In his first foray into the policy world of mental illness, Dr. Eric Hoskins, the new Ontario Minister of Health, has just announced that he is "promoting resiliency and well being for all Ontarians by expanding proven programs" and that he wants "the right care at the right time and in the right place" for all. It may be because all this sounds a bit like "a chicken in every pot and a pot in every kitchen" that this November 25 announcement was almost completely ignored by most of the media. Despite all the papers and news sites I read, I only came upon it on Facebook posted by someone who has been appointed to his new leadership council.
Not to be totally negative, there are some good things proposed. He is putting up $16 million for an additional 1000 supportive housing spaces in the next three years, $2.75 million to improve access to mental health care and reduce wait times at a number of hospitals in the Province, and he is improving supports for eating disorders.
But, he plans to increase awareness, fight stigma and promote mental health in schools and in the workplace. I'm not sure how much money will be devoted to this but to what end? Increasing awareness and fighting stigma is something that the Mental Health Commission of Canada has been very active doing and I don't see how this activity helps anyone who is having problems finding a scarce hospital bed or getting an early appointment to see a practitioner.
The stigma of leprosy ended when it was able to be treated effectively and not because of ancient PR campaigns to reduce its stigma. And, if you think that stigma reduction will result in more people seeking treatment when these illnesses have less stigma associated with them, where will they go for that treatment? We don't have enough beds now so wouldn't it make sense to forget about fighting stigma and put the money to use providing care for people who need it?
Part of an additional $138 million over three years will go to improving access to peer support groups. Dr Hoskins did state in his announcement that he is expanding proven programs but peer groups are not effective. A meta analysis of all the studies done on the efficacy of peer support found that "there is currently little evidence to support the clinical effectiveness of this intervention for people with severe mental illness." As a doctor who acquired his medical degree from McMaster University which pioneered evidence based medicine, I would have hoped for more from the minister.
The biggest insult and waste of money, in my opinion, is his establishment of a Mental Health and Addictions Leadership Advisory Council. I guess he did not read my Huffington Post blog when he was first appointed. What I said then was "We do not need another study or task force. They are costly and will likely only return the same suggestions you already have."
Much to her credit, NDP leader Andrea Horvath may have read my piece because she is quoted saying "the Liberal government had done very little to improve services for the mentally ill since a 2010 report from an all-party committee of the legislature. "None of the recommendations have actually been followed up on. The government has done little to nothing to implement those recommendations....."
As I said previously, two of the recommendations would cost very little to implement. Recommendation 21 in that 2010 report suggests changing the Mental Health Act to make it easier to provide treatment for people. The Select Committee also recommended that the privacy legislation be changed and that would not cost. In fact, it would save money. Many family members "told the Select Committee (P.17) of their frustration at being emotionally and financially responsible for their loved ones while not being considered a partner in care by the health care system."
The Mental Health Commission of Canada backed up making those privacy changes as well with the release of their report on caregivers. Recommendation 14.1 states that organizations "Develop and implement clear protocols for providing necessary information to family caregivers and require mental health service providers to follow them
So, what's the hold up in Ontario, Dr. Hoskins?
Ms. Horvath was actually being kind in reminding the Minister that his government is ignoring the recommendations of the 2010 report. They are also ignoring an extensive report they inherited in 2003 when they first took office. Called "The Time is Now," they did promise to consider and implement it but not only did they not but it is now gone from the government website.
A good effort Dr. Hoskins but you really can and should do better.