Establishing a Coordinated Crisis Continuum Across the Lifespan in Halton, Ontario Canada

Background: The Region of Halton current crisis continuum is experiencing similar challenges as many others, such as confusing and broken pathways, redundancies in services, organizational siloes, and poor transitions between services. With increasing needs for higher acuity care and crisis interventions in the community, these issues continue to exacerbate the difficulties faced the difficulties faced by community members of all ages seeking crisis support.To address this need for a comprehensive crisis response across the lifespan, a coalition of 4 organizations spanning community mental health, substance use, hospitals, first responders, family and patient advisory, housing, Ontario Health, Community Safety and Wellbeing, and Ontario Health Teams formed the Halton Crisis Working Group. Through collaborative efforts this group aims to identify and address the most pressing needs in crisis care within the region by establishing a coordinated crisis continuum that supports individuals across the lifespan. Approach: To accomplish this, a thorough examination of the region's current crisis care system was conducted. This involved mapping local crisis assets and pathways across child, youth, adult and older adult sectors and collecting organization data to understand current service use and capacity. Extensive engagement was also conducted with 22 different community stakeholders to assess current strengths, opportunities, and future vision. Additionally, a comprehensive population needs assessment, environmental scan of local, regional and provincial priorities, a review of global best practices and a scan of equitable model and equity, diversity, inclusion and accessibility (EDIA) principles were undertaken. Throughout this process, working group members actively participated in workshops to validate and discuss findings.At the culmination of these discovery activities, an in-person co-design workshop was organized, bringing together all working group members to review and evaluate current system needs, challenges, and opportunities. To guide this discussion, a prioritization framework was developed, utilizing criteria such as community need, readiness, support, and potential impact to determine top priorities to advance. Results: The top priority identified by both service providers and clients was to simplify, optimize, and align existing crisis services. This would make the system easier for clients to access, navigate, and understand. This streamlined system would reduce confusion, eliminate the need to retell their stories multiple times, and ensure they receive timely and appropriate support when in crisis.The second priority was to close gaps in care, particularly for those consistently underserved by the current system. Addressing these gaps would ensure that all clients, regardless of their circumstances, have equitable access to crisis services tailored to their unique needs and challenges. These priorities would translate into a more user-friendly, inclusive, and responsive crisis continuum. Implications: While this work is still underway, the process of collective engagement has already yielded significant implications. Notably, it has fostered strengthened relationships, built trust, and cultivated a shared sense of purpose across the region's service providers.The collective planning and action undertaken thus far have enabled the successful identification of priorities and generated substantial momentum, propelling the initiative forward. The collaborative is now well-positioned to embark on the next critical phase - developing and implementing actionable strategies to bring these priorities to fruition.

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