Addictions & Mental Health Ontario (AMHO) is committed to building a comprehensive and accessible system of care for addictions and mental health, which improves the well-being of all individuals, families and communities in Ontario.
Our work is rooted in our vision for a better system for addiction and mental health.
We are working for:
A Stronger System
AMHO and our members take a system-wide perspective. We are working to create a system that is accessible, integrated and comprehensive. Here is some of the work we are doing to build a stronger system:
Snapshots are short summaries outlining evidence, Ontario examples and policy recommendations on topics that are essential to improving the mental health and addictions system. These Snapshots can be used as a resource by service providers, policymakers and system managers in their advocacy, service design, system planning and decision-making.
- Cannabis Use and Mental Health
- Trans-Inclusion Designated People with Mental Health & Addictions Issues
- Alternate Level of Care Designated People with Mental Health & Addictions Issues
Ontario’s Mental Health and Addictions Leadership Advisory Council
In 2014, Ontario created the Mental Health and Addictions Leadership Advisory Council (the Council) to advise the Minister of Health and Long-Term Care on how to implement Ontario’s Comprehensive Mental Health and Addictions Strategy (the Strategy) over a 3-year period.
There were 20 members of the Council, including Gail Czukar, AMHO’s CEO. The full list of members of the Council can be viewed on the Council’s website.
Note: The Council completed its mandate in January 2018.
Our work in support of the Council
AMHO supports the work of the Council in various ways, including the following:
- Youth addictions working group
- Supportive housing working group
- System alignment and capacity working group
- Core set of services
- Primary care task force
Better Mental Health Means Better Health – The Council’s Annual Report 2015
In it’s first annual report, Better Mental Health Means Better Health, the Council outlines five priority areas to begin the system-level transformation of mental health and addictions in Ontario. These five priorities of the Council’s work include:
- Prevention, Promotion and Early Intervention
- Youth Addictions
- Supportive Housing
- System Alignment and Capacity
- Community Mental Health and Addictions Funding Reform
In addition to outlining the five priority areas, the Council’s 2015 annual report also provided some initial advice to government. The Council urged action in five priority areas, including:
- Make it easier for young people to transition from youth to adult mental health and addictions services and supports.
- Expect the same focus on quality from Ontario’s mental health and addictions system as you do from other parts of the health care system
- Move on key First Nation, Métis, Inuit, and urban Aboriginal mental health and addictions needs
- Prioritize investments in supportive housing focused on meeting the needs of individuals with mental illness and addictions
- Prioritize investments in supportive housing focused on meeting the needs of individuals with mental illness and addictions
Moving Forward: Better Mental Health Means Better Health – The Council’s Annual Report 2016
In the second annual report in 2016, titled Moving Forward: Better Mental Health Means Better Health, the Council identified youth, housing, quality and Indigenous partnerships as the four key areas of progress. The report was released by the Ministry of Health and Long-Term Care coinciding with an announcement of $140 million investment towards mental health and addictions over the next three years.
The council focused on three strategic considerations in the development of its recommendations: to promote, prevent, and intervene early; to close critical service gaps; and to build foundations for system transformation. These considerations led to the council making three key recommendations to the Ministry of Health and Long-Term Care:
- Promote, prevent, and intervene early: That the Ministry of Health and Long-Term Care work with other ministries and stakeholders to promote, prevent and intervene early across the lifespan
- Close critical service gaps: That the Ministry of Health and Long-Term Care address the chronic gaps in youth addiction, psychotherapy and supportive housing.
- Build foundations for system transformation: That the Ministry of Health and Long-Term Care undertake three critical first steps toward large-scale transformation, leveraging the work of the Ministry of Children and Youth Services in these areas
Finding mental health and addiction services can be frustrating. There are a variety of approaches, and organizations. Some services are privately funded. Waiting lists for the publicly funded programs are often discouragingly long.
In different Ontario regions health system administrators have developed mechanisms to streamline access to publicly funded mental health and addiction services. There are a variety of “coordinated access” mechanisms in place. These are programs like Here 24/7 in Waterloo Region, and the Access Point in Toronto.
Working closely with government – and with the support of the Ministry of Health and Long-Term Care – AMHO has undertaken efforts to document and assess Ontario’s programs for coordinating access to mental health and addiction services. This work has been a collaboration with Dr. Brian Rush of the Centre for Addiction and Mental Health (CAMH), as well as CAMH’s Provincial System Support Program.
The first step was to document existing models. In 2016, the Review of Coordinated/Centralized Access Mechanisms: Evidence, Current State and Implications was released.
The second step was the production of a report that assessed the effectiveness of existing coordinated access models. Evaluation of Coordinated Access Mechanisms was completed in 2017.
In February 2017 Ontario’s Minister of Health and Long-Term Care announced the launch of a provincial structured psychotherapy program. This was a response to a recommendation from Ontario’s Mental Health and Addictions Leadership Advisory Council.
