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Chronology of Reports, Recommendations and Plans

Mental health policy in Ontario has moved from an emphasis on institutionalization of people with mental illness to a system that depends on effective and accessible services delivered in the community. This redirection in policy is frequently referred to as mental health reform.
The following reports concerning mental health reform have been published in Ontario in the last 25 years. All reports have strongly endorsed the principle of moving mental health care from psychiatric hospitals into the community, where people with mental illness can receive the services they need when they need them.

Chronology

1983 – Towards a Blueprint for Change: A Mental Health Policy and Program Perspective (Heseltine Report)

The primary goal of this report was to provide support for the development of a continuum of service delivery, while ensuring that people with mental illness can receive appropriate help in their own communities.

1988 – Building Community Support for People: A Plan for Mental Health in Ontario (Graham Report)

The report followed a series of consultations and recommended that priority should be given to services for people with serious mental illness. The report proposed a plan for the development and implementation of a comprehensive community mental health system. [Copyright © Queen's Printer for Ontario, 1988. Reproduced with permission.]

1993– Putting People First: The Reform of Mental Health Services in Ontario

This report endorsed the Graham Report (1988) and proposed a 10-year plan for mental health reform in Ontario based on common vision and values. It also confirmed that priority should be given to services for people with serious mental illness and stated that the goal of the Ministry of Health and Long-Term Care should be to allocate 60 percent of the mental health funding envelope to community services and 40 percent for hospital care by 2003, reversing the actual funding allocations at that time. [Copyright © Queen's Printer for Ontario, 1993. Reproduced with permission.]

1994 – Implementation Planning Guidelines for Mental Health Reform

This report set out clear expectations for District Health Councils and their role in mental health reform based on Putting People First (1993). (This document is copyrighted.)

1996 – District Health Council Recommendations

Based on Putting People First (1993) and following the 1994 commitments, District Health Councils recommended that community mental health services be coordinated through strategies such as joint networks, lead agencies, joint protocols, assessment tools, and tracking with a clear point of access into the system, that models of delivery be based on best practices and that a continuum of services are offered, including case management.

1998 – 2000 and Beyond: Strengthening Ontario’s Mental Health System

This report was based on a consultation led by Dan Newman, MPP, who was at the time the Parliamentary Assistant to the Minister of Health and Long-Term Care. The principle of community-focused care set out in Putting People First (1993) was endorsed by the government, but the Newman report noted that at the five-year mark, funding had not yet been allocated to implement needed reform.

1999 – Building a Community Mental Health System in Ontario: Report of the Health Services Restructuring Commission

The provincial Health Services Restructuring Commission (HSRC) included in its recommendations to the Ministry of Health and Long-Term Care divesting Ontario’s nine provincial psychiatric hospitals to the public hospitals. It also recommended transitional funding so that services could be established before the beds were closed, and it estimated that $83 and $87 million would be needed for transitional investments until savings from the closed beds would be realized.

1999 – Making It Happen: Implementation Plan for Mental Health Reform

This report outlines the Ministry’s strategy “to increase the capacity of the system for comprehensive and integrated treatment, rehabilitative and support services while focusing on community alternatives wherever possible.” It was also intended to guide strategic investments over the next three years and committed to protecting mental health funding. With this report, the government committed to investing in community mental health care prior to the divestment of provincial psychiatric hospitals, so that appropriate services would be available for individuals when they left hospital. It also made a commitment to continued investments/reinvestments in mental health services to “support mental health reform and increase the overall capacity of the system.” The report also stated that in 2002 there would be a review of the plan to “revise implementation strategies and program funding priorities as necessary.”

2000 – Mental Health: The Next Steps: Strengthening Ontario’s Mental Health System

This is a short report on the consultation process on legislative changes to the Mental Health Act and the Health Care Consent Act. The report states that the proposed legislative changes will “ensure people with serious mental illness get the care and treatment they need in a community-based mental health system.”

2000 –  Making It Work: Policy Framework for Employment Supports for People with Serious Mental Illness

This report elaborates on the issue of employment supports, providing additional recommendations on issues not adequately addressed in the initial ten-year plan set out in Putting People First (1993). The goal was to develop a coordinated response at both the federal and provincial levels to income and employment supports and the business sector.

2001 – Making It Happen: Operational Framework for the Delivery of Mental Health Services and Supports

This document is a companion to Making It Happen: Implementation Plan for Mental Health Reform (1999). It established a framework to reform the mental health system. The report commits to including a continuum of services for persons with mental illness: first line, specialized and intensive. Again, the government re-affirmed its commitment to investment in community mental health care to alleviate pressure resulting from the divestment of psychiatric hospitals.

2002/2003 – Mental Health Implementation Task Force Reports

The Mental Health Implementation Task Forces were convened in 1999 to provide recommendations and advice to the Ministry of Health and Long-Term Care regarding the implementation of a reformed mental health system in Ontario. Over a three-year period, these regional task forces consulted with thousands of people in the field of mental health. Based on these consultations, the task forces submitted nine region-specific reports for implementation of mental health reform. The final report of the Provincial Forum of Mental Health Task Force Chairs identified the following themes for reform in their report, The Time is Now:

  • Adopting a recovery philosophy, with the consumer at the centre of the system
  • Creating partnerships with other supporting services in the health, social and justice sectors
  • Implementing regional decision-making, to improve local delivery systems
  • Building peer support into the mental health system
  • Increasing support to families of people living with mental illness
  • Providing safe and affordable housing
  • More emphasis on early intervention and treatment
  • Enhancing employment support
  • Ensuring adequate income support
  • Developing greater system accountability, performance standards and information systems
  • Appointing a provincial team to keep mental health reform on the provincial agenda

2009 – Every Door is the Right Door

This is a discussion paper developed by the Minister’s Advisory Group on Mental Health and Addictions for public consultation as part of the development of a new 10-year provincial strategy for mental health and addictions in Ontario.

2010 – Select Committee on Mental Health and Addictions Interim Report

This report provides a summary of major issues identified through the public hearings the committee convened throughout the province and submissions received by the committee during 2009/10.

2010 – Select Committee on Mental Health and Addictions Final Report

This report summarizes the results of the committee’s investigations into the mental
health and addictions needs of Ontario’s population and outlining their recommendations to improve the mental health and addictions system.

2011 – Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy

In June 2011, Ontario released this report, outlining the plan to support mental health and to provide the integrated services and supports that Ontarians need if they experience a mental illness or
addictions.