Of all the parties vying for Ontario's leadership in the recent election, it was clear that the NDP offered the best platform on mental health. They offered to bring 30,000 new supportive housing units on stream over the next number of years which will go a long way to helping solve homelessness. The Liberal government had mismanaged services and reports that offered solutions during their time in power, and the Progressive Conservative party pledged to spend $1.9 billion on mental health without going into details of what their plan entailed.
Now that the election results are in, Ontario premier-elect Doug Ford is responsible for transforming this vague promise into real action. It will be up to him and his PC party to rectify the mess of the past 15 years — and there are reasons to be optimistic that is exactly what they will do.
To make the most of this opportunity, Ford's biggest assets are Christine Elliot and Jeff Yurek.
Ms. Elliot was the driving force behind the ignored 2009 All Party Select Committee Report on Mental Health and Addictions, acting as its vice-chair. Prior to re-entering politics, she was Ontario's first patient ombudsman and learned firsthand the plight of patients and their families in navigating the health bureaucracy. And, as a mother with a child with disabilities, she knows the struggles that many face.
Jeff Yurek is a pharmacist and former conservative health critic. I've had some limited dealings with him and found that when it comes to the problems of mental illness he understands and is sympathetic.
What Ford must do is enact almost all the recommendations made in the Select Committee Report mentioned above, those that the Liberals ignored.
Imagine the waste, duplication and confusion as a result.
All three parties took part in the creation of the report and all agreed with its findings. The report's key recommendation — to establish an umbrella organization to coordinate all mental health services in one place — also happened to be in both the NDP and Green Party platforms. Presently, Ontario has 11 different government departments which provide services. Imagine the waste, duplication and confusion as a result.
The report called for a basket of institutional, residential and community services in every part of the province along with a system navigator to help families access the services they require. I get contacted all the time for help with the system, and once even a psychiatrist sent a family member to me for guidance. All I can do is offer sympathy for their plight.
Privacy and involuntary treatment
There were two key recommendations in the report dealing with privacy and involuntary treatment that absolutely must be dealt with if we are to improve services. Current privacy legislation prevents health care workers from disclosing information to family. The select committee report mentioned that many people told them 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 committee recommended in their report broadening privacy legislation similar to that in British Columbia. B.C. permits "the release of personal health information to health care professionals, family members, and others involved in a client's care without the client's consent, for the purposes of "continuity of care" and if it is in the best interests of the client."
The only improvement to the Mental Health Act was made under a Conservative government in 2000.
The committee also recommended a task force to evaluate the rules around involuntary treatment. They pointed out that the right of autonomy needs to be balanced with the right to be well. Families struggle with members who are too sick to be left without treatment, but who do not get the needed treatment because the laws on involuntary treatment are so limiting. This results in many examples of people being discharged from hospital who go on to commit suicide, or severely injure or even kill a loved one because of their illness. Others may commit minor offences and end up in the justice system when they need to be in the medical system.
And the most absurd part of all is that even if involuntarily committed, the person has the right to refuse treatment so they cannot be discharged because they are too dangerous.
Optimism that Ford will address mental health and addiction
I am optimistic that this new government will address this issue, as the only real improvement to the Ontario Mental Health Act was made under a Conservative government in 2000. That was Brian's Law, named after the Ottawa sportscaster, Brian Smith, who was killed by someone with untreated mental illness. That amendment resulted in the establishment of Community Treatment Orders, whereby someone could remain in the community and receive treatment rather than be locked up in hospital.
The Conservative law also established new committal rules removing the word "imminent" from the involuntary committal criteria. Threats of harm to oneself or others no longer needed to be imminent but likely. It also gave the police the ability to take someone to hospital even if they did not directly see them commit a disorderly act.
Ford's stance on addictions, something the Ford family is familiar with, offers less hope. Ford has foolishly rejected safe injection sites in the past. As Rosie Dimanno said in the Toronto Star, not everyone can afford to send their family member to an expensive rehab facility as the Fords did for brother Rob Ford. Safe injection sites save lives.
However, one tangible way that Ford could make a difference is by ending the war on pain patients who are falsely believed to be the cause of an opioid addiction epidemic. Governments have been cutting off life-saving medications to sick people, partly in the belief that they are diverting those drugs to the street or becoming addicted themselves with no evidence of that.
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A 2018 study published in the British Medical Journal found that of 665,000 patients given opioids and followed for two years, the rate of abuse or overdose was only 0.6 per cent. Ontario needs to end this discrimination immediately and order the medical regulator to stop persecuting doctors and allow them to treat their pain patients appropriately. We need a sensible approach to dealing with addictions, not one that scapegoats innocent victims.
The province is watching, Doug!
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