Mental Health and Addictions Strategic Aim
With approximately 20% of Canadians experiencing a mental illness during their lifetime, and the remaining 80% affected by an illness in family members, friends or colleagues, a continuing focus on those with mental health and addiction issues is paramount.
With the overarching goal of Living Healthier at Home - Advancing integrated systems of care to help Central East LHIN residents live healthier at home, the Central East Local Health Integration Network (Central East LHIN) 2016-2019 Integrated Health Service Plan (IHSP 4) will guide, direct and inspire health system change.
Through the engagement process for the LHIN's 2016-2019 Integrated Health Service Plan, patients, caregivers and providers identified where improvements to the health care system are required as the system continues to support people to achieve an optimal level of mental health and live healthier at home by spending 15,000 fewer days in hospital and reducing repeat unscheduled emergency department visits for reasons of mental health or addictions by 13% by 2019.
Who is this Priority Population?
Of particular focus will be those who are the most vulnerable, with the highest personal risk and facing the greatest challenges in obtaining appropriate care:
- persons with concurrent disorders and/or physical disabilities;
- persons with “Dual Diagnosis” or those with a developmental disability and a
- mental health and/or addictions issue;
- persons who identify as LGBTQ (lesbian, gay, bisexual, transgendered, questioning);
- persons who are marginalized and socially isolated;
- seniors with complex medical and social needs;
- persons with addictions, including expectant mothers;
- Indigenous Peoples; and,
- Adolescents, school-aged and transitional aged youth migrating from the youth to adult system.
Building on Key Accomplishments
Integral to achieving the aim and ensuring that residents achieve an optimal level of mental health is the Central East LHIN Mental Health and Addictions Coordinating Council (a skilled, broad-based body of both HSPs and service users) established to oversee the achievement of the MHA strategic aim and provide guidance to the Central East LHIN on overall accomplishment of its IHSP.
The following are a number of mental health and addictions priority projects and investments which have contributed to and will continue to contribute to achieving our Mental Health and Addictions Aim:
Quality Improvement based processes for Assertive Community Treatment Teams (ACTT Together Project) (Implemented)
- supporting a “recovery” philosophy, based on clinical best practices and living healthier at home, a “Step Down” model of care allows people to transition to less intensive treatment and free up capacity for those requiring regular ACTT coverage
- new and innovative models and partnerships between tertiary care and community based Mental Health providers has created a “Hub” model that provides housing and supports required to maintain residency in the community
- the Harm Reduction, Addictions Supportive Housing Model, (ASH) has provided many homeless and/ or precariously housed people across the LHIN with housing and supports tailored to specific need
Mental Health Physician Lead (Implemented)
- establishment of a MHA Physician Lead has supported the implementation of IHSP priorities and engagement of psychiatrists and other physicians throughout Central East Health Link communities and the province
Hospital to Home Initiative (Implemented)
- community teams based in all Schedule 1 Hospitals, provide a range of services (e.g., case man-agement, including dedicated resources for Community Treatment Order (CTO) program, and crisis placement) resulting in significant reductions in “unscheduled return visits” for MHA patients
Peer-led Services (Implemented)
- integration of peer-led services in both the Durham and North East Clusters has directed more resources to front-line services and established a strong peer support network across the LHIN, including increasing the availability of peer and vocational support services
- Peer Support Hub was established in West Durham providing an integrated access point to services and supports
Community Crisis Services (In development)
- provides recommendations for more integrated and consistent community crisis response system across the LHIN, producing viable alternatives to Emergency Department visits, including Mobile Crisis Service Teams
Health Links and Coordinated Care Plans (CCPs) (In development)
- people with complex MHA issues has been identified as one of the priority populations for Health Links, and as such MHA organizations are active in all Health Link networks and initiating CCPs
Provincial Bed Registry (In development)
- building on the Central East LHIN Schedule 1 Bed Registry established in 2011/12,
- the new Provincial Registry will incorporate both adult and child psychiatric beds into one common registry with common protocols that include repatriation between LHINs and timely discharge to home communities
Psychogeriatric Services (In development)
- GAIN and Behavioural Supports Ontario (BSO) are actively engaged with psychogeriatric community teams to plan a more seamless assessment and integrated care process for frail seniors living with behaviours and psychiatric conditions
- focused on ensuring that more people with dementia and other psychogeriatric issues are able to remain in their homes and communities of choice for a longer period of time
Suicide Strategy (Future development)
- using available data, the Coordinating Council will develop a strategy to address the issue of suicide within the parameters of incidence and best practice across the entire health care system
- targets will be developed to reduce the suicide rate within the LHIN and to ensure that people receive the supports they require in order to avoid this outcome
An integrated system of care that focuses on coordination of community resources is more likely to provide the immediate care and “lasting recoveries” needed by those with mental health and addictions issues. The Central East LHIN Mental Health and Addictions Coordinating Council in its oversight role will oversee the development and execution of a strategic plan to guide the achievement of the strategic aim. As well, with quality improvement in mind, the Council will make recommendations to the LHIN regarding ongoing adjustments and the incorporation of evidence-based solutions that support integrations to achieve the MHA Aim.
By building on the gains realized in IHSP 3, including building new cross-sector partnerships, the system will continue to improve on meeting the needs of people with mental health and addictions issues through a holistic perspective. Quality and choice remain fundamental to providing the best and most appropriate supports, allowing for a life rooted in preference rather than one imposed.
To track the system's ongoing progress against this Strategic Aim, please visit the Central East LHIN Performance page.
For more information on these accomplishments, please contact the LHIN at firstname.lastname@example.org or any LHIN-funded Health Service Provider.