Last month, economist Don Drummond released his much anticipated report on the financial state of affairs in Ontario. His mandate, to recommend ways to balance the budget without raising taxes, means cuts that will affect every Ontarian. To eliminate the 17-billion dollar deficit, Drummond recommends a shift out of hospitals and into homes for acute care patients, bigger class sizes, and holding health care increases to 2.5 per cent or the rate of inflation, whichever is less. Drummond states, the cuts will need to be virtually “unprecedented in post war history.”
His recommendations, with regards to mental health, are somewhat surprising. He begins by recommending an expansion to drug coverage: “The public payer model covers most primary care but less than half of drugs and relatively few mental health services. Extending medicare to more services would be controversial, but an open dialogue will at some point become necessary.” p. 21
The dire prediction for health care over all is a growth cap of 2.5 per cent until 2018. “After that, annual health cost increases must be restrained to no more than five per cent.” However, there is a silver lining for mental health care: “…some areas — including community health care and mental health — will need to grow more rapidly than the average, and the province should address the historic gap in funding and services for mental health and addiction.” p. 22
The report recognises that problems continue to mount while the system fails to respond. This results in individuals with mental health concerns going to prison, which is costly and ineffective in addressing the real concern. “We are going at things from the wrong end; we should conduct research and design programs to get at the roots of the issues.” p. 133
Mental health is identified as a strong contributor to frequent ER visits. The recommended response is more walk-in clinics and augmenting Family Health Teams with counselling services. p. 165
The Drummond report calls for services to be organised more effectively. It refers to the Select Committee on Mental Health and Addictions, which noted that
“mental health and addictions services are funded or provided by at least 10 different ministries. Community care is delivered by 440 children’s mental health agencies, 330 community mental health agencies, 150 substance abuse treatment agencies, and approximately 50 problem gambling centres.”
It also refers to Open Minds, Healthy Minds, Ontario’s Comprehensive Mental Health and Addictions Strategy, which calls for a focus on quality improvement, early intervention and improved service integration for mental health and addiction patients.