Mental health and addiction care
A critical issue
Mental health is critical to overall well-being, but access to mental health and addiction care continues to be a challenge for many patients. The COVID-19 pandemic has further exacerbated this issue. Physicians play a fundamental yet often inexplicit role in addressing mental health and addiction issues in Ontario.
Advocacy
The disruption of social connection and employment, among other factors brought on by the pandemic, is negatively impacting many Ontarians’ mental health. The health-care system is facing an unprecedented tsunami of new and worsening mental health and addiction conditions as a result. Emerging data suggests that more than one third of individuals may develop a mental health condition following a COVID-19 diagnosis. Equally concerning, a survey conducted during the pandemic states that Ontario faced a 40-per cent spike in opioid-related deaths in 2020.
One of the OMA’s top policy priorities, identified in Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care, is to support and strengthen Ontario’s mental health and addiction sector. To improve access to mental health and addiction care, Ontario’s doctors made 11 recommendations, including:
- Provincewide standards for equitable, connected, timely and high-quality mental health and addiction services to improve the consistency of care
- Expanding access to mental health and addiction resources in primary care
- Specific mental health supports for front-line health-care providers
- Increasing funding for community-based mental health and addiction teams where psychiatrists, addiction medicine specialists, family doctors, nurses, psychologists, psychotherapists and social workers collaborate
- More resources to fight the opioid crisis, particularly in northern Ontario, where the crisis is having a significant impact and resources are limited
Mental health and addiction are the top one or two health-care topics in which Ontarians are most engaged, according to ASI, a market research firm that uses artificial intelligence methodology to obtain insights into public discussions on social media.
The OMA, based on consultations with members and key system stakeholders, has developed a series of white papers outlining recommendations to enhance the delivery of mental health and addiction care in Ontario.
Approximately three-quarters of Canadians rely on their primary care provider to address their mental health needs, but there are longstanding system gaps that must be addressed to enhance the ability of primary care doctors to deliver mental health care. The OMA and the Primary Care Collaborative (an alliance of primary care organizations that joined together to collaborate on strengthening primary care as we move toward recovering from the pandemic) identified in a policy paper that the following policy actions are necessary to ensure greater support for primary care providers and improve care in this crucial area:
- Enhance primary care capacity to offer treatment locally by funding and establishing interprofessional care teams with expertise in treating moderate to severe depression and anxiety
- Improve the ability of primary care providers to connect their patients who have moderate to severe depression and anxiety to local services by leveraging and expanding the navigation service, Health Connect Ontario
- Expand access to harm reduction services, such as supervised consumption sites
- Implement an Indigenous-led mental health and wellness strategy
Read the paper, Strengthening the Delivery of Mental Health and Addiction Services in Primary Care.
The OMA made recommendations to address the existing gaps in mental health and addiction care in a paper called Responding to a Mental Health and Addiction Tsunami. The paper, which focuses on improving the mental health of children and youth, seniors, those who provide care and marginalized communities, outlines more than 20 immediate priorities and calls on the government to:
- Accelerate and evolve the rollout of the province’s psychotherapy program to provide equitable access to high-quality therapy for all Ontarians, given the cost of private therapy is out of reach for many
- Expand the number of supervised consumption sites and other harm-reduction initiatives
- Fund all Ontario hospitals to ensure that all emergency departments offer dedicated on-site mental health resources 24/7
- Report on and regularly update mental well-being indices and the emergence or exacerbation of mental illness and/or addiction and death from suicide and overdose
- Increase access to public health nurses and social workers in schools for early intervention
- Prioritize in-person learning at school only when it is safe to do so, based on sound public health evidence
The Ontario government is establishing a new online market for internet gaming and recently released a discussion paper titled A Model for Internet Gaming in Ontario that outlines the government’s preliminary thinking on key aspects of the iGaming model.
Many individuals in Ontario gamble, and the majority do so without causing harm to themselves or others. However, a minority (about 2.5 per cent) of Ontarians suffer from problem gambling or gambling addiction, a serious health issue with significant implications for gamblers and their families.
The OMA submitted recommendations to the government, suggesting that it conduct a health impact analysis that examines the effects of gambling and incorporates a harm reduction approach in the implementation of online gambling in Ontario.
Physicians play a fundamental yet often inexplicit role in addressing mental health and addiction issues in Ontario. The OMA’s white paper, Recommendations to Strengthen the Role of Physicians in Mental Health and Addiction Care, provides recommendations to improve care through strengthening the role of physicians in delivering these services.
The OMA recommends that the health-care system needs to:
- Formalize and make explicit the roles of various providers in mental health and addiction service delivery and identify the roles that are most effectively, efficiently and safely performed by physicians
- Match the supply, distribution and utilization of physicians to address the specific mental health and addiction needs of patients that are best served by physicians
- Establish and implement standards for equitable, connected, timely and high-quality mental health and addiction service delivery throughout the province
- Support mental health and addiction leadership training for physicians
- Enable specific leadership opportunities for physicians in Ontario Health Teams’ design and implementation to strengthen mental health and addiction care
- Promote physician leadership within the Mental Health and Addictions Centre of Excellence
OMA in the news
Read the latest articles on how the OMA is putting mental health and addiction at the forefront.
Three Ontario doctors receive grants to study burnout
Burnout is a critical issue in health care, impacting almost three-quarters of physicians and made worse by the pandemic. The Ontario Medical Foundation awarded $42,500 to each of three doctors to study solutions to the growing issue of physician burnout.
‘Dire consequence’: Ontario doctors pitch plan for buckling health-care sector
With a family doctor shortage, increasing burnout among health-care workers and long wait times at emergency departments putting more pressure on the health-care system, doctors are hoping the government heeds their suggestions for solutions.
COVID-19 impact on mental health: What we need to do now
Related articles from the Ontario Medical Review
The OMR has featured stories on physician mental health, the need for improved access to addiction services and how to recover after disaster strikes to highlight the issue of mental health and addiction care in the medical profession.
Winter 2023 online exclusive
When healers need help
Fall 2023 issue
Moving past burnout
Spring 2023 issue
Tackling physician burnout more important than ever
Winter 2023 online exclusive
What role does spirituality play in the practice of medicine?
Winter 2023 online exclusive
‘Revolutionary’: HQ Toronto clinic draws clients from across Canada
Spring 2023 issue
Burdensome paperwork targeted by Bilateral Burnout Task Force
Related episodes from the Spotlight on Health podcast
Removing barriers to Indigenous mental-health services
In this podcast episode, physicians discuss the barriers to mental-health services Indigenous doctors face and how the OMA’s Physician Health Program is working to bridge these gaps.
Addressing the primary care crisis
Dr. David Barber, chair of the OMA’s Section on General and Family Practice and assistant professor at Queen’s University’s department of family medicine, discusses the challenges facing the primary health system in Ontario, along with some possible solutions.
Coping with disasters in health
Trauma takes on many forms and the mental health impacts cannot be ignored, says Dr. Frank Sommers, founding chair of Disaster Psychiatry Canada at the University of Toronto. He emphasizes the importance of compassion for recovery and preparedness for what’s to come.