Aleksandra Larcina, a social worker with the Healthy Families team at CMHA Toronto, explains that the program is collaborative from the start. Once CAST refers a caregiver requiring support to Healthy Families, “we provide an orientation to our program with the client’s CAST case worker present to discuss what Healthy Families can offer.” With the client’s consent, the Healthy Families social worker will join service planning meetings with the CAST case worker and the client. “That way, we can take a collaborative approach around whatever concerns CAST might be identifying and determine how Healthy Families’ services can support those concerns that relate specifically to mental health,” says Aleksandra. 

Aleksandra says that Healthy Families’ overall goal is to support the caregiver’s mental health needs within the context of “overall family functioning, not only to assist during any possible apprehension but to prevent it from happening, if possible.” 

When it comes to child welfare, caregivers must follow CAST directives, however Healthy Families is voluntary. “For individuals who might say, ‘You know what? Perhaps this isn't for me,’ we try to have a discussion around working with us, even for a short period of time, to see what the program might offer them. We really want to meet individuals where they're at, and we know that not everyone is ready to take steps forward in addressing some mental health concerns.” 

Once engaged, caregivers gain access to a wide range of supports including psycho-education, supportive counselling, referrals to community services, and links to other CMHA Toronto programs. 

The families that Aleksandra and the Healthy Families team meet are typically in different stages of crisis. Extending support for about a year, Healthy Families walks alongside the caregiver as they navigate whatever psychosocial and mental health issues they are facing. This can range from “assisting an individual to obtain addiction services, getting a psychiatry referral and having an assessment completed, or looking at other determinants of mental health like employment, social programming, or how to build community as a parent,” Aleksandra says.  

Aleksandra emphasizes that the program is community-based and client-centric. Healthy Families social workers make a point of travelling to the client’s community to meet with clients. “CMHA Toronto really values that community setting. There's no better way for us to assess and support a client than by being able to meet them within their community and within their home, to fully grasp what their day to day looks like,” Aleksandra says.  

For CAST, the partnership with CMHA Toronto is of significant value to bridge the care gap that exists for mental health needs that are related to the cases they are managing. These needs are surging at a time when psychiatric referrals and other community resources are over capacity. 

"One of the large challenges CAST faces is an increase in concerns related to caregivers’ mental health given some of the stressors that we're facing today,” Aleksandra says. “We’re receiving referrals where families are struggling with how to cover housing costs, how to cover basic needs like clothing and food, while also trying to manage their personal goals. Some want to return to work or are struggling with maintaining their employment while also struggling with their mental health. They may have many other challenges, and their children might also be experiencing their own personal struggles as well with either mental or physical health.” 

Aleksandra acknowledges that this work is emotionally taxing for everyone involved. When people are involved with CAST, it can be confusing, painful, and demoralizing. A CAST case worker will have visited the home, spoken with everyone in the family, and often will have conducted a home assessment. The caregiver at the centre of the report often feels “very depleted and like they are not good enough as a caregiver,” says Aleksandra. “The whole process is rather overwhelming, and parents are coming to us feeling vulnerable, already being identified as requiring support through CAST and then with a mental health aspect as well.” 

That’s where Healthy Families can offer a positive, productive environment that builds hope and resilience. “We want to work with that individual and help them identify their strengths. We want to let them know that it's okay to seek help,” Aleksandra adds. 

Aleksandra says that one of the greatest satisfactions in her role occurs when clients feel safe to open up with her. “They start sharing things that they haven't been able to speak to anyone about before. Saying it out loud for the first time can be quite powerful.” 

She shares the story of a caregiver who told her about specific concerns they had about their mental health, which they had long kept to themselves. “Seeing the relief of being able to tell somebody and then being able to continue in that relationship with someone like me who could help identify specific supports in the community” marked a turning point in that person’s life, Aleksandra says. She adds that being able to offer her client that assistance and time, which included accompanying them to their physician’s office, “is one of the reasons why I enjoy community work. If somebody needs additional support to take that first step in the door to somewhere new where they might not feel comfortable, I can be with them and they can take comfort in knowing that they're not alone along that part of the journey. That's a big step for them, and I feel honoured when they say, ‘yeah, come with me. I would really appreciate your support with this.’”