Mental Health Service Systems

Mental health services, broadly defined, comprise a mix of health, social, vocational, recreational, volunteer, occupational therapy, and educational services, as well as housing and income support. They include a range of activities and objectives ranging from mental health promotion and the prevention of mental health problems to the treatment of acute psychiatric disorders and the support and rehabilitation of persons with severe and persistent psychiatric disorders and disabilities. In Canada the planning and delivery of mental health services is an area in which the provincial and territorial governments have primary jurisdiction. The federal government (chiefly through the Public Health Agency of Canada) collaborates with the provinces and territories in a variety of ways as they seek to develop responsive, coordinated and efficient mental health service systems. This site offers access to documents of interest to planners, policy makers and service providers in the field of mental health service delivery.

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Health Transition Fund Research Findings on Mental Health Services

The Health Transition Fund (HTF) was a $150 million fund which from 1997-2001 supported 140 projects across Canada to test and evaluate innovative ways to deliver health care services. These projects generated evidence that governments, health care providers, researchers and others can use in making informed decisions leading to a more integrated health care system.

Twenty-five of the HTF projects were relevant to mental health services. Summaries and factsheets are available for all projects, and full reports for most projects. In order to help communicate evidence from the projects to decision-makers, experts were employed by the Public Health Agency of Canada to synthesize the key process and outcome learnings in each of nine theme or focus areas (including mental health services  ), along with an overall synthesis. These synthesis documents, along with information about specific projects, can be found on the Health Transition Fund web site.

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Risk, Vulnerability, Resiliency - Health System Implications (Health Promotion and Programs Branch, 1997)

The risk/vulnerability/resiliency approach provides an opportunity to explore new ways of framing work across population groups and across health and mentalhealth issues. This publication features work on this approach and its implications for the health system. It consists of 1) a background paper; 2) a working paper based on discussions at a National Round Table; 3) reflections by the participants and other stakeholders; and 4) an account of five concrete applications of the concepts to specific health issues.

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Best Practices in Mental Health Reform -- prepared by the Health Systems Research Unit, Clarke Institute of Psychiatry

Best Practices in Mental Health Reform: Situational Analysis (1997)

This document consists of an analysis of mental health reform policies, practices and initiatives in Canada which approximated 'best practices'. These are descriptions of what can be done through innovative initiatives.

Review of Best Practices in Mental Health Reform (1997)

The purpose of this literature review is to summarize the evidence that is most relevant to the reform of our mental health systems and to guide the reader to other reviews and resources. The review has focused upon services and strategies for persons with serious mental illness at the program and system level. It has generally not included research into client-level treatment interventions. The question of interest is how to best organize programs and systems within which efficacious clinical interventions and treatments can be provided.

Best Practices in Mental Health Reform: Discussion Paper (1997)

This discussion paper summarizes the first two phases of the project (a critical review of the evidence base for "best practices" relevant to mental health reform, with a focus on chronic and severe mental illness, and a situational analysis of mental health reform policies, practices and initiatives in Canada which approximate "best practices"). It then addresses the implementation of best practices across entire systems of care, and offers several recommendations for action.

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Accountability and Performance Indicators for Mental Health Services and Supports 
- prepared by the Mental Health Evaluation and Community Consultation Unit, UBC

This document is intended as a follow-up to the three Best Practice publications by providing a Resource Kit of Performance Indicators to facilitate the ongoing accountability and evaluation of mental health services and supports.

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Quality of Life Measurement Among Persons with Chronic Mental Illness: A Critique of Measures and Methods (1996), prepared by Mark Atkinson, PhD and Sharon Ziblin, M.Sc.

This document is intended to cover the basic issues, methods and instruments, and to foster an understanding of what is needed to employ Quality of Life (QoL) measurement in a meaningful way in clinical practice, evaluation activities or research projects. Issues and methods addressed include definitions of QoL, instrument reliability and validity, the validity of measurement methods, evaluation design, and the role of QoL measurement in mental health planning and policy formulation.

Evaluation of Programs for the Treatment of Schizophrenia: A Health Economic Perspective (1994), prepared by Ron Goeree

This document presents a health economic perspective on the evaluation of treatment programs for schizophrenia, with a focus on quantitative research. The report touches on the different types of economic evaluations, describing and assessing in detail an evaluation model that focuses on outcome measures. The use of basic economic evaluation terms and concepts is also discussed.

Evaluation of Programs for the Treatment of Schizophrenia: Part II A Review of Aelected Programs in Canada (1996), prepared by Ron Goeree

This document presents a review and case study of several model programs and their evaluation activities, including instruments used. This second report, which is intended to be read in tandem with the first report, is useful in presenting concrete examples to illustrate the principles espoused in the earlier publication. These examples provide a basis for suggestions and recommendations on how to bridge the gap between what is currently being done and what might ideally be done with respect to the evaluation of schizophrenia programs.