Request for Proposal for the for the Halton Dual Diagnosis Action Table

Full Time contract

Hours: To be determined

Salary: To be determined

Requests for Proposals for the Halton Dual Diagnosis Action Table


Executive Summary

The term “dual diagnosis” is used inconsistently in different jurisdictions around the world. The Ontario Centre of Excellence for Child and Youth Mental Health defines dual diagnosis as “the co-existence of both developmental disabilities and mental health problems in the same individual”. Considering that this definition is generally accepted in Ontario, and in most places in Canada, the Dual Diagnosis Action Table has applied this definition, replacing the word problems with challenges, to conceptualize the complex interplay between developmental disability and mental health problems in Halton Region.

The Our Kids Network, Halton Intervention and Prevention Committee and Community Partners Committee have identified a gap in services needed to support children and youth with a dual diagnosis.

The memberships of The Our Kids Network and Halton Intervention and Prevention committee include the services supporting children and youth 6- 18 years with a developmental disability and/ or mental health challenge. The Community Partners Committee include agencies supporting children birth to 6 with a developmental disability and/ or mental health challenge.

A dual diagnosis-working group was created to address this gap. In 2017, Halton Region and the Halton Regional Police Service introduced a Halton Community Safety and Well-Being Plan. The Plan sets out how Halton Region and Police Services work with community partners to improve the safety, health and well-being of Halton residents. The Dual Diagnosis working group presented to the steering committee of the Halton Community Safety and Well Being Plan and as a result became an action table under the Halton Community Safety and Well-Being Plan.

The action table submitted a proposal to the Halton Community Investment Fund for funding to hire a consultant to assist with the development of a framework inclusive of a knowledge mobilization plan. The committee received funding for one year.

In Halton the expertise to diagnose a child with a dual diagnosis is limited to a very few psychiatrists. Consultation services for professionals and or caregivers do not exist at this time. Dual diagnosis assessment and treatment services for children living in Halton are out of Region and may involve separation of the child and family/supports, high costs and long waitlists. When a child returns home with a treatment plan, Halton service providers do not have the skills and resources to implement the plan. Some children are prevented from coming back to Halton as agencies are not equipped to manage the complexity of needs. Central West Specialized Developmental Services provides adult dual diagnosis services to the 18 plus population and have long waiting lists of individuals who have turned 18.

It is estimated that approximately 11% of the general population have a developmental disability. Large-scale studies indicate that people with developmental disabilities are three to six times more likely to develop a mental health challenge than other people. It is estimated that 30-50% of children and youth with a developmental disability also have a mental health challenge. Research suggests that 30%-70% of children and youth with Autism present with co- morbid mental health challenges. Both mental health challenges and medical conditions in the population of children and youth with a developmental disability are seldom communicated, diagnosed or treated. ‘Diagnostic overshadowing’ is used to describe the situation in which an individual’s symptoms are viewed solely as part of either mental health challenges or developmental disability but the co-occurring nature of the condition is neglected.

There has been a steady increase of children with complex needs, dual diagnosis or suspected dual diagnosis presented at the Halton Connections table and a steady increase of children referred to and receiving complex special needs funding due to complexities of their profile. In Halton, school systems are reporting more and more that they are unable to provide the necessary supports for children/youth with complex needs, resulting in: increased suspension, withdrawal or isolation from class peers and learning. Families are reporting that they are unable to care for the complex needs of their children/youth, resulting in 911 calls, emergency visits, hospitalizations, high levels of respite, requesting out of home placements. Mental Health Practitioners and hospitals report feeling perplexed as to how to support children/youth with developmental disabilities, resulting in inaccurate diagnoses, over-medicating and inaccurate treatment. It is well understood that there is a clear and present need for a multidisciplinary approach to assessment and care incorporating a family- centered, collaborative approach that permits diagnostic information from multiple sources and allows clinicians to develop a comprehensive plan together.

The objectives of the Action Table are to:

  • Develop a collaborative, multi-service, multi-sector Halton framework in order to support children and youth with a dual diagnosis and their families.
  • Increase local service capacity to holistically meet the needs of Halton children and youth with a dual diagnosis by building knowledge and skills.
  • Halton service providers will have the education, experience and local expertise to support children and youth who have a dual diagnosis or a complex presentation due to the interface between medical/physical, developmental and mental health challenges, reducing the number of individuals needing to be referred or served out-of-Region.

Project Description / Overview

    1. Complete a broad review of existing dual diagnosis service models and frameworks.
    2. Complete a current state community service needs analysis, across multiple sectors; health, justice, education, mental health and developmental services. This would include a comparison of existing expertise of services in Halton that work with individuals under 18 with a dual diagnosis (includes assessment, intervention, and therapy) with Individual/Family service needs, identifying local gaps in the service continuum.
    3. Through the amalgamation and comparison of data from above, a framework for Halton will be created.
    4. Development of a knowledge mobilization plan to build capacity in service agencies to provide identification of, intervention and therapy for children with a dual diagnosis.


Project Deliverables / Output

  1. Prepare a report and presentation to be presented to the Dual Diagnosis Action Table and Halton Community Safety and Well Being Steering Committee that identifies the key components of the Halton Framework/Model.
  2. Upon approval, prepare briefing notes regarding Framework to present to:Our Kids Network

    Halton Intervention and Prevention Committee

    Community Partners Committee

  3. A proposed Knowledge Mobilization Plan inclusive of a level one training event for knowledge mobilization. Identification of trainers with expertise in Dual Diagnosis. A recommendation of existing training materials (videos, webinars, etc.)Training event will be set up for a level one training/introduction to dual diagnosis for community agencies and services


Reporting structure

  • Related to Grant and Human Resources -Report to:

Alfred Barretto, Service Resolution/Solutions Facilitator – Halton Region, Central  West Specialized Developmental Services

  • Related to Project Deliverables and Output- Report to:

Halton Dual Diagnosis Action Table selected members, chaired by Roxanne

Young, Manager Children’s Developmental Services, Region of Halton


Project timeline:

Sept 15, 2020 to May 31, 2021 (8 months)

Evaluation Criteria

The Evaluation Committee will rank the Proposals based on the following criteria, that are not necessarily in order of importance:


Criteria: Weighting Factor/100

  1. Demonstrated ability to provide services/product 45%:
  • Demonstrated qualifications and experience of project team members 15 %
  • Demonstrated quality of product/service 15%
  • Demonstrated experiences in similar projects 15%
  1. Demonstrated approach and methodology 35%
  2. Cost Effectiveness 20%

Contact information:

Written proposal submissions will be reviewed by a panel representing the Dual Diagnosis Action Table. A virtual presentation will made to the Dual Diagnosis Action Table by the top 2 candidates.


Submission Contact Information and Deadline Date:

Due by: September 15, 2020

Submitted to: Alfred Barretto

Service Resolution/Solutions Facilitator – Halton Region

Central West Specialized Developmental Services

53 Bond Street, Oakville ON L6K 1L8

P: 905-844-7864 ext. 326

C: 289-681-7869

F: 905-849-6980