The Ontario Medical Association (OMA) and the Primary Care Collaborative want the province to support primary care providers in the treatment of severe depression and anxiety.
A report has recommended the provincial government invest $37.5 million immediately and $75 million annually for 10 years to help treat people through the expansion of team-based care.
The recommendation 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 Ontarians have trouble finding care in their communities.
The Primary Care Collaborative and the OMA noted that while it is urgent to address Ontario's mental health challenges, the scope of the issue is overwhelming and the solutions are complex. The report said 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 specialized support they require."
The plan also recommended the Ontario government expand Health Connect Ontario (formerly Telehealth) to allow primary care doctors and their patients to better navigate the mental health system, preventing unnecessary emergency visits and delays in care
The two groups also want expanded access to supervised consumption and treatment sites and other evidence-based harm reduction programs.
According to a media release, 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 overdoses have increased by 57 per cent and rates of fatal opioid overdoses 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.
Finally, the report called on the the province to implement an Indigenous-led mental health and wellness strategy to address the health inequities and challenges Indigenous Peoples experience. 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 for people with mental health and addictions issues," said the partners of the Primary Care Collaborative. "People underestimate the role that primary care providers play in providing this first point of contact as well as ongoing supports in many forms, including medication monitoring, counselling, referrals and other services. People in Ontario form trusting and continuous relationships with their family physician, nurse practitioner or primary care team, which enables this continuity of care.
"While primary care provides these services, clinicians are chronically underequipped to do so in a meaningful way and have not seen the investments they need to provide mental health and addictions support for their patients," the collaborative said. "The modest requests for funding in our four-point plan will ensure that people in Ontario continue to have access to mental health and addictions supports when they need them and from the providers that they trust."