CYMH agency - workload and caseload survey

Introduction and organizational context

Why take this survey?
This survey is part of a project that is responding to Auditor General recommendations to create caseload guidelines to improve the efficiency and effectiveness of the Ontario child and youth mental health system. This survey is an opportunity for you to provide feedback and help to inform the response.

How long does the survey take to complete?
Between 10 to 20 minutes to complete. There are 31 questions and many of them are 'tick-box' responses.

Who should fill out the survey?
The individual in your organization who has the best understanding about the caseload and/or workload data you collect and how it is used to assess/enhance the effectiveness and efficiency of your operations.

How the data will be used?
Your responses will help us to understand what is being done across the province, and help us identify agencies to follow up with further. We are committed to protecting your privacy. Your personal information will be kept confidential; however, collective evaluation results may be used in project communications, publications and reports. Should we want to profile some of the information you provide in a way that might identify your agency, we will follow-up with you to obtain consent.

Question Title

* 1. Please provide your contact information.

Name

Organization

Role

Email Address

Phone Number

Question Title

* 2. What number of paid full-time staff do you have across your organization (all roles)?

0 - 25

26 - 75

76 - 125

126 – 199

200+

How many paid part-time staff do you have (all roles)?

Question Title

* 3. Which of the core services does your organization provide based on the Program Guidelines and Requirements for community-based child and youth mental health? To which age groups?

	Not provided	0 - 6	7 - 12	13 - 17	18 - 25
A348 – Brief Services	A348 – Brief Services Not provided	A348 – Brief Services 0 - 6	A348 – Brief Services 7 - 12	A348 – Brief Services 13 - 17	A348 – Brief Services 18 - 25
A349 – Counselling and Therapy	A349 – Counselling and Therapy Not provided	A349 – Counselling and Therapy 0 - 6	A349 – Counselling and Therapy 7 - 12	A349 – Counselling and Therapy 13 - 17	A349 – Counselling and Therapy 18 - 25
A350 – Crisis Support Services	A350 – Crisis Support Services Not provided	A350 – Crisis Support Services 0 - 6	A350 – Crisis Support Services 7 - 12	A350 – Crisis Support Services 13 - 17	A350 – Crisis Support Services 18 - 25
A351 – Family/Caregiver Capacity Building and Support	A351 – Family/Caregiver Capacity Building and Support Not provided	A351 – Family/Caregiver Capacity Building and Support 0 - 6	A351 – Family/Caregiver Capacity Building and Support 7 - 12	A351 – Family/Caregiver Capacity Building and Support 13 - 17	A351 – Family/Caregiver Capacity Building and Support 18 - 25
A353 – Intensive Treatment Services	A353 – Intensive Treatment Services Not provided	A353 – Intensive Treatment Services 0 - 6	A353 – Intensive Treatment Services 7 - 12	A353 – Intensive Treatment Services 13 - 17	A353 – Intensive Treatment Services 18 - 25
A355 – Specialized Consultation and Assessment	A355 – Specialized Consultation and Assessment Not provided	A355 – Specialized Consultation and Assessment 0 - 6	A355 – Specialized Consultation and Assessment 7 - 12	A355 – Specialized Consultation and Assessment 13 - 17	A355 – Specialized Consultation and Assessment 18 - 25
A356 – Targeted Prevention	A356 – Targeted Prevention Not provided	A356 – Targeted Prevention 0 - 6	A356 – Targeted Prevention 7 - 12	A356 – Targeted Prevention 13 - 17	A356 – Targeted Prevention 18 - 25
***Key processes only	***Key processes only Not provided	***Key processes only 0 - 6	***Key processes only 7 - 12	***Key processes only 13 - 17	***Key processes only 18 - 25

If key processes only, which ones?

Question Title

* 4. If your organization provides INTENSIVE SERVICES, please indicate what type.

	Provided	Not provided	Not sure
Intensive community-based/day treatment services (e.g., community agency or school environment)	Intensive community-based/day treatment services (e.g., community agency or school environment) Provided	Intensive community-based/day treatment services (e.g., community agency or school environment) Not provided	Intensive community-based/day treatment services (e.g., community agency or school environment) Not sure
Intensive in-home services	Intensive in-home services Provided	Intensive in-home services Not provided	Intensive in-home services Not sure
Intensive out-of-home services (e.g., residential treatment settings)	Intensive out-of-home services (e.g., residential treatment settings) Provided	Intensive out-of-home services (e.g., residential treatment settings) Not provided	Intensive out-of-home services (e.g., residential treatment settings) Not sure

Other (please specify)

Question Title

* 5. Does your organization deliver services to any of these special populations?

	Yes	No	Not sure
Francophone	Francophone Yes	Francophone No	Francophone Not sure
LGTBQ	LGTBQ Yes	LGTBQ No	LGTBQ Not sure
First Nations/Inuit/Métis	First Nations/Inuit/Métis Yes	First Nations/Inuit/Métis No	First Nations/Inuit/Métis Not sure
other ethno-cultural group	other ethno-cultural group Yes	other ethno-cultural group No	other ethno-cultural group Not sure
newcomer children and youth	newcomer children and youth Yes	newcomer children and youth No	newcomer children and youth Not sure
street-involved youth	street-involved youth Yes	street-involved youth No	street-involved youth Not sure

Other (please specify)

Question Title

* 6. Aside from the child and youth mental health services your organization provides, do you provide services in other sectors?

Yes

Not sure

Question Title

* 7. If yes, what other sectors do you provide services in?

Adult mental health

Youth addictions

Youth justice

Child welfare/child and family wellbeing

Community Health

Education

Other (please specify)