Addictions & Mental Health Ontario (AMHO) is committed to building a comprehensive and accessible system of care for addiction 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
Snapshots are short summaries outlining evidence, Ontario examples and policy recommendations on topics that are essential to improving the mental health and addiction 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.
- Live-In Treatment for Substance Use
- Withdrawal Management Standards
- AMHO’s Equity, Anti-Racism and Anti-Oppression Framework
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.
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).
Equity, Anti-Racism and Anti-Oppression Framework
Addictions and Mental Health Ontario has finalized our Equity, Anti-Racism and Anti-Oppression Framework.
The Equity, Anti-Racism and Anti-Oppression Framework provides guidance and direction for how AMHO and our members will advance equity, anti-racism, diversity, and inclusion, starting with a preliminary focus on Indigenous Peoples and Black Peoples. We are deeply committed to this work.
Related to AMHO’s Strategic Plan, this framework will help achieve:
- Priority 1, by positioning AMHO as a leader in health system transformation by advancing equity, inclusion, and diversity through a collaborative approach and continuously engaging with critical stakeholders across sectors.
- Priority 2, by communicating to members, the public and government our commitment to advancing equity, inclusion, and diversity.
AMHO is committed to meaningfully advancing equity, inclusion, diversity and anti-racism with dedicated staff to lead this work. We are excited to embark on this journey and acknowledge that this will be a process spanning multiple years.
- 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.
Residential Treatment of Adult Substance Use Disorders
This paper serves to give a collective voice to those people, whose voice needs to be heard, now more than ever:
- From those Ontarians who have been challenged with addiction – the ones who have been unsuccessful or unable to get the help they needed – and also the more fortunate ones who have managed to achieve more tangible recovery goals, in part through the residential treatment system;
- From the dedicated service providers who have helped their clients to begin and continue on their journey to recovery; and
- From our invaluable partners who have supported and advocated for residential treatment as an essential part of the addictions and mental health continuum of care.
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 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 Services Standards set out core standards of professional and clinical practice to guide the operation of Withdrawal Management Services in the Province of Ontario.
The approach to creating the guidelines was evidence-informed and highly collaborative. The primary goals of the standards are:
- To help ensure quality and consistency of withdrawal management services across the province;
- To support funders and service providers by establishing recognized criteria for effective services and supports across the province, while respecting regional differences between health funders and the need for innovative services that respond to local requirements and situations; and
- To improve the information available to people about what they can expect when accessing withdrawal management services in the province as well as what is expected of them while they are using a service.
These standards are intended to be a minimum standard; members are encouraged to meet them and stay current with best practice. They should be used in conjunction with other relevant quality and clinical standards (i.e Health Quality Ontario, META:PHI) where appropriate.
Vocational and Educational Services
This report explores almost 40 vocational and educational offerings across Ontario.
No Time to Wait
At AMHO, we believe that all Ontarians deserve access to high-quality, publicly funded mental health and substance use health care whenever and wherever they need it. We also believe that people with lived and living experience (PWLE) should be actively engaged as partners in designing the system of care.
As part of our 2022 budget submission, we are calling on the Ontario government to:
- Implement a strategy to address growing wait times for mental health, addiction, and substance use health services.
- Develop and implement a Health Human Resources plan to address the staffing challenges in the sector.
- Respond urgently to the escalating overdose crisis and the drastic rise in overdose deaths.
- Use a social determinants of health approach in designing and implementing mental health and substance use supports and 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.
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.
- 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 firstname.lastname@example.org
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.