Due to a shortage of family physicians and a desire to expand alternatives to private family practices, in 2005 the provincial government announced the creation of family health teams (FHTs) that now serve 3 million Ontarians through 184 teams across the province. 74 new community health centre (CHC) sites have been created since that time that serve over 250,000 people with primary health care services . Primary health care can also be accessed through nurse practitioner- led clinics, solo primary health care physician practices, and community programs such as home care and long-term care facilities.
There is a growing trend for community mental health and addictions agencies to work in partnership with family health teams and community health centres. FHTs and CHCs provide primary health care using a model of multidisciplinary care that includes physicians and other providers such as nurse practitioners, nurses, social workers and dietitians. In addition, CHCs provide a variety of health promotion and illness prevention services that focus on addressing and raising awareness of the broader social determinants of health, such as employment, education, environment, isolation, social exclusion and poverty.
CHCs are designed to meet the specific needs of a defined community, often with a focus on groups of people who face particular barriers to health. FHTs are designed to give doctors support from other professionals in providing primary health care to the general population. CHCs are non-profit, community-governed organizations. Most FHTs are physician-led, although some are community-led. CHCs, FHTs, and community-based mental health and addictions providers are now working together to provide more connected care through Ontario Health Teams.
Primary care, mental health and addictions
Access to primary health care is often an issue for people with mental illnesses or addictions. Individuals with mental health and addictions needs have difficulty accessing mental health and addictions services through their primary health care provider, and often have other health needs that may not be met if receiving care for a mental illnesses or addictions. We also know that individuals with mental illnesses and addictions are also more likely to have a co-occurring chronic health condition, making the need to ensure that a holistic approach to care is provided in primary health care settings for individuals with mental health and addictions needs.
The Primary Care and Mental Health and Addictions Working Group
In January 2019, leaders from Ontario’s primary care and community-based mental health and addiction sectors convened a new table, the Primary Care and Mental Health and Addictions Working Group, to work towards greater collaboration and to improve patient/client mental health and addictions care. This table is a joint initiative between Addictions and Mental Health Ontario, the Alliance for Healthier Communities, the Association of Family Health Teams of Ontario, Children’s Mental Health Ontario, the Nurse Practitioners’ Association of Ontario, the Ontario College of Family Physicians, the Ontario Association of Social Workers, the College of Psychologists of Ontario, and the Canadian Mental Health Association, Ontario. The vision guiding the Primary Care and Mental Health and Addictions Working Group is that everyone in Ontario who has a mental health challenge or who uses drugs has access to timely, seamless, comprehensive primary health care and community-based mental health and addiction care.
The Primary Care and Mental Health and Addictions Working Group was formed to exchange information, identify leading practices, and advance shared priorities. More specifically, this group set out to develop recommendations for member organizations to support and inform activities being driven by Ontario’s health system transformation as they relate to the intersection of primary care and community-based mental health and addiction care.