Mental Health Director Impacts Quality of Life at SAI

By Nicole Linzmeyer, SARC Communications Officer

Haley Ralko, a registered psychiatric nurse, began working at SAI over a year and a half ago as SAI recognized that they serve many individuals with dual diagnosis and thought that they could really benefit from this position.

“Throughout the last ten years, the people that SAI serves has really changed; there has become more complex needs and more dual diagnoses. There has been the recognition that people suffering from mental health or addictions are falling through between the gaps,” Haley said. “If somebody has already connected with CLSD a lot of time they have difficulty obtaining additional support within mental health or addictions because their needs are usually unique compared to the majority of other users of these services.”

Since starting her role, Haley has seen a lot of success providing supports in a number of ways, including acting as a liaison between individuals and services, providing medication management education and focusing on reducing medication through support plans, as well as providing education for staff and clients in a variety of areas. “At first it was sitting back and seeing where I could jump in,” said Haley. “We had a couple of folks that had been in crisis several times in the past couple of years. When I spoke with their coordinators, it was the lack of services and difficulty connecting them with services that was missing for those individuals. So, I started liaising with their psychiatrist and their team in order to get that continuity of care.  I also work with CLSD clients, if they find someone is who unable to connect with services, or they are a little bit transient, I can be a lot more flexible to run over and meet someone when it is convenient for them, instead of waiting to meet a nurse from health, where it is usually scheduled and routine.”

Haley has also started focusing on medication assistance for individuals, and how it can be managed more effectively through training support staff to monitor and assist with medications safely, using the proper techniques. “I’ve been focusing on the staff having an understanding of the medications their folks are taking to reduce the number of medication errors,” said Haley. “We have also been able to do medication reduction for folks, because we are able to put more into their care plan based on my assessments and suggestions. By offering a supportive environment and having our employees well-trained and informed about mental health and their concurrent diagnosis, we are able to equip them well enough so that we don’t have to medicate in order to curb behaviours. We are able to do that with relationships and support plans that work.”

Education is also a very important part of Haley’s role for prevention.  She holds a variety of sessions and training for support staff, clients and health region staff.  She has worked with other organizations to educate staff on mental health diagnoses and get into the specifics of the individuals that they serve, what kind of medications they are on and how that affects their moods, and what kind of side effects they should be watching for.  She also offers group sessions to clients, which have included a health living series on the importance of sleep as well as a sexual health group called “Tell it like it is” where individuals learn about relationships, communication styles, gender identity, sexual health and more. Haley has also provided presentations to health staff on how to work with people experiencing intellectual or physical disabilities, how to connect them with community and why it is important.

“Person-centredness is the first thing I look at when I sit down to chat with anyone about the individual that is being referred my way,” Haley said. “A lot of times I don’t even jump to the diagnosis at first. I just get a picture of what this person likes to do and how much of that we are including in their world right now.  A couple of the folks that I’ve been involved with, it’s been enough as tweaking their regular routine and offering a little bit more predictability. That might not have been an avenue that was looked at at the time – that this predictability would help with this anxiety symptom, for example,” she said. 

The impact that Haley’s supports have on an individual’s quality of life is very significant. “One of the gentlemen that I first started working with was very commonly presenting to the emergency room, usually on a weekly basis.  So I worked quite extensively with him and his team,” said Haley. “We developed support plans, did some medication management, and got more involved with his psychiatrist.  He went from about 5-10 emergency room visits a month to one in the last year.  Which is great, the quality of life for this gentleman has just gone up because he is so content with his life, he doesn’t feel like he needs to be at the ER constantly. Another gentleman that I have been working with has been very up and down.  He had to move homes around every two years because his neighbours would get upset, or the police would get called too many times. He had the tendency to be quite aggressive and had difficulty holding a team around him. He has recently stabilized and is more able to get through tough situations.  That was achieved through working with his team and focusing on what his needs and wants are. His aggressive incidents have gone down significantly They are small successes but they make the difference for the individuals that we serve.”

It is evident that Haley’s role not only has numerous benefits for individuals by providing them with a higher quality of life through education, connecting them to services, and incorporating person-centredness into support plans, but it also provides cost benefits to the Health Region and CLSD as well. “They say that an ER visit costs about $800, so if we’re stopping someone from going there 10 times a month, that’s a huge cost benefit,” said Haley.  

Thanks to Haley for sharing information about your role with us! As we look at growth of the disability services sector over the last 50 years, creating capacity for mental health supports is a relatively new area for many organizations. It is great to see that organizations like SAI and others are looking into how to better address individual needs and improve their quality of life through providing more of these types of supports!


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