guidelines, regions implement the service delivery model according to their reality and strengths.The central components of the framework include the following:

• Accessible and timely services by establishing a network of communication between various departments, service providers and family members to ensure awareness of available methods of intervention;
• Ensuring appropriate programs and services are offered during all stages of intervention to promote positive childhood and youth development;
• Effective case planning practices deliver interventions at the proper intensity and time for each individual child;
• Enhanced relationships in that there is an increased sharing of information among partners and collaboration with community stakeholders;
• System efficiencies, meaning there is an increased collaboration between partners in the provision of services and assessments and reduction of redundancies and duplications;
• Effective use of resources for the provision of, and access to, the right service, at the right time, at the right intensity;

The ISD framework places emphasis on the elaboration of strength-based counselling or service modalities which underscore the importance of using the child or youths’ capacities, interests and preferences to realize and sustain positive changes. Strength-based methods affirm that children /youth and their respective contexts have a range of unique internal and external resources that should be used as part of the case planning process. These approaches are characterized by counsellor-child/youth interactions that are respectful and that validate the child or youths’ efforts to confront or deal with struggles and adversity. They also recognize that a range of risk factors may be associated with the emergence of oppositional and conduct problems in children/adolescents, and that protective factors, which reflect areas of internal or external strength or resources for youth and their families, may serve to decrease or mitigate the presence of specific risk factors. Recognized therapeutic applications that support strength-based frameworks include solution-focused therapy, narrative therapy, self-determination theory, positive psychology methods, positive youth development approaches and comprehensive school health models.

Implementation Information

Some of the critical elements for the implementation of this program or initiative include the following:

• Organizational requirements: The ISD requires:
  • Public bodies to share information (bill passed to enable departments to share information in order to determine program eligibility); and
  • An exercise in change management (i.e., new way of delivering services to children/youth).
• Partnerships: The Departments of Education and Early Childhood Development, Social Development, Justice and Public Safety, and Health, as well as the School Districts (4 Anglophone and 3 Francophone) and Regional Health Authorities (Horizon and Vitalité).
• Training and technical assistance: Training in key modules (e.g. Practices, Approaches and Interventions)
• Risk assessment tools: The Child and Adolescent Functional Assessment Scale (a risk assessment tool) is used to assess the level of emotional/behavioural risks in participants.
• Materials & resources: Utilizes an electronic case management system.

International Endorsements

The most recognized classification systems of evidence-based crime prevention programs have classified this program or initiative as follows:

• Blueprints for Healthy Youth Development: Not applicable.
• Crime Solutions/OJJDP Model Program Guide: Not applicable.
• SAMHSA's National Registry of Evidence-based Programs and Practices: Not applicable.
• Coalition for Evidence-Based Policy: Not applicable.

Gathering Canadian Knowledge

Canadian Implementation Sites

ISD is currently being implemented across New Brunswick. Based on the information provided on the ISD’s website, this initiative is available in the Charlotte County, Acadian Peninsula, Saint John, Sussex, Miramichi and Chaleur-Restigouche areas.

Main Findings from Canadian Outcome Evaluation Studies

No information available.

Cost Information

No information available.

References

There is no Canadian reference available at this time.

For more information on this program, contact:

Bob Eckstein
Government of New Brunswick
250 King Street
Fredericton, New Brunswick E3B 5H1 
Telephone: (506)444-2618
E-mail: bob.eckstein@gnb.ca
Website: http://www2.gnb.ca/