Chronic Disease Prevention and Management
Physical and mental health are fundamentally linked, yet health systems tend to address them separately. Nowhere is this more evident a problem than in the area of chronic conditions. Poor mental health and mental illness are risk factors for chronic physical conditions and people living with chronic conditions often experience poor mental health.
The place of mental illnesses and mental health within the CDPM framework in Ontario has yet to be well-defined. The Canadian Mental Health Association, Ontario is raising issues and opportunities for promoting mental health, supporting people with mental illnesses, and addressing the prevention and management of co-existing mental illnesses and chronic physical conditions.
In late 2008, the Government of Ontario announced the implementation of a Diabetes Strategy as the first phase of providing a comprehensive CDPM strategy for the province. Given that depression and schizophrenia are risk factors for the development of diabetes and people with diabetes have nearly twice the rate of diagnosed mental illnesses as those without diabetes, this is a timely opportunity to ensure that actions to address mental health and mental illness are incorporated in the Diabetes Strategy.
How CMHA Ontario Is Addressing This Issue
CMHA Ontario has written the following papers on the issue:
- Backgrounder: The Relationship between Mental Health, Mental Illness and Chronic Physical Conditions, December 2008
- Discussion Paper: What is the Fit Between Mental Health, Mental Illness and Ontario’s Approach to Chronic Disease Prevention and Management? August 2008.
- Position Paper: Recommendations for Preventing and Managing Co-Existing Chronic Physical Conditions and Mental Illnesses, August 2008
- Diabetes and Serious Mental Illness: Future Directions for Ontario, April 2009
CMHA Ontario is also collaborating with a group of partners through the Diabetes and Mental Health Peer Support project. This project will increase the skills of mental health peer support workers to provide support for the prevention and self-management of diabetes in the high-risk population of people living with a serious mental illness; and will increase awareness in the diabetes community of the role mental health support workers can play in prevention and self-management support. A diabetes peer support training module will be developed and pilot tested by peer support trainers across Ontario.
CMHA Ontario is conversing with stakeholders, presenting at conferences and utilizing other knowledge transfer tools to increase awareness and develop opportunities for addressing mental health, mental illness and chronic disease prevention and management. A teleseminar, Mental Health, Mental Illness and Chronic Disease Prevention and Management in Ontario was held with stakeholders in February 2009, and CMHA Ontario presented Poor Mental Health: A Risk Factor for Chronic Disease at the Ontario Chronic Disease Prevention Alliance (OCDPA) Systems Think Tank on Mental Health and Chronic Disease Prevention on February 6, 2009.
CMHA Ontario is a member of the Ontario Chronic Disease Prevention Alliance (OCDPA), an alliance of provincial organizations involved in health promotion and chronic disease prevention. Within OCDPA, we have been involved in developing key messages on mental health as a risk factor for chronic disease and raising awareness in the chronic disease prevention community of the issues related to mental health and chronic disease. The Alliance held a forum in February 2009 to discuss how to integrate mental health as a risk factor/protective factor for chronic disease into chronic disease prevention. Proceedings for Systems Think Tank on Mental Health and Chronic Disease Prevention: Moving Forward as a System are available on the OCDPA website.
CMHA Ontario held a Think Tank on Diabetes and Serious Mental Illness on March 30, 2009 with key stakeholders from primary care, community mental health and the diabetes sectors, as well as the Ministry of Health and Long-Term Care and three LHINs, to explore what can be done cross-sectorally to improve the prevention and management of diabetes for people with serious mental illnesses. Betty Harvey, a nurse practitioner in the Primary Care Diabetes Support Program, St. Joseph’s Health Care, London, made a presentation on the disparities in chronic disease prevention and management for people with serious mental illnesses. Joan Canavan, manager of chronic disease programs at the Ministry of Health and Long-Term Care, made a presentation on the Ontario government’s approach to chronic disease prevention and management. Participants then discussed what could be done to improve the situation. A report on the think tank, Diabetes and Serious Mental Illness: Future Directions for Ontario, was published at the end of April 2009.
CMHA Ontario is also in discussion with the MOHLTC and LHINs on other ways that Ontario might address mental health and mental illness within Ontario’s Diabetes Strategy.
Minding Our Bodies is a multi-year project (2008-2013) of the Canadian Mental Health Association, Ontario, in partnership with YMCA Ontario, York University’s Faculty of Health, the Nutrition Resource Centre and Mood Disorders Association of Ontario, funded by the Ministry of Health and Long-Term Care, to promote active living and healthy eating for people with serious mental illness in order to reduce the risk of chronic physical conditions and support recovery from mental illness.
Training mental health peer support workers so that they can help people living with mental illness understand the risk of developing diabetes and learn prevention and self-management strategies is a success story that can be emulated across the country.