The Work of the Mental Health Commission

1. The Work of the Mental Health Commission Mental Health Commission Service Systems Advisory Committee Steve Lurie April 2010

3. The Problem • 1 in 5 of us will experience a mental health problem this year • About 1/3 of us with problems will actually be able to get some help • Of those people who do get help, up to 50% do not get what they need • Canada is one of the few OECD countries without a mental health strategy

4. The Problem • Jacobs, Bland and colleagues (2008)report that Canada has the lowest rate of mental health spending in the OECD • Billions of dollars are lost in productivity each year due to mental health problems/ mental illness • Access to services and supports is a problem in many provinces and territories

5. The Problem • Access to services and supports for First Nations, Inuit and Metis, immigrants, refugees, racialised communities, children and youth and the elderly is even worse. • People living with mental illness report experiencing stigma and discrimination in health care and the broader community • Too many people with mental health problems end up in the criminal justice system

6. The Solution • Senate Committee (2006) recommended the establishment of a Mental Health Commission to act as a catalyst to for action on mental health across the country • MHC has five jobs: • 1) Develop a mental health strategy • 2) Develop and implement an anti-stigma/ anti-discrimination campaign

7. The Solution • 3) Document best practices in reducing homelessness for people living with mental illness in five communities across the country and encourage additional research • 4) Improve knowledge transfer through the development of a knowledge exchange • 5) Develop a national social movement

8. Progress to date • Board of Directors appointed, staff hired and offices established • Website launched www.mentalhealthcommission.ca • 8 advisory committees have been appointed • National strategy and anti stigma campaigns launched • Homelessness projects starting in five communities • Advisory Committee projects have started • Knowledge exchange launch planned for Fall 2010

9. Service Systems Advisory Committee • Advisory Committee Role • Provide input to Commission priorities- i.e. anti-stigma campaign, knowledge transfer • Help the Commission write the “how to” elements of the service system components of the mental health strategy • Committee process needs to be focused, but transparent and open to stakeholder input

10. Context • Senate Committee report details numerous service delivery system issues including but not limited to: • Areas of federal jurisdiction: immigrants and refugees, corrections, Aboriginal and Inuit funding and service delivery • Provincial systems issues: supportive housing, basket of services, funding, concurrent disorders, peer support, integration, to name a few

11. How we work • Our membership reflects a range of stakeholders and members have content expertise on some of the areas the committee could be looking at, e.g. peer support, diversity, telemedicine, collaborative care, chronic disease management • Project work done by task group/ subcommittee drawn from sectors which are the focus of the project

12. Priority Projects • Review of Peer Support across Canada- Making the case for peer Support • As improving the lives of people living with mental illness, is central to the Commission, this project will examine the range of supports and services that that are directed and provided by people who live with mental illness • will identify range of services, promising practices and cost effectiveness- aligns with choice, community support pillars, will contribute to KEC and issues and options paper

13. Peer Support Review • Project Committee led by consumer leaders from across the country • Will coordinate efforts with similar project in Ontario • Project completed Spring 2010

14. Proposed Year 1 Projects: Diversity • Diversity: Towards an understanding of issues, best practice and options for service development to meet the needs of ethno-cultural groups, immigrants, refugees and racialized groups- review progress or lack of it on meeting the mental health needs of immigrants and refugees and racialized groups since the publication of After the Door Has Been Opened (1988) and the mental health implications of the 2006 census. Aligns with Commission pillars of choice and community support systems and will also contribute to KEC, anti stigma, and provides a foundation for the national strategy and Commission work in a number of areas.

15. Year 1 Priority Project Proposals • Supportive Housing readiness survey: Turning the Key- survey the readiness of regional and local systems across the country to develop supportive housing units over the next 10-15 years. Review will include an assessment of housing options required, financing options, services and supports that need to be available- Aligns with Commission pillars: Choice, Community Support Systems, will also contribute to KEC and anti stigma campaign. We believe this project is a critical issue for the National Mental Health Strategy.

16. Other Projects- years 2-3 • primary health care and mental health: prevention, shared care and chronic disease management. • Aligns with Commission pillar of integration- will contribute to KEC

17. Primary Health Care and Mental Health: Some facts • 40 % prevalence of mental health problems in primary care settings • 40% of people living with mental illness only receive care from a GP • 72% of people with a psychiatric disorder receive no treatment in the course of a year; 81% of these individuals will visit a family physician • Collaborative primary and mental health care is evolving- in Hamilton 68% of the population is covered under a family health team scheme involving 80 physician practices

18. Primary Health Care and Mental Health • The Canadian Collaborative Mental Health Initiative, funded through the Primary Care Transition Fund has developed tool kits, policy documents, a charter and research which are available to the Commission, as well as a website www.CCMHI.ca • CCMHI is now doing provincial consultations and finding high degrees of interest from RHAs, provincial governments, and other stakeholders and is willing to collaborate with the Commission • This is a strategic issue for the national mental health strategy

19. Other issues for the National Mental Health Strategy • Issues that need work for the national strategy: • Concurrent Disorders: The Commission needs to ensure that work is done on concurrent disorders as part of the national strategy, given the large numbers of people with concurrent disorders who are ill served by both the mental health and addictions systems due to the lack of integrated treatment and community supports. People with concurrent disorders are also over represented in correctional services and do not get adequate treatment .

20. Other Strategic Issues • health human resource planning ( training, recruitment, retention), • mental health system quality assurance • FAS (work with First Nations, Inuit and Metis Committee and NADD • Supported employment • How to achieve integration- what actually works • Work over the next two years will be influenced by results of current projects, and issues MHC selects to build the how to for the national mental health strategy • A number of issues will require collaboration with other Commission advisory committees i.e. dual diagnosis, supported employment, workforce planning, diversity, MH and corrections.