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Why I Don't Count on Government Mental Health Recommendations

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The Ontario Government just released an all party Select Committee report on improving services for those suffering from developmental disabilities (see new definition). That report is called Inclusion and Opportunity: A New Path for Developmental Services in Ontario and I don't want to sound overly cynical but I suggest that the families of those with developmental disabilities not expect much if anything to change.

There are a total of 46 recommendations in this report starting with the formation of a new inter-ministerial committee on developmental services made up of representatives from nine ministries to ensure that the recommendations are implemented.

This new committee is tasked with eliminating wait lists for services within 12 months and then to set out a timetable for implementing the other recommendations. They are to report to the legislature within 18 months and to report regularly every 12 months thereafter. And they call for the Developmental Service Ontario Organizations (DSOs) to be realigned to emphasize system navigation, building connections between families and community agencies and information dissemination.

The DSOs were established in 2004 to streamline service delivery and to provide more equitable access but the committee heard that this did not happen. In fact "many families feel that the DSOs are duplicating assessments and impeding access to support. Agencies and individuals told us that the establishment of the DSOs has severed long -- standing connections between families and local agencies, making it harder for families to navigate the system and for agencies to provide flexible solutions tailored to individual needs."

The to do list to improve services is impressive. In addition to eliminating all waiting lists and providing system oversight and accountability, they call for empowering individuals, families and communities; building capacity for such problems as Fetal Alcohol Spectrum Disorder and Autism Spectrum Disorder; and inclusion and opportunity for people in areas like housing and employment.

But, the reason for my cynicism is that in 2010 an all party select committee made numerous recommendations on improving services for those with mental illness and addictions which have been largely ignored. The vice chair of that committee was Christine Elliott, the Conservative health critic, who is also the vice chair of this most recent committee. And both Liberal member Bas Balkasoon and Conservative Sylvia Jones were on both committees.

That 2010 mental health committee made recommendations around access to beds, emergency treatment, housing, employment, privacy legislation and consent to treatment. We are still waiting.

The language used in both reports is eerily similar. In 2010, the mental health committee wrote that

It is an understatement to say that we have been moved by what we have heard. Rather, we have been changed by what we have heard, and are now convinced that a radical transformation of mental health and addictions care is necessary if Ontarians are to get the care they need and deserve.

In 2014, the developmental services committee wrote that:

The Committee recognizes that the situation is urgent. We are deeply troubled and alarmed by the range of barriers confronting persons with developmental disabilities or a dual diagnosis. We firmly believe that everyone has the right to full social inclusion, and to receive the services and supports they need without delay.

We note that this right was recognized by the Ontario Legislature when it passed the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008 (SIPDDA)

For the sake of families with loved ones with developmental disabilities, I hope that something comes of these recommendations but I would not count on it. But, if these recommendations are implemented, then it might put more pressure on the Ontario government to actually do something for those with mental illnesses as well. After all, the situation in Ontario is so bad that a psychiatric hospital can refuse to accept a patient referred to it by the courts for treatment and have that individual sent directly to jail instead as a result.

In late 2010, Toronto judge Mary Hogan concluded that a man with schizophrenia was unfit to stand trial on a minor offence. She ordered that he be sent to the Centre for Addiction and Mental Health to stabilize his symptoms as soon as possible. He was left in the hall. The hospital appealed complaining that the courts could not order them to take a patient when a bed was not available. The Court of Appeal agreed that while jail is no substitute for medical care and can't provide adequate psychiatric help, a judge cannot force hospitals to take mentally ill offenders.

Ontario has a long way to go to become the compassionate society as recommended by legislative committees. Let's hope they start showing some compassion soon.

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