A joint submission to the Ministry of Health and Long-term Care from the Canadian Mental Health Association, Ontario and Canadian Pensioners Concerned based upon the feedback of two forums on mental health issues facing older adults in Ontario. (May, 2012)
In the Fall of 2011, Canadian Pensioners Concerned, Ontario Division (CPC, Ontario) and the Canadian Mental Health Association, Ontario Division (CMHA Ontario) partnered together to pursue two common goals. The first goal is to raise awareness of the incidence and impacts of mental health and addiction issues in Ontario’s for our older adult population. The second, an equally important goal, is to advocate for improving services and supports to meet the many underserviced needs that exist in communities across the Province.
To determine an action plan to meet these goals the two organizations decided to hold a two-part, invitational forum to advise them on how to proceed. A broad and diverse range of service providers, researchers, funders, decision makers, seniors’ organizations, media, clergy members, and law enforcement personnel were invited to help CPC, Ontario and CMHA Ontario to look for practical and meaningful solutions to addressing the mental health and addiction service needs of older adults. A secondary objective of the forum was to capture the interest and support of the attendees to further strengthen the coalition for action on seniors’ mental health and addictions.
The first of the two forums (held Feb 16, 2012) was entitled “Making the Case”. One goal of this forum was to ensure a common base of understanding of seniors’ mental health issues by briefing attendees on current issues concerning service delivery and policy initiatives at the national, provincial and local levels; answering questions about the nature of the issues and the work to be done; and setting the stage for action steps to be recommended at the second forum to be held March 29, 2012.
Presentations were made by four panelists representing the perspectives of a local service provider, a faith leader who seeks out services for congregants, and seniors’ mental health and addiction experts at the national and provincial level.
Highlights of the February 16, 2012 Forum:
The first forum was held at Oakham House in downtown Toronto. The attendees are listed in Appendix 1. The highlights of the key points made by the presenters appear below.
Local Service Provider:
Presenter: Debra Walko – LOFT Community Services
Community Services Are At Their Best When They…
- Decrease length of or necessity of hospital and ALC stays
- Reduce use of emergency departments
- Demonstrate that “high risk” seniors can remain in the community with the appropriate supports
- Enhance the community where the programs are located.
- Improve access for seniors to existing community and clinical services through system navigation and psychosocial support
- Improve coordination among various community support agencies, who deliver services to this high risk senior population
- Increase stability in housing as well as other social determinants of health.
- Keep seniors at home in the community while embracing their individuality and diversity.
Presenter: Rabbi David Seed – Adath Israel Congregation, Toronto
- Recognize that faith leaders are often the first point of contact and can be key to helping deliver services to senior populations
- Bring together clergy across all faiths for education about Seniors and Mental Health + Addictions; Domestic Violence; Grief/Bereavement; Help With More Effective Access To Services
Mental Health Expert: MHCC Seniors’ Mental Health Committee
Presenter: Dr. Marie-France Tourigny-Rivard
- Those planning a comprehensive integrated mental health system must understand the diversity amongst seniors, must understand the local context and resources, and must consider the need to modify existing practices and relationships to achieve a transformed system.
- Policies, program and services that affect seniors should be assessed with the Seniors Mental Health Policy Lens.
- Mental health promotion should be embedded in all policies, programs, and services for all older adults (including those with mental illness) and their caregivers, and encompass anti stigma strategies, public awareness, education, and training
- A transformed mental health system supports caregivers and provides information to the public and service providers about the journey towards recovery and well-being for older adults living with mental illnesses.
- The specific components of an integrated mental health service system for older adults may vary according to local context and resources, but all service systems should provide access to the following range of services for the entire senior population:
- Community-based support services
- Primary care services
- General (adult) mental health services
- Specialized geriatric mental health services
- There should be clear mechanisms in place to facilitate collaboration and access between services
- Benchmarks should be used to review existing services and staffing levels and guide future allocation and deployment of resources.
- To facilitate a comprehensive mental health system, cultural safety and diversity must be embedded in structures, programs, policies and services.
- Caregivers must be considered active partners in the journey towards recovery and well-being, and their roles must be supported and valued in programs, policies, and services.
- Transformation of a mental health service system must include training, education and support for caregivers and health care providers to increase their capacity to respond to the mental health needs of seniors
Mental Health Expert: Provincial Advisor on Seniors’ Mental Health and Addictions:
Presenter: Dr. Ken LeClair
- Need to work against “Triple Jeopardy”: Ageism + Mental Illness + Addiction
- Go where the door is ajar rather than closed…take advantage of current policy and project opportunities
- Need to focus on self-care and prevention
- Need for collaborative care, shared expertise – including patient’s or family’s lived experience
- Use the “Improvement Model” – Small rapid improvements that can be tested and inform the next step
Highlights of the March 29, 2012 Forum:
The second forum held March 29, 2012, was entitled, “Towards the Answers”. The goal of this forum was to gather the advice of participants which would help CPC, Ontario and CMHA Ontario to move from recognizing and raising awareness of problems with the seniors’ mental health and addictions ‘system’ to action plans to devise a strategy and find solutions.
