Intensive Case Management Program

Program Description

The Intensive Case Management Program is a high-intensity, longer-term service designed for children and youth with complex mental health and behavioural needs who require coordinated support across multiple providers and sectors. This program supports those with significant mental health needs, including co-occurring challenges, where service involvement is extensive and system navigation is complex.

Program Goals

• To provide high-intensity, coordinated case management for children and youth with complex and multi-sectoral mental health and behavioural needs;
• To lead the development and implementation of comprehensive, integrated service plans with clear, measurable goals and defined roles across providers;
• To improve collaboration and alignment across sectors, including mental health, education, child welfare, justice, and developmental services;
• To monitor service delivery, respond to crises, and adjust supports based on evolving needs and outcomes;
• To coordinate and support access to higher levels of care, including referrals to live-in treatment, and to ensure continuity of involvement during placement and after discharge;
• To promote stability in home, school, and community environments and reduce the risk of service disruption or placement breakdown;
• To strengthen caregiver capacity through engagement, support, and skill-building;
• To ensure timely access to appropriate specialized, community, and natural supports; and
• To support successful transitions to lower-intensity services through thoughtful planning and continuity of care.

Eligibility Criteria

• Children and youth, up to 17 years of age, with complex mental health and behavioural needs, including those with co-occurring challenges;
• Involvement with multiple service providers and/or sectors (e.g., mental health, education, child welfare, justice, developmental services);
• Families/caregivers experiencing significant challenges navigating multiple systems; and
• Situations where there is a high risk of service disruption, placement breakdown, or instability across home, school, or community settings, including those who may require or are being considered for live-in treatment.

Referral and Intake Process

• Accessing our services begins at Central Intake. To facilitate the intake process, we recommend that you complete the online self-referral form, available here.
• If you prefer to complete the self-referral over the telephone, please call us at 1-877-539-0463, and our team will support you.
• Once a referral is received, our team will contact you to schedule an intake appointment, where we will get to know your strengths, needs, and concerns, and complete a standardized screening tool to better understand the level of support required; this process helps determine whether this service is the best fit or if an alternate service may better meet your or your child’s unique needs.