Canada’s mental-health data should be standardized, report says
Research billed as starting point for collecting, comparing stats
A new report is providing a rare opportunity for health care providers and policymakers to directly compare statistics on mental illness and treatment in different parts of Canada.
“Toward Mental Health Services in Canada,” published by the Centre for Applied Research in Mental Health & Ad- diction at Simon Fraser University, with contributions from researchers across the country, has compiled standardized information on mental health and addiction care and access in Ontario, Quebec, Manitoba, Alberta and B.C.
“This is ultimately about accountability,” Dr. Paul Kurdyak, co-author of the report, told the Star.
“Everybody is crying for better results in the mental health system and yet the mental health system, historically, has been invisible — and there’s no way to address the deficiencies that we know exist unless at minimum you’re able to measure the status quo.”
While province-to-province comparisons are common in areas of medicine such as cancer care, data collection for mental health and addictions in Canada is fractured and inconsistent.
Healthcare is administered by the provinces and territories, making national oversight difficult, said Kurdyak, a scientist at the Institute for Clinical Evaluative Sciences and associate professor of psychiatry at the University of Toronto.
Different jurisdictions collect different statistics and define information in different ways, making apples to apples comparisons next to impossible.
Youth mental health care, which in most provinces is split between multiple government departments such as health, child services and education, is particularly hard to keep stats on. And care by private psychologists and other professionals whose services aren’t covered by public insurance plans are also poorly tracked.
“In order to be able to do a better job in mapping the entire mental health system, you really have to do what we’ve done currently, which is to go to each province and go to a lot of trouble to standardize how we’re measuring things,” Kurdyak said.
By amassing and comparing provincial data on access to family physicians, emergency room visits as a first point of contact for mental health services, physician followups after hospital discharges, mortality rates, rates of suicide and suicide attempts, this new report makes it easier to find bright spots and weak points in the mental health system, its authors say.
Manitoba, for instance, has a markedly higher rate of suicide attempts among people with mental health or addiction issues, though Quebec and B.C. have higher rates of suicide deaths. Albertans who spend time in hospital for mental health or addiction issues are the most likely to visit their psychiatrist or family doctor within seven days or 30 days of being discharged. People in Quebec are least likely to get those timely followup appointments.
“(The data) really helps to inform, not only at a national level but on a provincial level, strategies and approaches for meeting a health-care need. It’s key information for deci- sion makers in the health sector and in government,” said Dr. James Bolton, report co-author and associate professor of psychiatry at the University of Manitoba.
But this project was more about “the art of the possible” than it was about the specific statistics findings, Kurdyak said.
It’s a starting point that shows standardized data can be compiled from different provinces, with some hard work.
“I would like to see us learn from the process that we went through this time,” Kurdyak said. “I would like for us to very quickly come to standardized definitions . . . and I would very much like for there to be more provinces and territories brought on board.”
To do that, Canada needs a “mechanism for oversight” that can act as a home base for regular, comprehensive measurement of the mental health and addictions care system, the report says.
“We have demonstrated that collaborative, cross-province processes for the generation of performance measures for mental health services is possible,” the report concludes. “There is enormous potential now to sustain and expand these successes for the ultimate benefit and quality of life for Canadians with mental health and addictions issues and their families.”