Participants were informed that following the second forum, CPC, Ontario and CMHA Ontario would consolidate the advice and circulate the results widely to solicit interest and build a stronger and more active coalition for change and that a summary of recommendations and advice would be shared with appropriate Ministries.
Recommendations Made By Forum Participants:
- The proposed Framework for Seniors’ Mental Health and Addictions should be based on the following guiding principles:
- Quality community-based care
- Collaboration across all relevant sectors
- Client-centred approach
- Client and family-caregiver involvement at all stages of planning and implementation
- The proposed Framework for Seniors’ Mental Health and Addictions must:
- Be action oriented
- Focus on achievable and measurable goals and outcomes
- Take advantage of current opportunities presented by government (and other) planning, policy and initiatives – and learn from and link to related initiatives and projects
- Include educational/training opportunities across all relevant sectors including older adults and those who care for and about them
- Support the development of a process of data collection and evaluation particular to the broad range of older adults’ mental health and addiction issues. This should include cost-benefit and cost-saving analyses
- Top priorities for immediate action include:
- Supporting the development of a coalition for action on seniors’ mental health and addictions that will undertake initiatives where feasible at a community level and act as an advisory body to the provincial government as it moves forward with the next phases of the Mental Health Strategy and the development of a Seniors’ Health Strategy.
- Initiating educational and feedback opportunities for non-health, non-social service oriented groups (e.g.- interfaith clergy) so that they may gain necessary information and resources while informing this work.
- Forming liaisons with others working towards common goals including relevant provincial government ministries and departments, the Mental Health Commission of Canada and the Canadian Coalition on Seniors’ Mental Health.
CPC Ontario Division and CMHA Ontario in partnership with other forum participants have undertaken the following action steps:
- Upon circulation of a summary of forum proceedings, meetings will be sought with the Minister of Health and Long-Term Care and with the Assistant Deputy Minister at the Ontario Seniors Secretariat to discuss the need to maintain a mental health and addiction focus within the evolving Seniors Strategy – and a seniors’ focus in the implementation plan of the Government’s Mental Health and Addictions Strategy.
- The summary of forum proceedings will be disseminated to forum participants and broadly circulated to other interested parties.
- As an early action, plans for the development of an educational program on older adults’ mental health and addiction issues for interfaith clergy to be piloted in June in Toronto, with further dissemination in selected areas across the province.
- Discussions be held regarding a proposal to the Canadian Coalition on Seniors’ Mental Health that this evolving group become a provincial affiliate – the Ontario Coalition on Seniors’ Mental Health and Addictions.
- A working group be established for the development of a Seniors’ Mental Health and Addictions Framework and Action Plan that is achievable, concrete and measurable.
CPC/CMHA Seniors’ Forum
Oakham House, 63 Gould Street, Toronto Date: February and March 2012
- Angela Robertson, Women’s College Hospital
- Barbara Kilbourn, CPC
- Breanne John, LOFT
- Cammy Kong, Alzheimer Society of Ontario
- Charlotte Maher, Care Watch
- Christine Mounsteven, CPC
- David Bruce, Good Neighbours’ Club
- David Harvey, Alzheimer Society of Ontario
- David Kelly, OFCMHAP
- David Ryan, Regional Geriatric Program of Toronto
- Debra Walko, LOFT
- Diane Doran, PAARC
- Donna Rubin, OANHSS
- Dorothy Archer, CPC
- Erin Harris, OWN
- Mary Hynes, OWN
- Faith Malach, Baycrest
- Gabby Golea, CAMH
- Gerda Kaegi, CPC
- Heather Bain, Older LGBT Service Coordinator
- Jacquie Micallef, Alzheimer Society of Ontario
- Jane Muller, CPC
- Janet McMullan, CAMH
- Jennifer Durst, Senior Pride Network
- Jenny Gannon, Ontario Seniors’ Secretariat
- Jim McMinn, LOFT
- Joe Bornstein, Health Innovations Group
- Joel Sadavoy, Mount Sinai
- John Pare, Ontario Association of Chiefs of Police
- John Van Damme, Ministry of Health and Long Term Care
- Josie Santos, RNAO
- Katherine Mortimer, Ontario Seniors’ Secretariat
- Kelly Downs, CMHA Ontario
- Ken LeClair, Providence Care
- Kendelle LaBella, Senior Pride Network
- Kimberly Wilson, Canadian Coalition for Seniors’ Mental Health
- Liz Birchall, COPA
- Lois Dent, Concerned Friends
- Lorne Zon, CMHA Ontario
- Maggie Knapp, York West Living Centre
- Marie-France Rivard, MHCC
- Nancy Cooper, Ontario Long Term Care Association
- Nargess Zahraei, CAMH
- Peggy, CPC
- Rabbi Michael Dolgin, Temple Sinai Congregation
- Rabbi Seed, Adath Israel Congregation
- Randi Fine, CMHA Ontario
- Ruth Dale, National Association of Federal Retirees
- Shirley Bush, CPC
- Sui Mee Cheng, OPHA
- Susy Nunes, St. Christopher House
- Suzanne Teixiera, York West Active Living Centre
- Vasdev Sawhney, FSNA York Branch