Systems Approach Workbook
A Systems Approach to Substance Use
Services and Supports in Canada
Communication Tools: Sample PowerPoint presentation
The original template text for this file, as well as other useful material, is available in the Tools & Templates section of
the Systems Approach website (www.nts-snt.ca). Production of this material has been made possible through a
financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of
Health Canada.
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Outline

Background

Why pay attention to the treatment system?

Systems Approach recommendations

Tiered Model

Systems Approach implementation
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Background

Treatment is one of 13 priorities under the National Framework
for Action to Reduce the Harms Associated with Alcohol and
Other Drugs and Substances

40+ National Treatment Strategy Working Group members were
tasked with producing recommendations toward “improving the
quality, accessibility and range of options to treat harmful
substance use, including substance use disorders”
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Background (cont’d)

The Working Group released its
report in October 2008

The report makes 20 systemlevel recommendations to
 Improve the quality, range
and accessibility of services
and supports
 Close the gap between
“need” and “response”
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Why Pay Attention to the Treatment System?

Treatment for problematic substance use works and is an
efficient use of resources

Substance use problems drive health and social costs
beyond the addictions treatment field

Substance use is a major contributor to chronic diseases
such as cancer and diabetes
There are large gaps in service and barriers to accessing
the help people need

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Systems Approach Recommendations
Develop a continuum of services and supports


Improve care, coordinate services and make better use of existing
investments by shifting the focus toward integrated, community-based
care rather than specialized care

Look at the system using a tiered framework representing logical
groupings of services and supports and varying levels of risk and harm
Develop knowledge exchange capacity

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Promote evidence-informed policy and practice
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Systems Approach Recommendations
Reduce stigma and discrimination


Develop a targeted, evidence-based approach

Increase the understanding of substance use problems and the treatment
system to reduce the barriers faced by those who might access the
system and those who work within it
Develop a research program


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Support and enhance efforts to build system capacity
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Systems Approach Recommendations
Measure and monitor system performance


Collect information in a consistent way to inform and monitor system
improvements
Promote leadership and implementation

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
Coordinate allocation of resources

Develop collaborations across systems and sectors
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Tiered Model: A Service Perspective
Each tier represents a cluster of services and supports that


Respond to varying levels of risk and harm

Address problems of similar severity and provide services of similar
intensity and specialization

Movement within and across tiers is facilitated

In a comprehensive continuum, each tier has the tools,
resources and supports required to meet population needs
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Tiered Model: A Service Perspective


Lower-tier services and supports

Meet the needs of the greater number of people

Represent a higher level of community integration and lower degree of
specialization
Upper-tier services and supports

Meet the needs of people with more severe substance use issues

Represent a higher level of specialization
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Tiered Model: A Population Perspective

Tiers represent groupings according to levels of
individual risk and harm

Movement through connected tiers is facilitated as
individual needs and risk/harm profiles change over time

Five Tiers

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1: Individuals with low risk/harm
2: Individuals with moderate risk/harm
3: Individuals at risk of acute harm
4: Individuals experiencing harm
5: Individuals experiencing harm and with complex risk profiles
(e.g., concurrent disorders)
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Tiered Model: Guiding Principles

No wrong door

Availability and accessibility

Matching

Choice and eligibility

Flexibility

Responsiveness

Collaboration

Coordination
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Benefits of the Tiered Model


Flexible

Responds to the particular needs of Canada’s jurisdictions and
populations, but…

Based on common principles that can be applied in any context
Promotes the efficient use of resources

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Emphasis on developing capacity in the lower tiers rather than relying on
more resource-intensive, specialized services
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Variations of the Tiered Model

Variations of the Tiered Model can be found in

Healthy Minds, Healthy People: A Ten-Year Plan to Address Mental Health
and Substance Use in British Columbia (2010)

The Action Plan for Mental Health in New Brunswick, 2011-18 (2011)

Creating Connections: Alberta’s Addiction and Mental Health Strategy (2011)
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Systems Approach: Rationale for Change
EXAMPLES OF WHAT TO INCLUDE:
The
reasons improvements are needed in your
jurisdiction; for example:

Responding to or proactively addressing




New research evidence
Population trends
An emerging problem
An identified gap
The
ways areas that are working well can support and be
supported by system change
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Systems Approach: Rationale for Change
EXAMPLES OF WHAT TO INCLUDE:
Address




The clients
The services
The practitioners
The system
Cost


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benefits to
savings associated with earlier intervention
Reduced reliance on specialized, intensive services
Reduced health and social impact of substance use
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Systems Approach: Outcomes and Benefits
EXAMPLES OF OUTCOMES AND BENEFITS:
[TO BE CUSTOMIZED]
Increased
partnerships and coordination between services
Improved
client outcomes through increased access to
appropriate services
Increased
capacity to identify and address gaps in the
service continuum
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Systems Approach: Work to Date
EXAMPLES OF ACTIVITIES: [TO BE CUSTOMIZED]
Examined
provincial strategy for consistency and guidance
Examined
strategic plans for consistency with the Systems
Approach
Identified
areas of the system that need improvement or are
working well
Identified
benchmarks through provincial reports and
national indicators (e.g., CIHI, National Treatment Indicators)
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Systems Approach: Decisions Required
[TO BE CUSTOMIZED]
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Systems Approach: Next Steps
[TO BE CUSTOMIZED]
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Additional Information

www.nts-snt.ca

www.ccsa.ca

[ADD RELEVANT REGIONAL LINKS]
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