The provincial government should invest $37.5 million now and $75 million annually for 10 years to help treat people with moderate to severe depression and anxiety by expanding team-based care.
This recommendation from the Ontario Medical Association and Primary Care Collaborative is part of a four-point plan to strengthen mental health and addiction services within primary care settings. A recent Angus Reid poll found one in three Canadians is struggling with their mental health. Rates of new mental health and addictions diagnoses are rising, exacerbated by the pandemic, yet many have trouble finding care in their communities.
The requested funds would be used to embed much-needed mental health supports in interprofessional teams of primary care providers with expertise who could offer treatment locally for moderate to severe depression and anxiety.
“About three-quarters of Canadians rely on their primary care provider to treat their mental health needs and it’s significant care, especially in communities where there are no or few mental health specialists or wait times are long,” said OMA President Dr. Rose Zacharias. “If we created and funded these interprofessional teams for moderate to severe depression and anxiety, we could help seven to 10 per cent of Ontarians. Otherwise, these patients suffer alone or use hospitals that are not equipped to provide the specialised support they require.”
The plan also recommends:
• Expanding Health Connect Ontario to allow primary care doctors and patients to navigate the system, preventing unnecessary emergency visits and delays in care
• Expanding access to supervised consumption and treatment sites and other evidence-based harm reduction programs
• Implementing an Indigenous-led mental health and wellness strategy to address health inequities and challenges.
Ontario’s COVID-19 Science Advisory Table reported in September 2021 that since the onset of the pandemic, rates of emergency medical services for suspected opioid overdose have increased by 57 per cent and rates of fatal opioid overdose have increased by 60 per cent.
One in four Ontarians who died of an opioid overdose during the pandemic had an interaction with the health-care system in the week prior to death, suggesting potential missed opportunities for overdose prevention. In addition to allowing people to use substances safely, supervised consumption and treatment sites provide the opportunity for multiple contacts with health-care staff, social workers and other professionals.
Throughout this pandemic, Indigenous Peoples with chronic conditions have consistently had worse physical, mental and social health than other Canadians. Low income, food insecurity, disrupted family dynamics, lack of immediate and ongoing social support, and increased substance use are among the most significant factors contributing to deteriorated mental wellness among Indigenous Peoples and communities.
“For most Ontarians, primary care is the first point of contact,” said the partners of the Primary Care Collaborative. “People underestimate the role that providers play as well as ongoing supports in many forms. People form trusting and continuous relationships with their family physician, nurse practitioner or primary care team, which enables this continuity of care. And, “while primary care provides these services, clinicians are chronically under equipped to do so in a meaningful way and have not seen the investments they need to provide support.”ϖ
The Ontario Medical Association represents Ontario’s 43,000-plus physicians, medical students and retired physicians.
The Primary Care Collaborative is an alliance of primary care organisations working to strengthen primary care as we move toward pandemic recovery.