Project IN4M is a three-phase research project, jointly funded by Health Canada and the Mental Health Commission. It’s overall goal is to improve the accessibility of high-quality mental-health services “through needs-based predictive modelling of health, social, education, criminal justice and private sector human resources – including informal caregivers.” Phase One, the subject of this report, examines possibilities for predictive modelling based on needs-based planning experiences in Canada and around the world.
Overall, Phase One of Project IN4M confirms that the potential exists to put in place a reliable, needs-based predictive model built around incidence and prevalence of mental health disorders and leading practices here in Canada and imported from other countries such as Australia. While the project confirms that mental health is, for the most part, a “data-free zone”, models exist for estimating the prevalence and incidence of some of the key mental health diagnoses and for better estimating the effective supply of the broader range of health and social service providers. We can also draw upon the lessons learned from the case studies conducted to refine our models around optimal mix of inputs to maximize health outcomes.
Project IN4M is a multi-sectoral project managed by the Canadian Mental Health Association (CMHA) in association with the Mental Health Commission of Canada (MHCC). This collaborative initiative proposes to explore the feasibility of taking needs-based human resources planning from theory to practice in the mental health domain. The MHCC sees a need for a predictive tool that would supplement its research agenda. Project IN4M is designed to produce a human resources planning tool that will be robust over time, across jurisdictions and across major diagnostic categories. The predictive tool would give governments, service providers and the public a better picture of what is needed in terms of human resource capacity for both formal and informal care-giving (including peer support and peer workers) to address the demand, both now and in the future, for mental health services.
In order to provide contextual qualitative information on the design and delivery of needs-based planning models, the Project IN4M team conducted four case studies of existing approaches to planning human resources. Case studies for the purpose of this project are a study of a unit, such as an organization, that stresses factors contributing to its success or improvement. These studies are highlighted as an exemplar, cautionary model or instructive/illustrative example. The Health Canada approved IN4M project plan provided for three case studies, but to provide additional insights, an additional case was added.
During August and September 2010, IN4M staff surveyed experts on existing planning models and to determine strategies to deal with the current lack of data; these strategies included a discussion of the use of data proxies – facts, figures or criteria. The survey results will form the basis for a national roundtable of policy-makers from a variety of sectors (including education, criminal justice, social services, health, private sector, private practice, informal caregivers and NGOs) in November 2010. The invitational roundtable will consider the results of an environmental scan, a review of peer-reviewed and grey literature, and these results to give expert advice on the development of a needs-based model for mental health human resources for Canada, and its provinces and territories.
This Analysis in Brief by the Canadian Institute for Health Information looks at symptoms and diagnoses of depression in a sample of nearly 50,000 seniors living in 550 Canadian residential care facilities (also known as long-term care, nursing or personal care homes) in Nova Scotia, Ontario, Manitoba, Saskatchewan and the Yukon. Relationships between depression and medical conditions, functional and social factors, quality of life and use of health services are explored, comparing those who have symptoms and/or a diagnosis of depression with other residents. The analysis concludes with a discussion of opportunities to improve the quality of care for seniors with symptoms of depression using new information available from the CCRS at CIHI.
The purpose of this analysis by the Canadian Institute for Health Information was to identify various factors related to whether or not a person was readmitted following a first-ever stay in hospital for the treatment of depression. To do this, the analysis examined various socio-demographic, treatment, clinical and discharge environment characteristics and assessed their relationship to hospital readmission during various time periods following the first admission.
Although lower socio-economic status (SES) has been linked consistently with higher rates of mental illness, it has not always been associated with higher rates of mental health service use. In this Analysis in Brief the relationship between SES, as measured by neighbourhood income, and inpatient hospital mental health service use for depression was examined in persons age 15 to 64 in 13 cities across Canada. The results suggest an inverse relationship such that individuals from lower-SES neighbourhoods were more likely to be hospitalized for depression than those in higher-SES neighbourhoods. However, no relationship was observed between SES and hospital length of stay or hospital readmission rates, suggesting that differences in SES were not linked with differences in severity of illness or persistence of treatment.
According to a new analysis from the Canadian Institute for Health Information (CIHI), 38% of patients discharged with a diagnosis of schizophrenia from a general hospital in Canada had unplanned readmissions (through emergency departments) for a mental illness within one year of their discharge. The analysis also found that 12% of schizophrenia patients (or one in eight patients) were readmitted to hospital within 30 days of their initial discharge, in the years 2003 to 2005.
From a public policy perspective, investing in the health of our children is as essential to our growth as a nation as investing in infrastructure. Seeking recommendations to help improve the health and wellness of Canada’s children and youth, Canada’s Health Minister, the Honourable Tony Clement, asked for this report. It provides advice related to existing federal government programs, the need for new policy directions and programs and the concept of establishing an office for the health and wellness of children and youth.
This document was published by Health Canada. View the full report here.