Commission on the Reform of Ontario's Public Services

Mental health and addiction issues, including co-morbidities, have been the subject of many
recent consultations and reports, 55 including that of the Ontario legislature’s Select Committee
on Mental Health and Addictions, which reported in August 2010. 56 The committee noted
that “mental health and addictions services are funded or provided by at least 10 different
ministries. Community care is delivered by 440 children’s mental health agencies,
330 community mental health agencies, 150 substance abuse treatment agencies, and
approximately 50 problem gambling centres.” Like the <strong>Commission</strong>, the Select Committee
was surprised to discover “that no one person or organization is responsible for connecting
these various parts, or “breaking down the silos” as we so often heard. There is also no single
organization responsible of ensuring that mental health and addictions services and supports
are delivered consistently and comprehensively across Ontario.” 57
Further, there is a need to link the health system and social service planning, including youth
protection services, more effectively to serve mental health and addiction patients better.
In June 2011, MOHLTC released “Open Minds, Healthy Minds, Ontario’s Comprehensive
Mental Health and Addictions Strategy” in response to the Select Committee’s observations.
The strategy includes a plan to focus on quality improvement, early intervention and improved
service integration for mental health and addiction patients. In addition, it addresses other
significant underlying causes of poor health outcomes in Ontarians: the social determinants of
health such as poverty and access to care. 58
Health care: how it works now and how it should work in future
Canada’s health system, and that of Ontario, developed to deal with acute care and largely
remain in that mode. First, the focus is on patching up people after a health problem has
struck rather than taking a broader approach that might prevent problems or at least mitigate
the effects. Further, the system is designed to bring the patient to the practitioner, often in
a hospital setting. Medicare pays the bills for physicians and hospitals, but little else.
55 Some recent reports include “Wired for Success: An Ontario Brain Strategy,” Neurological Health Charities Canada (December 2010);
“Respect, Recovery and Resilience,” Minister of Health and Long-Term Care’s Advisory Group (December 2010), downloaded from
http://www.health.gov.on.ca/en/public/publications/ministry_reports/mental_health/mentalhealth_rep.pdf, and “Every Door is the Right
Door: Towards a 10-Year Mental Health Strategy,” MOHLTC (July 2009), all of which are available online.
56 Select Committee on Mental Health and Addictions, “Navigating the Journey to Wellness: The Comprehensive Mental Health and
Addictions Action Plan for Ontarians,” downloaded from
http://www.ontla.on.ca/committee-proceedings/committee-reports/files_pdf/Select%20Report%20ENG.pdf.
57 Ibid, p. 3.
58 Ontario Ministry of Health and Long-Term Care, “Open Minds, Healthy Minds, Ontario’s Comprehensive Mental Health and Addictions
Strategy,” June 2011, p. 4, downloaded from
http://www.health.gov.on.ca/english/public/pub/mental/pdf/open_minds_healthy_minds_en.pdf.
166