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- Page navigation anchor for RE: Making the most of the federal investment of $5 billion for mental healthRE: Making the most of the federal investment of $5 billion for mental health
We applaud Mary Bartram for her analysis “Making the most of the Federal Investment of $5 billion in Mental Health”.1 While recognizing the dire need for publicly funded psychological services (available in other countries such as the UK and Australia), we share Bartram’s concerns about inequitable distribution of such services. We also add concerns about creating yet another silo in our health care system whereby psychological services operate independently of primary care and community-based supports important to patients.
Collaborative mental health care involves primary care providers, mental health specialists, patients and other allied providers working together in structured methods founded upon Wagner’s chronic care model.2 Collaborative mental health care has well-demonstrated effectiveness, cost efficiency, patient-centeredness, provider satisfaction, and has been shown to reduce disparities in healthcare processes and outcomes based on ethnicity and socioeconomic status.2-4 When provided via telemedicine and/or telephone, collaborative mental health care can also close the gap between urban and rural care.5
Lack of implementation of the collaborative chronic care model for mental health is a major failure in health care systems across Canada, perpetuating scarce and inequitable access to care and poor population health outcomes. The federal investment in mental health provides a tremendous opportunity to overcome the initial cost barrier to impl...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Making the most of the federal investment of $ 5 billion for mental healthRE: Making the most of the federal investment of $ 5 billion for mental health
Bertram says that making the most of the new federal mental health transfer will require strong accountability frameworks and a spirit of learning.
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Judging from my experience attempting to promote uptake of short-term acute mental health home care ( SAMHH) , these are unlikely to happen.
SAMHH is an even more transformative innovation shared by the UK and Australian mental health systems , than provision of psychotherapy. All psychiatric patients destined for admission are diverted to home treatment wherever possible, plus suitable inpatients are discharged early to home treatment ( 1)
In 1989 I founded Canada's first SAMHH service--Hazelglen--at Kitchener's Grand River Hospital.
After SAMHH was recommended in the Romanow report ( 2) in 2002 and after it was included as a priority in the 2004 Health Accord, I tried to engage the Ontario Ministry of Health to promote its uptake in 2006
By then, Hazelglen had proven itself an effective alternative to admission over 17 years and my book on home treatment had just been published to excellent reviews ( 1)
The local MPP tried unsuccessfully for months to arrange a meeting with someone in the Ministry
My letters to the Ministry went unanswered.
Requests to the local federal MP for a meeting with the federal department of health went unanswered
I could not find an entry point into the healthcare system for this innovative idea--and--even stranger, no one else knew of...Competing Interests: None declared.