Project IN4M is a multi-sectoral project managed by the Canadian Mental Health Association (CMHA) in association with the Mental Health Commission of Canada (MHCC). This collaborative initiative proposes to explore the feasibility of taking needs-based human resources planning from theory to practice in the mental health domain. The MHCC sees a need for a predictive tool that would supplement its research agenda. Project IN4M is designed to produce a human resources planning tool that will be robust over time, across jurisdictions and across major diagnostic categories. The predictive tool would give governments, service providers and the public a better picture of what is needed in terms of human resource capacity for both formal and informal care-giving (including peer support and peer workers) to address the demand, both now and in the future, for mental health services.
In order to provide contextual qualitative information on the design and delivery of needs-based planning models, the Project IN4M team conducted four case studies of existing approaches to planning human resources. Case studies for the purpose of this project are a study of a unit, such as an organization, that stresses factors contributing to its success or improvement. These studies are highlighted as an exemplar, cautionary model or instructive/illustrative example. The Health Canada approved IN4M project plan provided for three case studies, but to provide additional insights, an additional case was added.
During August and September 2010, IN4M staff surveyed experts on existing planning models and to determine strategies to deal with the current lack of data; these strategies included a discussion of the use of data proxies – facts, figures or criteria. The survey results will form the basis for a national roundtable of policy-makers from a variety of sectors (including education, criminal justice, social services, health, private sector, private practice, informal caregivers and NGOs) in November 2010. The invitational roundtable will consider the results of an environmental scan, a review of peer-reviewed and grey literature, and these results to give expert advice on the development of a needs-based model for mental health human resources for Canada, and its provinces and territories.
The Canadian Mental Health Association (CMHA), Ontario has prepared this review to offer insights into strategies and action plans of other jurisdictions’ activities in mental health reform. The similarities in core elements reflect the growing recognition of factors that influence mental health and support the journey of recovery. The differences in implementation reflect the variations that arise from local context. Nonetheless, the degree of consensus in the need and direction of reform is illuminating.
The implementation of Medicare in the 1960s required a major investment in capacity-building to train health professionals. The Heath Resources Fund Act – introduced by the federal government in 1966 played a key role in enabling a significant expansion in training capacity across the provinces for a range of health practitioners. Over forty years later, with the challenges associated with an aging workforce and a higher volume and complexity of population health needs, the Health Action Lobby (HEAL) believes that bold action is once again required.
People living with mental illness are severely affected by social and economic inequality. Through no fault of their own they face extended and often lifetime unemployment, social exclusion, isolation, relationship distress, poor physical health and lack of hope for the future. In Canada, persons who suffer from mental illness constitute a disproportionate percentage of persons living below the poverty line, thus exacerbating problems associated with mental illness and contributing to stressors which cause poor mental health.
Although lower socio-economic status (SES) has been linked consistently with higher rates of mental illness, it has not always been associated with higher rates of mental health service use. In this Analysis in Brief the relationship between SES, as measured by neighbourhood income, and inpatient hospital mental health service use for depression was examined in persons age 15 to 64 in 13 cities across Canada. The results suggest an inverse relationship such that individuals from lower-SES neighbourhoods were more likely to be hospitalized for depression than those in higher-SES neighbourhoods. However, no relationship was observed between SES and hospital length of stay or hospital readmission rates, suggesting that differences in SES were not linked with differences in severity of illness or persistence of treatment.
The Mental Health Commission of Canada (MHCC) was created by the federal government in its budget of March 2007. The goal of the MHCC is to help bring into being an integrated mental health system that places people living with mental illness at its centre. To this end, the Commission encourages cooperation and collaboration among governments, mental health service providers, employers, the scientific and research communities, as well as Canadians living with mental illness, their families and caregivers. In this, the MHCC’s inaugural Annual Report, we are eager to share with Canadians the progress that has been made towards accomplishing our mandate.
Research and practice often operate fairly independently from one another. The recent interest in knowledge transfer and exchange in mental health can be understood as a response to the gap between research information and action on that information by policy makers, decision makers, and providers. It is an attempt to ensure that research outcomes can improve the system, and ultimately enhance the delivery of services and supports on the ground.
There is no doubt that a gap exists between research and practice, and that it has to be bridged. Nor is there any question that the service system could use improving. But it is important to remember that knowledge exchange is not a one-way street, and that recipients of knowledge in one context may be the producers of knowledge in another.
Mental health promotion is not a new concept, but it is still not well understood. Nevertheless, research is showing that mental health promotion initiatives can have concrete, positive outcomes for the entire population. It is a powerful resource with significant potential for grounding the work of the Mental Health Commission of Canada.