3. Development and pilot testing an integrated mental health and substance use Needs-based Planning model: Lessons learned for local planning and model refinements

NBP models that incude both substance use and mental health services are increasingly important given trends towards more integrated service and support systems. Building upon previous work we developed a national integrated NBP model retaining earlier features of a substance use model. The development process included pilot testing in diverse Canadian jurisdictions which presented unique opportunities to assess strengths and challenges in design and implementation of an integrated model.

Model development began with triangulation of a diagnostic-based mental health model, including substance use disorders, and the trans-diagnostic tiered framework underlying the previous substance use model. Following the steps previous used for the national substance use model (see earlier presentations for methodology) we conducted iterative rounds of pilot testing in six diverse jurisdictions. Pilot site stakeholders were significantly engaged in their respective regions. The research team was supplemented with expert health system consultants who assisted in model development and validation.

The iterative pilot testing and input from local stakeholders and health system experts identified several areas for model enhancements. For pilot site participants the inclusion of substance use and mental health in the one model was widely seen as an important advancement, in particular the inclusion of a national 'basket' of core substance use and mental health services.

Close engagement of local stakeholders as well as health system experts familiar with specific regions, ensures an important feedback loop for ongoing model improvement. The national core services framework was viewed as an important step towards identifying service standards and core competencies.