Pre-budget Consultations 2014 – Canadian Alliance on Mental Illness and Mental Health
The Canadian Alliance on Mental Illness and Mental Health (CAMIMH) is a non-profit organization comprised of 18 national health care providers as well as organizations which represent individuals with lived experience of mental illness. Established in 1998, CAMIMH provides collaborative national leadership to assure individuals living with mental illness receive the services and supports they require for recovery. CAMIMH also advocates for government policies aimed at reducing the burden of mental illness on the Canadian population and economy.
CAMIMH appreciates the opportunity to provide the following recommendations for improving mental health services, supports and resources for Canadians.
ACCELERATING THE ADOPTION OF INNOVATION IN MENTAL HEALTH PROGRAMS & SERVICES
“Increase resources and capacity for a range of community mental health services that serve people of all ages”. Recommendation 3.1.1 Changing Directions, Changing Lives: The Mental Health Strategy for Canada.
While we know there are a many pockets of excellence when it comes to providing Canadians with access to leading-edge, innovative mental health services and programs, the reality is that there is a lack of national coordination and resourcing to ensure that they are spread across the health system effectively.
While the term “innovation” is an often cited solution to many of the challenges facing the health system, CAMIMH understands that we need to identify and implement more cost-effective ways to provide mental health care programs, resources and services to Canadians.
In this context, CAMIMH was pleased to see that the Federal Minister of Health created an Innovation Panel to examine the state of innovation in Canada. CAMIMH agrees that it is time to get innovative and looks forward to contributing a number of creative evidence-based ideas and approaches in the area of mental health.
We know that mental illness costs the Canadian economy more than $51 billion per year. Adopting proven innovations on a country-wide basis is crucial to alleviating some of this economic burden and will serve to improve the overall mental health of Canadians, while offering improved support and resources to all.
While the delivery of health care services is largely a provincial and territorial responsibility, CAMIMH knows there is a catalytic role the federal government can play when it comes to accelerating the adoption of proven innovations in mental health.
CAMIMH is of the view that the federal government can build on the foundation of the work of the Mental Health Commission of Canada by creating a strategically-targeted, time-limited Mental Health Innovation Fund (the Fund). This fund would support the identification of and spread of evidence-based mental health programs, resources and services that we know are effective at the community level.
CAMIMH recognizes that while there are a many innovative programs and services in mental health (i.e., pockets of excellence), the Fund would provide the resources needed to advance the broader sharing and uptake of innovations that improve patient access, quality of care, supports and health outcomes. The fund would allow the translation of these best practices into action through a collaborative, coordinated centralized knowledge-exchange approach.
The Fund would also fulfill an important component of the Mental Health Strategy of Canada including Strategic Direction 3 on access to services and Strategic Direction 6 on leadership and collaboration. “Encourage broadly based coalitions in the non-government sector to help mobilize leadership and build shared approaches to complex issues”. Recommendation 6.1.3 Changing Directions, Changing Lives: The Mental Health Strategy for Canada.
The Fund would provide the means by which the mental health community and health care providers and organizations could facilitate the coordination and sharing of best practices, moving these to availability across the country, leading to increased health care options and more cost efficient and expanded services nationally.
Recommendation #1: Establish a Five-Year $50 million Mental Health Innovation Fund with a clear mandate to encourage the dissemination and implementation of best and promising practices of services, supports and resources to improve health outcomes, and establish and report on performance indicators.
This fund will promote best practices on a pan-Canadian basis for the advancement of mental health and for the proliferation of treatments and innovative approaches that work effectively to reduce the economic, social, and human cost of mental illness. It would also work towards the establishment of pan-Canadian mental health indicators and objectives that are currently lacking.
As it stands, there are no agreed upon performance indicators that provide Canadians with a clear picture of how mental health systems are performing. Currently, when it comes to tracking publicly-funded mental health expenditures we only have data focused on acute care hospitals. While useful, this provides us with a limited picture
as to how the mental health system is performing. As we know, a significant proportion of mental health programs and services are provided within communities.
CAMIMH believes the Mental Health Commission of Canada is best suited and should be the administrator of the fund, and that the MHCC would work in collaboration with CAMIMH, its national member organizations, all levels of Government, and other stakeholders as identified.
ESTABLISHING CLEAR PAN-CANADIAN MENTAL HEALTH INDICATORS
THE MEASUREMENT, PERFORMANCE & EVALUATION OF MENTAL HEALTH SYSTEMS
As the saying goes, you cannot manage what is not measured. In the area of mental health, we need a set of system performance indicators to effectively assess the performance of Canada’s mental health services and systems.
At present there are no agreed upon mental health indicators that provide a clear picture of how Canadian mental health systems are performing. Currently, when it comes to tracking publicly-funded mental health expenditures most available data focuses on acute care hospitals and not community programs. Additionally, there is little available information in terms of the quality of services and systems. The measurement of service and system performance requires the development and reporting of performance in the quality domains of access to services, appropriateness of services received and, most importantly, the outcomes of services.
