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Mental health, addiction, suicide prevention standards introduced in Canada

Health Standards Organization says aim is to improve care, meet needs of Canadians
Alysha Gill, seen in an undated handout photo, says she was in and out of hospitals for anxiety and depression but did not get much say in her care so she’s hoping new standards introduced by the Health Standards Organization will help empower people when it comes to their own mental health. THE CANADIAN PRESS/HO-Alysha Gill

An Ottawa-based non-profit that helped develop Canada’s long-term care standards now wants to set national guidelines for mental health and addictions treatmentand suicide prevention.

The Health Standards Organization (HSO) said Tuesday it is responding to the growing use of illicit substances in a country where nearly 4,000 people die by suicide each year.

Spokeswoman Kaye Phillips said the HSO’s aim is to improve care throughout people’s lives, provide more support to their family members and meet the needs of diverse populations, including youth and Indigenous communities.

The suicide prevention standard, for example, requires mental healthteams to be trained on routine screening and assessing of suicide risk and for policymakers to develop programs and build the workforce to implement them.

Consultations with groups including the First Nations Health Authority in British Columbia were part of the process that began in 2017.

Phillips said the well-being of health-care workers is one focus of the standards, which will be adopted next year by Accreditation Canada, a program that certifies about 1,500 organizations including hospitals and community care facilities such as treatment centres. All of Quebec’s mental health and addictions facilities are accredited through that system, she added.

Carole Ann Alloway, who represents the HSO through her experience as a patient and caregiver for her ill husband, said the challenge will be ensuring that all provinces and territories use the standards that are meant to ensure consistency in services regardless of where people live.

However, getting accredited may be an incentive for publicly funded facilities that would be recognized for using evidence-based standards.

The standards come at a time of general acknowledgment about the need to improve mental-health services across the country, and before Canada introduces a three-digit suicide prevention hotline in November.

The federal government was also set to announce national standards this year for the same issues. They were created by the Standards Council of Canada (SCC) but will now be announced in 2024 “due to larger than anticipated stakeholder interest” and staff training, Mental Health and Addictions Minister Carolyn Bennett said in an emailed response.

The HSO standards, which predate those by the SCC, are a framework for the federal standards,Bennett said.

Those will focus on six priority areas such as integration of mental health and substance use into primary care, including for youth, early intervention and digital mental health and substance use apps.

They are expected to help formalize what people can expect in terms of the timeliness of care across the country, Health Canada said in unveiling the initiative in March 2022.

Alysha Gill of Surrey, B.C., said she was in and out of several hospitals between 2015 and 2018 after being diagnosed with anxiety and depression but did not have much say in her care, especially when she was released while still feeling suicidal.

“I went in wanting help and I was told, multiple times, that I was OK, that people are worse off. Things like that.”

Gill, who is now an outreach worker at a high school, said youth who are in distress often have to wait too long to see a psychiatrist, and in her case it took three months to get an appointment.

She is hoping the HSO’s standards will empower people with a mental illness to advocate more for themselves and for health-care professionals to work more closely with families that are also in crisis.

“I think, honestly, in general, having more compassion. I’ve been through a lot in the system.”

Kulpreet Singh, director of the South Asian Mental Health Alliance, based in Surrey, said he’s glad the HSO has recognized the importance of cultural safety but there’s a huge need for language interpreters in the health-care system.

“People kind of nudge the family members to do the interpretation for them but that’s very unethical because family members can also add things or remove things from the instructions or from what the patient is saying,” Singh said.

He said health-care professionals should understand “patient-centric care” can include family whenever that is helpful instead of ignoring the “collectivist” model of care that is more appropriate for some communities, including South Asians.

Singh also called for more recognition about the vast diversity among various groups.

“A South Indian person is very different from a North Indian person is very different from a Pakistani person is very different from a Sri Lankan person. It’s too much for decision-makers to deal with. Their thing is like, ‘Do you have something that’s kind of easy for me, to check a box?”

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