National GAR Case Management – Client Support Services 

Location:  Greater Toronto Area, ON

Quick Facts

• Audience: Settlement, social, and health service providers
• Population of Interest: Government assisted refugees
• The Need:  Exploring the impact of an intensive case management framework for high needs GAR clients. Prior to the CSS program, there was not a standardized model that combined case management with other holistic methods to support GAR settlement in Canada, or a formal network for settlement agencies to share information and best practices.
• What's Promising:  The CSS program is unique in its flexible, client-centered approach to supporting GARs.
• Key Takeaway:  1) Working collectively is a benefit to everyone involved in the refugee resettlement sector; 2) A standardized national approach also allows our national coordination team to target common issues with training, research and consultation to come up with creative solutions.

National GAR Case Management – Client Support Services (CSS) is a national program providing specialized settlement services to meet the complex needs of government assisted refugees (GARs) in their first 12-24 months of resettlement in Canada. Program partners are 16 organizations in provinces across the country.

CSS was developed by the YMCA of Greater Toronto in 2005 as a pilot project in partnership with COSTI Immigration services in Toronto and 70 GAR clients with complex needs, with a goal of exploring the impact of an intensive case management framework for high needs clients. The pilot found that using a case management framework that includes continual reassessment of needs, a focus on holistic community development to increase knowledge, and working in a mobile and desk-free environment significantly improved clients’ ability to achieve short- and long-term goals. Following the pilot, funding was expanded to a regional program and, in 2017, a national program.

The CSS program is unique in its flexible, client-centered approach to supporting GARs. Prior to the CSS program pilot, there was not a standardized model that combined case management with other holistic methods to support GAR settlement in Canada, or a formal network for settlement agencies to share information and best practices. As a nationwide program with a coordination team and standardized database and needs assessment, we have a unique ability to track and report on GAR needs and gaps in settlement services. Our network of service providers connects regularly through working group meetings, management best practice information sharing, professional development trainings and annual meetings. These connections result in better service provision, and creative solutions to common issues in serving GARs.

CSS’s holistic model is based around three key components:

• Intensive Case Management: providing GARs with client centered assessments, planning and support in a flexible, mobile environment, connecting them to supports within the community in their first 12-24 months post arrival.
• Community Capacity Building: working to strengthen community understanding of GAR needs and barriers, and aiming to increase ability to provide culturally sensitive services.
• Coordinated Approach: The YMCA of Greater Toronto coordinates the CSS program nationwide, and engage GAR serving agencies through community of practice model, providing database development and support, program evaluation, reporting and development.

Supporting the mental health of refugees

There is broad data within the social service sector that speaks to the positive mental health impacts of client centered models on service consumers: greater independence, higher client satisfaction, and ultimately, better outcomes for settlement and increased belonging within settlement community. Our model allows for flexibility between different communities and organizational models, giving service providers the opportunity to use CSS framework in a way that fits with their clients, communities and regional realities.

Another way that the CSS program seeks to address refugee mental health needs is by empowering and training service providers to improve collective knowledge. These trainings are funded through our CSS coordination team budget from IRCC, and are free for network members. Some examples of recent and upcoming trainings include Trauma-Centered Crisis Intervention, ASSIST, Gender Based Violence, Client Caseworker Boundaries and Anti-Oppression / Anti-Racism.

Finally, the Community Capacity Building aspect of our program allows for diverse connections within partner agency communities that help service providers of all types better understand refugee needs, including mental health care providers. Through initiatives like collaboration with community-based service providers to meet client needs, organizational advocacy through policy and structural changes, and other related practices, we’ve found we’re better able to support clients in getting the best care possible. Increased knowledge of the unique intersection between refugee status and various health needs allows (mental) healthcare providers to better serve this community, and account for their needs in staff training and broader organizational development.

Transitioning service provision due to COVID-19

Since our sites are located across the country in areas with varying COVID risk levels, there have been a broad range of changes made to provide safe, effective services to clients. Sites are taking innovative steps to support both clients and staff in staying healthy, including initiatives like:

Developing partnerships with regional hospitals to conduct weekly voluntary COVID testing for RAP clients and agency employees, and support clients in receiving fast-tracked mental health services with culturally sensitive service models.
Conduct interdisciplinary case management team meetings (CSS, refugee clinic, mental health) to discuss complex cases and better delegate work to parties with the training to best support clients.
Hiring a wellness advocate to support both clients and staff in meeting their health needs through internal practices and community resources.
Implement a staff debriefing initiative to support staff in reflecting on high stress or complex cases.
All sites in our network have transitioned to either a fully virtual, or hybrid model of service delivery in response to the COVID-19 pandemic. We’ve also seen an increase in the mental health and compassion fatigue support for front staff, as the impacts of this work grow and the ability to separate work and home life becomes less clear. Practices like bolstered wellness programs, increased workplace flexibility and targeted professional development opportunities have been implemented by leadership staff to support their teams.

Key takeaways

Above all, working collectively is a benefit to everyone involved in the refugee resettlement sector. Working with different organizations across the country allows us to see this in action. People in our network are dealing with different realities based on their location and funding, but we experience many of the same issues.

A standardized national approach also allows our national coordination team to target these common issues with training, research and consultation to come up with creative solutions. Ultimately, we have an opportunity to work behind the scenes and come up with broader practical changes that are preventative to certain issues re-arising, which is impossible to complete internally in many of our partner sites due to size and funding. I would encourage other service providers to make building connections within their field a priority, and use them to support you in making both small- and large-scale changes to how you serve your clients, staff and community.