The first phase of the structured psychotherapy program has launched. Ontarians can now access help in the following three ways:
- Structured psychotherapy programs are being offered by Ontario’s four specialty mental health hospitals, in collaboration with community partners. For more information please contact Royal Ottawa Hospital, Ontario Shores, Waypoint, or the Centre for Addiction and Mental Health.
- The Canadian Mental Health Association (CMHA) Ontario has expanded access to Bounce Back, a coaching program that includes telephone support and instructional workbooks. Bounce Back is intended to address problems related to moderate depression and anxiety. More information is available here.
- The Ontario Telemedicine Program has launched an on-line self-management tool, the Big White Wall. More information is available at here.
AMHO and our members work continuously to improve the quality of mental health and addiction services in Ontario. Check out some of the ways we are working to better our services:
Excellence through Quality Improvement Project (E-QIP)
Since 2016, the Excellence through Quality Improvement Project has been working with the community mental health and addictions sector to enhance the ability of agencies within this area of healthcare to understand and apply quality improvement methods. E-QIP has offered QI project coaching support to agencies, an extensive training and education program and developed an online community of practice to continue that is a portal for QI resources and sharing.
E-QIP is a collaborative initiative of Addictions and Mental Health Ontario (AMHO), Canadian Mental Health Association (CMHA Ontario), and Health Quality Ontario (HQO). Together these organizations are supporting Ontario’s community mental health and addiction service providers to make care better by enhancing a sector-wide culture of Quality Improvement (QI).
In April 2017, AMHO developed Supportive Housing: Recommendations for the Provision of Support Services. This report was developed to support and inform the implementation of supportive housing units, and, to guide the implementation of models for the provision of support within housing. The intended outcomes of the recommendations for the design and structure of the system are to guarantee that:
- The needs of clients seeking supportive housing are met
- Supportive housing providers are held accountable for high quality standards in the delivery of services
- Support for the integration of the supportive housing system with other parts of the health and social service system is provided
- Investments are allocated in a standardized way across the province while taking into account local characteristics
Building on this work, AMHO has also be leading research regarding promising practices in supportive housing across Ontario, to facilitate knowledge sharing and identify how providers are meeting unique challenges.
The Evaluation of Residential Support Services* project set out to look at best practices associated with adult residential addiction treatment in Ontario. Based on this analysis of best practices, the project developed standards for residential addiction treatment (see below).
The Ontario Adult Residential Treatment Standards set out minimum standards of professional and clinical practice to guide the operation of residential addiction services in Ontario. The standards are clearly defined for each category of service delivery. The manual is divided into the following sections:
- Model of Substance Use Services and Supports
- Residential Substance Use Services and Support in Ontario
- Provincial Standards for Adult Residential Substance Use Standards
- Principles that Inform the Standards
- How to Use the Standards
*The Evaluation of Residential Support Services project is one of the 12 Ontario Drug Treatment Funding Programs, funded by Health Canada as part of the Treatment Action Plan under the Federal National Anti-Drug Strategy (2007).
The Best Practices in Peer Support* project aims to identify best practices for active engagement with mutual aid/self-help and peer support resources in mental health and addiction. The final report provides information and resources to ensure peer support services are provided in the best way possible and are appropriately incorporated into the addiction and mental health system.
The project focuses on best practices in three areas:
- Capacity building: How to meaningfully engage people with lived experience at the systems level?
- Public speaking: What are the promising practices to create training for PWLE to share their story?
- Training: What currently exists for peer support training; what are the gaps and barriers in training?
As part of this work, the project mapped where providers across the province are implementing peer support programs.
*The Best Practices in Peer Support (BPPS) project is one of the 12 Ontario Drug Treatment Funding Programs, funded by Health Canada as part of the Treatment Action Plan under the Federal National Anti-Drug Strategy (2007).
Withdrawal Management Services
The Ontario Withdrawal Management Standards (2014) set out minimum standards of professional and clinical practice to guide the operation of Withdrawal Management Services in the Province of Ontario. They were developed in consultation with the withdrawal management services sector, and build on previous versions of the standards.
There are five categories of standards:
- Administrative standards
- Program standards
- Client care standards
- Education standards
- Physical structure standards
Vocational and Educational Services
Employment and education are important factors that influence recovery for people with mental health and addiction issues. Research has shown when people obtain education and employment, they have an improved quality of life with a reduction in mental health and addiction symptoms and hospitalizations.
This report explores almost 40 vocational and educational offerings across Ontario.
For too long, mental health and addiction have been treated as secondary to physical health. Working with our partners and our members, AMHO raises our voice about the need to reduce stigma and invest in better mental health and addiction care. Scroll down to learn about how we are increasing the profile of mental health and addiction:
Together We Can
Addictions and Mental Health Ontario members are on the ground in communities across the province, supporting Ontarians through their addiction and mental health challenges with community-based treatment, counselling, withdrawal management services, residential treatment, peer support, family support and community housing. Every year, local mental health and addiction providers help more than 300,000 Ontarians on their recovery journey.
