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A Focus on Addictions and Mental Health: Review of LHIN Integrated Health Service Plans

April 1, 2007

A review of the Local Health Integration Network (LHIN) first integrated health service plans (IHSP) was undertaken by the partnership of Addictions Ontario, the Canadian Mental Health Association Ontario, the Centre for Addiction and Mental Health and the Ontario Federation of Community Mental Health and Addiction Programs. The purpose of this review was to assess the extent to which these plans address addiction and mental health issues. (June, 2007)

For the complete review, download the PDF above. NOTE: The review was revised on June 5, 2007.

Executive Summary

A review of the Local Health Integration Network (LHIN) first integrated health service plans (IHSP) was undertaken by the partnership of Addictions Ontario, the Canadian Mental Health Association Ontario, the Centre for Addiction and Mental Health and the Ontario Federation of Community Mental Health and Addictions Programs. The purpose of this review was to assess the extent to which these plans address addiction and mental health issues. The criteria for assessing the IHSPs were based on the critical success factors for mental health and addictions identified in the partnership’s 2005 position paper ‘A Strong Provincial Focus for the Addictions and Mental Health Sector in Ontario.’

Key Findings

    • Every LHIN is addressing addictions and mental health to some extent, although the sector is a priority in only half the LHINs.
    • In focusing exclusively on integration, access issues and service gaps are not consistently addressed within all LHINs.
      • Barriers to access are sometimes underestimated. IHSPs often state that accessibility of services will be improved by improving people’s access to information about services, making the system easier to navigate, and coordinating intake between agencies. While these issues are important, other barriers to accessing services, such as those facing marginalized groups are often missed.
      • The chronic underfunding of the sector and the resulting service gaps are often not acknowledged.
    • The importance of housing, income, employment and social supports for people with addictions and mental health concerns are recognized by very few LHINs. Even fewer have made plans to address these as determinants of the health.
  • Most LHINs do not demonstrate an understanding of the importance of involving consumers and families in the planning, delivery, and evaluation of services.
  • The importance of peer support programs is not recognized by many LHINs.
  • Diversity is being addressed almost exclusively through breaking down language barriers. There is little recognition or commitment to culturally competent services.
  • Where the addiction and mental health sector’s voice was united and strong throughout a LHIN, the sector was more likely to be consulted and to have impact on the LHIN’s priorities and planning.

Recommendations

  1. Ensure that a strong addictions and mental health system is considered a provincial strategic priority.
  2. Maintain a focus on addictions and mental health in each LHIN.
  3. Working collectively in the sector is critical – consumers, families and service providers working together.
  4. Reviewing the capacity of the existing service system is a critical next step.
  5. Ensure a clearer focus on the critical success factors for mental health and addictions.

Critical Success Factors for Addiction and Mental Health

The following critical success factors are drawn from the partnership 2005 position paper, ‘A Strong Provincial Focus for the Addictions and Mental Health Sector in Ontario’:

  • Addiction and mental health care will be fully integrated within a transformed system.
  • Consumers and families will be involved in all aspects of planning, decision-making, implementation and service delivery.
  • People across Ontario will have access to the best mental health and addiction services in their communities, supported by widely shared research findings, best practices and professional development.
  • There will be a continuum of mental health and addiction services and supports from community-based to hospital care, and including consumer and family initiatives.
  • Access to housing, income, employment, social supports and other determinants of health will be acknowledged and supported as critical aspects of treatment and recovery.
  • Mechanisms for addressing the historical marginalization, stigma and under-funding of addiction and mental health services will be in place.
  • Equitable and transparent mechanisms will be in place to guide funding decisions for the sector.
  • The needs of diverse, rural and remote communities will be met.

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