Availability Does Not Equal Accessibility
Written by Matthew Meyer, Alexander Smith, Summer Thorp, and Stephanie Simpson, Mental Health and Addiction Strategic Direction Office Team
Dr. Daniel Siegel proposes a "name it to tame it" approach as the first step in identifying and addressing emotions and their triggers. A commonly expressed emotion when describing the mental health and addiction system (MH&A) in London-Middlesex is frustration.
In an LCF-funded study in 2019, our team identified 473 mental health and addiction-focused programs and practitioners in the London-Middlesex region and an additional 31 external programs that provided services here. A repeat study is underway, and those numbers have grown. With so many people available to help, why do individuals continue to fall through the cracks? Clearly, availability does not equal accessibility. Our team frequently hears from people with lived experience, their caregivers, and providers across the system that they do not know where to turn and do not have the bandwidth to pursue every possible avenue. Despite lots of talk about "no wrong door", our system continues to struggle with how to provide integrated care as programs and services compete with one another for funding and clients. We can do better.
The Mental Health and Addiction Strategic Direction Council was established to support collaboration across all levels of the MH&A system. With open arms, we bring together the leaders of system planning tables, operational groups, and organizations to increase collaboration and set shared strategic priorities. We’ve established an office to support system-level coordination and, over the past year, have focused on improving communication between our members. In addition, we’ve begun to create an engagement strategy and accompanying toolkit to improve how our partners incorporate the voices of people with lived experience into their work and planning; it’s a good start, but will only take us so far.
What we really need is a collective commitment to take responsibility for the mental health and wellbeing of our full population, and to working together to support them one at a time. This starts by building a central registry of who we’re caring for and what they need. We need a common approach to screening, assessment, triage, and care planning that includes the client and their full care team. We need clear accountability for who carries out each part of the plan (including the client’s role), willingness to share this information between programs/providers, and trust in each other to do our part. We need to empower employees from different organizations to work together as one team to meet the needs of the person they are supporting. Finally, we need to work together to collectively, and constructively, monitor the progress of each individual and hold each other accountable.
None of these ideas are new; however, they are collectively coming to be known as Population Health Management. Effective health systems around the world are moving in this direction and it’s time for us to do the same. As demand for MH&A services grows, there is plenty of work to go around. Yet, only by committing to work together at the point of care will we ever be able to truly support the needs of our community and turn our shared frustration into collective pride.