Open Minds, Healthy Minds, Ontario’s Comprehensive Mental Health and Addictions Strategy

Open Minds, Healthy Minds, Ontario’s Comprehensive Mental Health and Addictions Strategy, is a plan to support mental health throughout life, from childhood to old age, and to provide the integrated services and supports that Ontarians need if they experience a mental illness or addictions. One of the biggest challenges is that mental health and addictions services are fragmented, spread across several ministries and offered in a variety of care settings.

Open Minds, Healthy Minds addresses this complicated system by striving to keep the person at the centre and providing the support they need to direct their own care and build on their strengths. The strategy is aligned with the Excellent Care for All initiative, which encourages the use of best practices to organize health care delivery around the person in the most efficient, integrated way possible.

Objectives

The long-term, comprehensive strategy reinforces Ontario’s efforts on The Poverty Reduction Strategy, Early Learning Strategy and the Long-Term Affordable Housing Strategy with four guiding goals:

  1. Identify mental health and addictions problems early and intervene
    • Expected Results:
      • More Ontario youth will graduate from high school and move on to post-secondary education
      • More Ontarians with mental health and addictions problems will be identified early and receive appropriate services and supports.
  2. Create healthy, resilient, inclusive communities
    • Expected Results:
      • Less stigma and discrimination in public services and in the workplace
      • More community supports for people with lived experience and their families
      • More people with mental health and/or addictions issues employed and integrated in their communities
      • More people living in safe, stable homes and fewer living in shelters or hospitals
  3. Improve mental health and well-being for all Ontarians
    • Expected Results:
      • Lower prevalence of mental health and addictions problems in Ontario
      • Fewer attempted and completed suicides
  4. Provide timely, high-quality, integrated, person-directed health and other human services
    • Expected Results
      • Shorter wait times for community and hospital-based services
      • Fewer repeat emergency department visits and unplanned hospital readmission
      • More appropriate service linkages and referrals from the justice system
      • Better mental health outcomes
      • Better quality of life for people with a mental illness and/or addictions, and for their families
      • Lower per-person cost of mental health and addictions services

The first three years will start with children and youth. The focus will be on early intervention and support to protect children from the many associated costs of mental illness and addictions and help steer them on the road to safe futures. The strategy will: Provide children, youth and families with fast access to high quality services; Identify and intervene in child and youth mental health and addictions issues early; Close critical service gaps for vulnerable children and youth, children and youth at key transition points, and those in remote communities.

Evaluation

The government will work with leaders, experts and stakeholders to:

  • Develop performance measures for monitoring and public reporting on wait times, client experience, health outcomes and quality of life, service continuity and integration
  • Standardize public reporting across the province, by region and by agency
  • Require all mental health and addictions agencies to publicly post annual quality improvement plans
  • Every two years, the government will work with the Advisory Council to publish and post a public progress report on the Comprehensive Strategy
Roles of Various Stakeholders

The white paper highlights the multiplicity, complexity and frequently un-coordinated nature of relationships between the various stakeholders in the area of student mental health, noting in particular the need for the following:

Government Ministries.

Colleges need to work closely with universities and lead government ministries to clarify respective roles and responsibilities and to develop a funding model that is clear, efficient and fair. There is an urgent need to address the gap in student support at the point of transition from secondary to postsecondary education. Similarly, there is a need to ensure more seamless transitions between the institutions and off campus services and strong collaboration between colleges and the community agencies in their jurisdiction.

Individual Colleges.

Colleges need to define clearly what services they should and should not be providing, including possible limits on service provision. They need to identify what specialized expertise they need/are capable of providing on campus, and develop more fluid and seamless relationships with community agencies and services. As colleges begin to reconsider the current shift to a crisis interventional model, there has to be greater investment in mental health awareness and prevention strategies across the campus, including in residences, where on-campus housing exists. There are significant opportunities to use technology to expand service delivery and offer new types of service.

Province-wide Bodies.

There is a strong role for Colleges Ontario in advocacy, particularly on specific issues, such as the funding of more Family Health Teams on campuses and in supporting and sustaining the new Centre for Innovation in Campus Mental Health as a hub for sharing information on best practice and a forum for collective engagement.

Post-secondary Health-related Committees.

Colleges have a range of committees working on aspects of student mental health including the Heads of Student Affairs (HOSA), the College Committee on Disability Issues (CCDI) and the Ontario College Counsellors (OCC). Colleges are less active in system-wide organizations such as the Canadian Association of University College Health (COUCH). COUCH, which is a division of the Canadian Association of College and University Student Services (CACUSS), supports various system-wide mental health initiatives such as the National College Health Assessment (NCHA) survey. Similarly, colleges do not have a strong role in the Ontario University and College Health Association (OUCHA). More active participation in these bodies would increase possibilities for college/university dialogue and shared advocacy.

Community Agencies/Partners. Greater collaboration and integration is required between colleges and community partners, recognizing that the nature of that collaboration will always be dependent on the size and location of the institution and the available resources in the community.

Recommendations

The following recommendations were distilled from the 26 key considerations that form the basis for the nine recommendations covering policy, the development of new models, collaboration, transitions, data, advocacy, and funding as well as a series of considerations related to each area of recommendations.

Vision

  1. Establish a clear vision and approach to develop healthy campus communities that are inclusive, foster a sense of belonging and assist students to develop coping mechanisms and resiliency both while at the postsecondary environment and when the student transitions into the workforce.

Transitions

  1. Recommend that all colleges develop formal transition and entrance strategies related to mental health with a focus on seamless transition, prevention and early warning mechanisms.

Collaboration

  1. Recommend increased collaboration between: a. student groups b. colleges, universities c. CICMH, MCYS, MTCU and MOHLTC and d. Key community agencies within mental health services within the community.
  2. Recommend utilizing the CICMH as a vehicle to promote research, sharing of best practices, assessment and evaluation of model experimentation, leveraging existing resources, advocacy and development of shared services.

Models

  1. Recommend that each college consider local and regional factors when designing models to support students and consider the following:a. Acknowledge and endorse the diversity of possible approaches and models. Recognize and respect that each college will develop/adapt the model and framework that is best suited to its context and to the needs of its student body.b. Encourage ongoing experimentation with new models with thoughtful evaluation practices and develop specific opportunities for sharing best practice through the Centre for Innovation and other appropriate vehicles.

Policy

  1. Recommend that all Ontario colleges conduct a review and renewal of college policies with a lens on how the policies provide appropriate support for students with mental illness as part of the normal policy review cycle.

Data

7. Advocate for improved institutional and systemic data collection and analysis in order to strengthen evidence-based decision-making.

Advocacy

  1. Advocate for a joint PSE working group on mental health with representation from Colleges Ontario, the Council of Ontario Universities, student groups, MOHLTC and MTCU with the goal of developing a plan for greater integration of programs and services.
  2. Continue to promote the student mental health issues in the overall Colleges Ontario advocacy agenda.

Funding

  1. Collaborate with college and university partners to develop a proposal for a funding model that is coherent and fair across the sector and that rationalizes the respective roles of government, postsecondary institutions, student governments and community agencies.
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