The quality of mental health services varies across the province, says new report

16/12/2015

A new report released today by Health Quality Ontario and the Institute for Clinical Evaluative Sciences (ICES) explores the impact of mental illness and addictions in Ontario and examines the quality of care Ontarians dealing with them are receiving.

While the majority of Ontarians report that their mental health is very good or excellent, about two million people are affected by a wide variety of mental illnesses or addictions each year. In addition, one-third of Ontarians who identified themselves as needing mental health or addiction services in a 2012 survey reported not getting help, or having their needs only partially met.

Called "Taking Stock: A report on the quality of mental health and addictions services in Ontario," the report finds that access to mental health and addictions services varies across the province, and the quality of services that are provided is inconsistent.

“Ontarians have various mental illness and addictions services available to them, but not a comprehensive mental health system that meets their needs and provides services when and where they are needed, to everyone who needs them,” said Joshua Tepper, president and CEO of Health Quality Ontario. “The aim of Taking Stock is to begin to map out a route toward a comprehensive, effective, and equitable mental health system for Ontario that can alleviate people’s suffering.”

Taking Stock also says that improvements have been made in the data, but there are still critical information gaps preventing pinpointing access and quality issues, and resolving them.

“Our report makes it clear that not all Ontarians are getting the timely mental health and addictions care that they need," says the report’s co-author Dr. Paul Kurdyak, lead of the Mental Health Research Program at ICES and director of Health Outcomes and Performance Evaluation at the Centre for Addiction and Mental Health. “As with many other illnesses, people have the best outcomes when a mental illness or addiction is identified and treated early. Finding ways to improve access to care will not only improve the immediate mental health of Ontarians, it will also ease the future burden of care needs for the individual patients and their families, as well as for the system overall.”

The report should help guide the Open Minds, Healthy Minds strategy for mental health and addictions services undertaken by Ontario’s Ministry of Health and Long-Term Care, with input from the province’s Mental Health and Addictions Leadership Advisory Council (who are releasing their annual report on the Council’s progress).

“Taking Stock will be an invaluable tool as we move forward on a provincial strategy to transform mental health services in Ontario,” said Susan Pigott, chair of the province’s Mental Health and Addictions Leadership Advisory Council. “It identifies many of the priorities that need to be addressed in order to enhance the accessibility, quality and outcomes of programs and services for Ontarians coping with mental illness and addictions.”

In addition to facts and figures on the state of mental health services in Ontario, the Health Quality Ontario / ICES report includes patient stories that provide invaluable perspectives on the impact of mental illness and addictions on people’s lives.

Key report findings:

About two million Ontarians are affected by a wide variety of mental illnesses and addictions each year.

In total, there are roughly seven million visits to physicians’ offices in Ontario each year for mental illness or addiction, accounting for about 10% of all visits to physicians in the province.
One-third of emergency department visits for mental illness or addiction are by people who have not been assessed and treated for these issues before by a physician in the last two years.

Members of some population groups don’t receive the same quality of mental healthcare as others.

People with the lowest incomes are less likely to have a follow-up visit with a physician within seven days of leaving the hospital after admission for mental illness or addiction (26.9% of people of the lowest income group have a visit, compared to 32.5% of the highest income group).
People from rural areas who are hospitalized for a mental illness or addiction are less likely to have a follow-up visit with a physician within seven days after leaving the hospital (23.1% of rural residents have a visit vs. 30.4% of urban residents)
Young people are more likely to visit an emergency department for mental illness or addiction issues without prior outpatient contact with a physician for mental health or addiction care (42.7% of people aged 16 to 24 vs. 29.8% of people aged 25 and above).
Immigrants are more likely to be assessed for a mental illness or addiction for the first time in a hospital emergency department (38.6% of immigrants are assessed for the first time vs. 32.5% of non-immigrants).

Whether, how soon and how often people are able to see a psychiatrist may depend on where they live.

The number of psychiatrists per 100,000 residents varies widely across Ontario, from a low of 4 per 100,000 in the Central West Local Health Integration Network (LHIN) just northwest of Toronto, to a high of 62.7 per 100,000 in the Toronto Central LHIN.

Ontarians do not wait as long as they used to for addiction treatment programs.

The average wait time for community addiction treatment programs in the province improved to 16 days in 2012/13 from 26 days in 2008/09, and to 42 days for residential addiction treatment programs in 2012/13 from 49 days in 2008/09.

The Ministry of Health and Long-Term Care’s 10-year Open Minds, Healthy Minds strategy began in 2011 with a first phase focusing on child and youth mental health. Taking Stock supports Phase 2 of the ministry’s strategy as it bridges the transition from child and youth services to adult services.

Health Quality Ontario (HQO) is the provincial advisor on quality in healthcare. HQO reports to the public on the quality of the healthcare system, evaluates the effectiveness of new healthcare technologies and services, and supports quality improvement throughout the system. Visit www.hqontario.ca for more information.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario