Vancouver Sun Op-Ed: Improving mental health and addiction services

By Jonathan Oldman, Executive Director, The Bloom Group
Published in The Vancouver Sun, September 23, 2014

The Vancouver mayor’s task force on mental health and addictions recently presented its report to council. In it were recommendations — all unanimously approved — that could significantly improve the landscape of mental health and addiction services in Vancouver.

These recommendations are the result of a year of research and consultation that began in September 2013, after Mayor Gregor Robertson, police chief Jim Chu and Kip Woodward, chair of Vancouver Coastal Health, called for urgent action. People with severe mental illnesses and addictions were encountering police and entering hospital emergency rooms at rapidly increasing rates.

The ministry of health and VCH announced a package of new services, and the mayor convened a panel of community groups, government agencies, researchers and people with lived experiences of mental illness and addiction, to examine how to further improve care.

We participated in and support these efforts because we simply cannot afford a mental health and addictions system in which a large number of people have access to treatment predominantly when they are in crisis. The human cost for people and their families is far too high, and the system costs — spread across health, welfare, law enforcement, and many other jurisdictions — are enormous.

At that time we also wrote an opinion piece in this newspaper calling for a fundamental re-think on how we work together to support vulnerable members of our community, and for a commitment to build a truly coordinated system that improves the continuity, effectiveness and quality of care.

Co-ordinating services is neither a simple undertaking nor a natural outcome of a system that is split across so many jurisdictions, and provided, by necessity, through myriad individual services.

Encouragingly, one of the task force’s key recommendations, supported, and now funded, by the city, as well as Vancouver Coastal Health, Vancouver Foundation, and Pacific Blue Cross, will help build such a co-ordinated approach.

Different providers and health care workers have always worked together to deliver services on the front lines. People and families who are already receiving effective support will tell you there is a diverse team that makes that possible. We want to take the best of that co-ordination and apply it system-wide, using a planning model called Collective Impact.

Collective Impact sets out a series of good practices to bring all the different community and government agencies together; in this case, health care, housing, social supports, and law enforcement groups, along with people with lived experience of mental illness and addictions, and their family members.

In the Collective Impact model, these diverse groups will create a common vision for a successful mental health and addictions support system. They will decide together how to measure success, and ensure everyone involved is working toward these same goals. They also work together to solve problems when improvements in service delivery are required. Greater emphasis is put on improving how organizations and agencies communicate and collaborate with each other and with the people they serve on a continuing basis, all towards better providing these individuals with the support they need to be safer and healthier in our community.

Interest in the Collective Impact model is growing around North America, as communities apply this approach to better address a range of social challenges: from youth aging out of foster care and improving Aboriginal health, to improving social inclusion and belonging, to improving access to end-of-life care for the most marginalized.

We need to pursue a new collaborative approach with urgency, but also with patience. We need understanding from the wider community that allocating some resources in such system co-ordination is not wasting money on administration. It’s investing in necessary good design.

What Collective Impact helps us understand is that no one single group or government agency should have all the answers or to be held responsible for where we are falling short. An approach based on a fundamentally different principle — that we can and must work together — could indeed be a game-changer.

Jonathan Oldman is executive director of The Bloom Group, and a member of the mayor’s task force on mental health and addictions. He submitted this piece on behalf of: Michael Anhorn, executive director of Canadian Mental Health Association, Vancouver/Burnaby Branch; Darrell Burnham, executive director of the Coast Foundation; Michelle Fortin, executive director of Watari Counselling & Support Services; Nancy Keough, executive director of The Kettle Friendship Society; David MacIntyre, executive director of the MPA Society; Greg Richmond, acting executive director of Raincity Housing & Support Society; Krista Thompson, executive director of Covenant House Vancouver; and Shayne Williams, executive director of the Lookout Emergency Aid Society.