With a commitment of $3.8 billion in new mental health and addiction funding from the Ontario government and the establishment of the Mental Health and Addictions Centre of Excellence there is a real opportunity to effectively address the substance use, addiction and mental health crisis in Ontario.
We are calling on the government to:
1. Invest $380 million this year in addiction and mental health services to respond to the urgent and rising
demand for addiction and mental health care.
2. Mobilize the potential of the Mental Health and Addictions Centre of Excellence to drive systematic change and establish a comprehensive and connected addiction and mental health system in Ontario, inclusive of an implementation fund.
3. Meaningfully engage with people with lived experience, their loved ones and caregivers to direct investments and design a system that works best for people who need substance use, addiction and mental health services.
With the upcoming legalization of cannabis, Canadian governments have a once-in-a-generation opportunity to place public health at the center of cannabis policy. Governments also have access to a body of evidence that demonstrates how this can be achieved.
AMHO’s main message to government is straightforward: use evidence to address the demonstrated harms associated with cannabis use, including cannabis dependence.
Whether legalization will lead to increased cannabis use or dependence is unclear, and will need to be evaluated. But cannabis is already the presenting drug dependence issue for about one-third of the cases that are reported by Ontario’s specialized addiction treatment services. Ontarians seeking help for substances through publicly-funded programs are looking at wait times of months to years to access treatment.
That’s why AMHO recommends that the government both invest upfront as well as earmark future revenues to be invested in greater capacity for addiction and mental health services, in addition to public education and prevention.
Ontario’s response to the opioid crisis needs to focus not only on keeping people alive, but on enhancing supports and services to assist people in their recovery.
This is the central message in the joint response to Ontario’s Strategy to Prevent Opioid Addiction and Overdose delivered by Addictions and Mental Health Ontario (AMHO) and the Canadian Mental Health Association (CMHA).
The evidence shows that accessing services and supports in the community increases recovery rates for people seeking treatment for opioid use. Our response provides feedback on implementation of the strategy, and delivers recommendations for how the province can ensure people have access to the services and supports they need to recover.
Health Minister Dr. Eric Hoskins announcing $222 million over three years to support people impacted by the opioid crisis
It’s important that the work AMHO and our members do is sustainable so we can ensure high quality and accessible services now and in the future.
In early 2017, AMHO and our partners at Children’s Mental Health Ontario (CMHO), Canadian Mental Health Association, Ontario (CMHA Ontario) and Family Services Ontario (FSO) undertook a survey of community mental health and addiction compensation practices. The survey looked at four areas of interest:
- Human resource policy practices
- Benefits availability and cost sharing formulae
The survey was completed by 203 organizations. Reports for all organizations, for AMHO member organizations and by LHIN are available. Organizations who completed the survey were provided access to the reports. If you did not complete the survey, but are interested in purchasing the reports, please e-mail email@example.com
AMHO is delighted to be a partner in an exciting, multi-year leadership initiative that will transform the leadership landscape in community and primary health care.
LeaderShift will give our current and emerging leaders the opportunity to develop their skills, advance their careers, and join a network of their peers from team and community-based primary care, home and community support services, and community mental health and addictions. Project funding is provided by the Ministry of Health and Long-Term Care. The Project partners are:
- Addictions and Mental Health Ontario (AMHO)
- Association of Family Health Teams of Ontario (AFHTO)
- Association of Ontario Health Centres (AOHC)
- Canadian Mental Health Association, Ontario (CMHA Ontario)
- Ontario Community Support Association (OCSA)
The centrepiece of this initiative is the LEADS Learning Series—Canada’s gold standard in health leadership development. Over the next two years, LeaderShift will deliver 22 cohorts of the LEADS Learning Series across Ontario and will also build and strengthen leadership through e-learning, a leadership conference, and more.
Community Mental Health and Addictions Privacy Toolkit: A Guide to Ontario’s Personal Health Information Protection Act
The privacy toolkit was developed to support community-based mental health and addiction service providers in meeting the requirements of the Personal Health Information Protection Act (PHIPA), which came into effect on November 1, 2004.
The 2017 Toolkit amendments presented in the toolkit were authored at the invitation of CMHA Ontario by Mary Jane Dykeman (DDO Health Law), with Anna Tersigni Phelan (CMHA Waterloo Wellington).
This Toolkit was first published in September 2005. Its principal author was Mary Jane Dykeman, consultant to CMHA Ontario, in association with then CMHA Ontario staff, Ministry of Health and Long-Term Care staff and an advisory group of community mental health and addictions representatives, who are listed in the report.
As well as explaining the new legislation, the toolkit provides templates which allow service providers to meet the requirements it sets out. There are also scenario-based question-and-answer sections which help illustrate how the legislation applies to our specific sector. The information is presented in a clear, user-friendly format, and we hope that it conveys a complete picture of how PHIPA will impact the work of community-based mental health and addiction service providers.