Once performance indicators are developed and reported, this evaluation capability will become the basis and driver of significant improvements in services and systems and the foundation for mental health system transformation in the territories and provinces,.
While we are pleased to see that important work has been initiated in the area of mental health indicators and expenditures by the Mental Health Commission, the Public Health Agency of Canada and the Canadian Institute of Health Information, work on mental health performance indicators needs to be advanced as a national priority, CAMIMH is of the view that the federal government, working in close partnership with the provinces and territories, can play a groundbreaking role in terms of developing this national mental health performance reporting and quality improvement initiative
CAMIMH recommends that the government of Canada supports the acceleration of the development, and ultimately, the adoption of a common set of mental health performance indicators.
WORKPLACE HEALTH & PRODUCTIVITY
Canadians spend more waking hours in the workplace than anywhere else. $20 billion is the estimated total economic burden associated with mental illness linked with workplace losses, according to the Mental Health Commission of Canada.
As one of the country’s largest employers, CAMIMH believes the federal government can play a significant leadership role in advancing workplace health, and has an important opportunity to build on its recent announcement of a doubling of coverage for psychological services for federal employees, which CAMIMH advocated for and celebrated.
More specifically, the federal government can be a positive example to other employers by adopting the National Standard for Psychological Health and Safety in the Workplace (the Standard) developed by the Mental Health Commission of Canada (MHCC). In our view, the standard can play an important role in improving overall workplace health while increasing productivity.
While the Standard is currently being piloted by a number of public and private organizations under the auspices of the MHCC, our hope is that it be more widely adopted by public and private sector employers across the country. As the country’s biggest employer, the federal government should lead the way.
Recommendation #3: Implement the Standard in a federal department
That the federal government implements the Standard in a federal department, with a view to widespread adoption across the civil service. This would demonstrate leadership for all Canadian employers that the Standard is an important tool at their disposal for the advancement of the mental health of their respective workplaces and for the good of the bottom line as well
The federal government is one of the biggest direct providers of health care in the country, being directly responsible for many populations such as First Nations, Canadian Forces, RCMP, Veterans, Corrections, and others.
Building on the recent and highly positive announcement that federal employees would see psychological service coverage doubled from $1,000 to $2,000 per year, CAMIMH recommends that the federal government continues to lead by example by improving its own capacity to deliver services in areas for which it has direct responsibility.
It is CAMIMH’s view that the implementation of a more robust mental health strategy for populations for which the federal government is directly responsible is equally consistent with reducing the economic and health burden which the federal government eventually bears when investment in mental health services is inadequate.
The work identified in the Mental Health Innovation Fund, would support the federal government’s role in this area through making available proven services and programs.
Recommendation #4: Establish and implement a mental health strategy to provide better services to the populations for which the federal government has direct responsibility.
Recognizing that the populations for which the federal government is responsible face unique mental health challenges and that services currently provided are inadequate, the government has an opportunity to lead by example by providing a more robust set of mental health services to these groups, and can help demonstrate that in the long run enhanced investment in mental health pays fiscal and economic as well as social and human dividends.
MENTAL HEALTH COMMISSION OF CANADA
In 2007, the Government of Canada invested $130 million to establish the Mental Health Commission of Canada (MHCC) to act as a catalyst for improving the mental health system and changing the attitudes and behaviours of Canadians regarding mental health issues. The MHCC is funded by Health Canada and has a 10-year mandate (2007-2017). CAMIMH had advocated for the creation of the MHCC, has steadfastly congratulated the Federal Government on implementing the MHCC, and has worked tirelessly in support of the work and mandate of the MHCC. Prior to the creation of the MHCC, Canada was the only G8 country not to have a mental health strategy. The MHCC launched Canada’s first mental health strategy, Changing Direction, Changing Lives: The Mental Health Strategy for Canada, in May 2012, has established the Knowledge Exchange Centre, and has lead the Opening Minds initiative, the largest ever mental health stigma reduction effort. The MHCC also led the At Home/Chez Soi projects to examine how best to help people who are homeless and living with a mental illness.
The Mental Health Commission role and work is of utmost importance to the advancement of mental health in Canada. There is far too much work in mental health which needs to be accomplished not to have this centralized facilitator of collaborative approaches to change.
CAMIMH strongly advocates for the extension of this mandate. The MHCC acts as a catalyst for change and improvement and we firmly believe Canadians and the mental health community requires the ongoing presence of the MHCC.
Recommendation #5: Mandate Extension for the Mental Health Commission of Canada
CAMIMH recommends the Government of Canada provides an extension of the term for the Mental Health Commission of Canada with a revised mandate to build upon the progress and accomplishments made thus far. Term and mandate to be identified by the Government of Canada.
Dave Gallson/ John Higenbottam
CAMIM H Co-Chairs 2014
141 Laurier Avenue West, Suite 702,
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