Is This The End of the Mental Health Commission?

By Marvin Ross

In December, I wrote a blog pointing out that the Mental Health Commission of Canada should be disbanded. Those of you who follow my writing on Huffington Post know that this has been a constant theme of mine over the past few years. Last Fall, the Federal Health Minister set up an inquiry into what they called Pan Canadian Health Organizations (PCHOs). These are federally mandated groups established to carry out specific tasks in health across the country when, in fact, health care comes under provincial rather than  federal jurisdiction.

The review was to evaluate the role and relevance of these groups in advancing federal health policy objectives and meeting national goals. One of the PCHOs is the Mental Health Commission and my advocacy colleague Lembi Buchanan and I submitted a brief on the Commission through the Best Medicines Coalition.

With amazing speed for a government report, the findings were just released. Much to our delight, the Commission recommended that the Mental Health Commission either be ended or radically altered.

The basic premise for health care in the 21st Century as outlined by the World Health Organization and endorsed by most countries including Canada is that it be people centred. “It puts people at the centre of the health system and promotes care that is universal, equitable, and integrated. The framework emphasizes a seamless connection to other sectors, notably those focused on the social determinants of health. This framework also promotes providing a continuum of care that requires high-performing primary care.”

The conclusion the reviewers reached about the Mental Health Commission of Canada is that “Mental health is now “out of the shadows”. The integration of mental health care services into the core of Canadian health systems requires a different type of leadership, capable of driving a bottom-up approach in which patients and families, providers, researchers, and the broader mental health community come together to break down silos.”

As a positive, the report states that “The MHCC has been particularly effective in developing strategies around mental health, along with initiatives and campaigns to increase awareness and reduce stigma. It has made great strides in delivering on its objectives and helped to bring mental health “out of the shadows at last.” It has also created valuable contacts and built trust among its closest stakeholders.”

It did develop a mental health strategy mostly ignored and it did help to raise the awareness of mental illness. However, the report states that:

“The need to build greater capacity in Canada on mental health is still as pressing today as it was when the MHCC was established. What has changed, however, partly as a result of the advocacy work undertaken by the Commission, is the overarching policy goal. What Canada needs today is the complete and seamless integration of mental health into the continuum of public health care. What Canadians want is public coverage of proven mental health services and treatments, beyond physicians and hospitals. To be successful, those services must be integrated with primary care and supports for physical health, rather than isolated from them. We came to the conclusion that MHCC, in its present form and with its current orientation, is not the best instrument to achieve the objective of integrating mental health into Medicare.

They then state that these goals might be achievable if the MHCC changed itself but suggest that to accomplish this they would have to engage “health leaders at provincial and territorial levels in joint decision-making over service funding and quality standards; a different “knowledge base” in support of evidence-informed advice and performance evaluation; and a different, more flexible, and less centralized structure.”

This, in fact, is one of the many criticisms I’ve made over the years. The MHCC churns out papers but has zero influence in decision making and that is exactly what is needed. Policy papers are fine but they need to be implemented and the MHCC has yet to accomplish that from what I’ve seen. The report concludes in its section on the MHCC that “It is because mental health is so critically important to Canadians- and their governments- that a new approach is now needed.”

I was impressed with the team tasked with this job and I’m impressed with the speed in which it produced its report (October 2017 to March 2018). Let us hope that the Health Minister implements the recommendations.

And, a documentary we did on schizophrenia

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5 thoughts on “Is This The End of the Mental Health Commission?

  1. Thank you Marvin for all the advocacy that you, Lembi Buchanan and Dr. Dawson do. I know how deeply deeply frustrating it is to get the decision makers to listen. But they seemed to have listened here!

    The following paragraph captures the essence of the report:

    “The integration of mental health care services into the core of Canadian health systems requires a different type of leadership, capable of driving a bottom-up approach in which patients and families, providers, researchers, and the broader mental health community come together to break down silos.”

    Currently, families of the most seriously mentally ill are forced to straddle silos to try and cobble together some sort of support for their most seriously mentally ill loved ones. Our loved ones are denied service from community agencies because they have the symptom of anosognosia and do not believe that they are ill and therefore will not ask for help. Publicly funded agencies have adopted a cult like philosophy which appears to deny the existence of serious mental illness. We are denied a voice on health committees where we are tokenized and our input is overlooked. We endure condensation. Our lives supporting a severely ill loved one is made more stressful by the interpretation of patient rights read by the Patient Advocate to a vulnerable and confused individual which threatens whether he/she will stay in hospital and receive needed medical treatment after we have worked so hard to get that individual into hospital.

    The following paragraph is also hopeful:

    “They then state that these goals might be achievable if the MHCC changed itself but suggest that to accomplish this they would have to engage “health leaders at provincial and territorial levels in joint decision-making over service funding and quality standards; a different “knowledge base” in support of evidence-informed advice and performance evaluation; and a different, more flexible, and less centralized structure.”

    I have just attended a public meeting where a politician referred to mental illness as “mental situation”. We need to have more mental illness literacy, so that decision makers know what people with serious mental illness are dealing with. And also more mental illness literacy among service providers!!!!

    You say that the present MHCC churns out papers which have zero influence in decision making. A good example of that is the brilliant 2013 MHCC Family Guidelines which if they had been incorporated would save lives. I have been so discouraged about the resistance in implementing these Guidelines. It is totally unbelievable.

    So perhaps this report will spur a new direction in improving mental health services. Let us hope.

    Liked by 1 person

  2. Well done, thank you so much for this. I also agree that the MHCC now serves no purpose.

    MHCC could *possibly* make a contribution if they were willing and able to focus, for example, on the tens of thousands of Canadians with mental illness now locked up in our jails and prisons.

    There is a desperate need to stop the scandalous and ongoing shift of Canada’s most vulnerable citizens from the health care system into the criminal justice system. It is a scandal of enormous proportion that requires strong national advocacy.

    Unfortunately, MHCC has shown its disregard for the needs of people with severe and chronic mental illness — as witnessed by their Recovery Declaration. One of the major pillars of the Recovery Declaration is “Recognizing that each person is unique, with the right to determine their path toward mental health and wellbeing… ” By insisting on the individual’s right to choose, MHCC failed to include people with psychotic disorders who are sometimes too ill to be able to “choose” the very treatment they need to recover and be restored to their family and community.

    As Ms Buchanan has so aptly put it: “What about the right to be well?”

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    1. I agree whole heartedly with your comments Jane. Where was the Commission as this trend (incarceration instead of proper essential healthcare) was accelerating ? The Commission got on with hyping stigma inflated stats and wellness and all sorts of fluffy issues.

      Well funded from the beginning it indulged itself by having on its family committee w a professor who did not believe that mental illness even existed. The excuse for that was ” we have to have all points of view” ! There were also some nonsense quotes by some of its members.

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