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

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:

AMHO Snapshots

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.

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.

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:

  1. Prevention, Promotion and Early Intervention
  2. Youth Addictions
  3. Supportive Housing
  4. System Alignment and Capacity
  5. 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:

  1. Make it easier for young people to transition from youth to adult mental health and addictions services and supports.
  2. 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
  3. Move on key First Nation, Métis, Inuit, and urban Aboriginal mental health and addictions needs
  4. Prioritize investments in supportive housing focused on meeting the needs of individuals with mental illness and addictions
  5. Prioritize investments in supportive housing focused on meeting the needs of individuals with mental illness and addictions
Better Mental Health Means Better Health
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:

  1. 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
  2. Close critical service gaps: That the Ministry of Health and Long-Term Care address the chronic gaps in youth addiction, psychotherapy and supportive housing.
  3. 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
2016 Annual Report of Ontario's Mental Health & Addictions Leadership Advisory Council

Coordinated Access

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.

Full report

Executive Summary

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.

Full report

Executive summary

Review of Coordinated/Centralized Access Mechanisms: Evidence, Current State, and Implications

Structured Psychotherapy

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:

Better Services

Better Services

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).

Supportive Housing

In April 2017, AMHO developed Supportive Housing: Recommendations for the Provision of Support ServicesThis 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:

  1. The needs of clients seeking supportive housing are met
  2. Supportive housing providers are held accountable for high quality standards in the delivery of services
  3. Support for the integration of the supportive housing system with other parts of the health and social service system is provided
  4. 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 Services

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).

Evaluation of Residential Support Services

Standards

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
  • 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).

Peer Support

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:

  1. Capacity building: How to meaningfully engage people with lived experience at the systems level?
  2. Public speaking: What are the promising practices to create training for PWLE to share their story?
  3. 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).

Map of provider implemented peer support programs. Click on the map for an expanded view.

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:

  1. Administrative standards
  2. Program standards
  3. Client care standards
  4. Education standards
  5. Physical structure standards
Effective Voice

Effective Voice

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:

Where Change Happens

Our members know a thing or two about change. Addictions and Mental Health Ontario represents the organizations that provide front line care in our communities.

These services save lives and help people live a better quality of life. We must redress the historical funding inequalities that have made it challenging for people and families to access help for addiction and mental health problems.

The following outlines AMHO’s four priorities to improve Ontario’s community mental health and addiction sector, and make change happen:

1. Improve access to services by keeping good people.
2. Plan better services by collecting better data.
3. Help more people by hiring more people.
4. Enable more recovery by building more safe places.

Pre-Budget Submissions

Pre-budget consultations are an important opportunity for AMHO to share our members expertise and provide recommendations to the government about how to build a more comprehensive and accessible system for addiction and mental health.

Federal Pre-Budget Submisson 2018

AMHO urges the federal government to be a strong partner in addiction and mental health

This year’s federal pre-budget consultation asked Canadians to share their recommendations on how to build more productive workplaces and communities. AMHO and our 220+ members see firsthand the impact of mental illness and addiction on productivity and the health of our communities. Each week, 500,000 Canadians will miss work due to a mental health or addiction issue, and the Conference Board of Canada has estimated that untreated mental illness and addiction costs the Canadian economy upwards of $50 billion a year.

AMHO asked the federal government to be a strong partner in mental health and addiction, and offered the following four recommendations (full submission available here):

  1. Invest in our communities;
  2. Partner with Indigenous Communities on mental health and addiction;
  3. Prevent the opioid crisis from continuing to worsen in Ontario; and,
  4. Target investments from the National Housing Fund into supportive housing for those with mental health and addiction issues.

The Health Accord investments in mental health and addiction are a welcome start. But Ontario currently spends only 6.8% of our healthcare budget on addiction and mental health. Other jurisdictions invest at least 9 to 10%, and the UK 13%. The Mental Health Commission of Canada recommends increasing investments to a minimum of 9%. In Ontario, at current health spending levels, the health transfer in year 5 will bring mental health and addiction spending up to 7.3% of the total health budget – an improvement, but we still have a long way to go.

Ontario Pre-Budget Submission 2017

AMHO calls on Ontario to make addiction and mental health care a priority

AMHO’s 2017-2018 pre-budget recommendations are directed towards making it easier for Ontarians to access comprehensive addiction and mental health care by investing in community-based services and supports.

We recommend that the Government of Ontario:

  1. Keep the lights” on for community mental health & addiction organizations to ensure current service levels can be sustained
    • Provide a 3 per cent base budget funding increase for the community mental health and addiction sector, who have not had increases to their operational budgets in five to ten plus years.
      Investment for 2016/2017: $30 million
  2. Ensure the response to the opioid crisis focuses not only on saving lives, but on ensuring people have access to comprehensive community-based treatment and the opportunity to rebuild their life.
    Investment for 2016/2017: $3 million per year
  3. Invest in a more comprehensive and accessible mental health and addiction system by implementing the recommendations of the Mental Health and Addiction Leadership Advisory Council, including:
    • Core services: Work towards ensuring that all Ontarians, regardless of where they live, have access to the same core mental health and addiction services.
    • Supportive housing: Provide greater access to supportive housing to help people in their recovery by funding the implementation of the Supportive Housing Strategy developed by the Council, which calls for the creation of a minimum of 30,000 units with supports over the next ten years, and is essential for the province to deliver on the strategy to end homelessness.
      Investment for 2016/2017: $278 million
    • Youth: Address the critical service gaps for mental health and addiction services for youth by increasing investments in additional staff and capacity.
    • Psychotherapy: Improve access to psychotherapy by funding the training, hiring and competitive salaries of counsellors at community-based organizations
    • Data and performance strategy: Support a comprehensive data and performance measurement strategy for the mental health and addiction sector, to identify health outcomes and measure the return on government investment
      Investment for 2016/2017: $8 million
  4. Direct future tax revenue from the sale and distribution of cannabis to increase the capacity of addiction and mental health prevention and treatment.

Click here to read our full provincial pre-budget submission 2016/2017.

Cannabis Legalization

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.

Privacy Toolkit

Opioid Crisis

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

System Sustainability

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.

Sector Compensation

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:

  1. Compensation
  2. Human resource policy practices
  3. Vacation
  4. 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 info@amho.ca

LeaderShift

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.

Privacy Toolkit

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.

The toolkit was funded by the Ministry of Health and Long-Term Care to address a need identified by community-based mental health and addiction service providers.

Download the privacy toolkit

Download the privacy toolkit templates

Privacy Toolkit