January has been a busy month as we work to finalize the program for our annual conference (April 5-6, 2013), update our progress with our strategic plan, and start to identify our priorities for the coming year. We are looking forward in April to joining our colleagues from across the province, hearing about the latest updates in our field, and continuing our dialogue about the challenges and opportunities that face us as a profession. This year we are excited to host a public forum on the Thursday evening (April 4, 2013) where invited speakers on mental health policy, including David Goldbloom from the Mental Health Commission, will debate the issues facing psychiatry and possible solutions. Continuing the theme of “Partners in Care: Transforming the System” we will be hosting a second annual meeting of the leaders of organized psychiatry within Ontario. We will also build on last year’s workshop on “The Future of Psychiatry” and provide an opportunity for OPA members to meet Council members and discuss opportunities for advocacy and change. Alina Marin is our incoming president and will build on this momentum with her theme “Preparing the Future”.
We are in a time of significant change, and that brings both challenges and opportunities. Although I spend much of my time in administrative work, the time I spend with my patients grounds me, and refocuses my attention on the important issues. I have been reflecting on how much clinical time I seem to be spending on advocacy and problem solving – helping my patients negotiate issues of poverty, unsuitable housing, unrelenting work stress, and the challenges associated with social assistance and disability insurance. There has been a growing recognition of the impact of the social determinants of health on physical and mental illness and in 2008 the WHO published their report from the Commission on the Social Determinants of Health with a call for action. Canada has been a leader on research within this area, and the Ontario government’s public policy has focused on these issues in recent years. In 2008 Ontario launched the Poverty Reduction Strategy, which called for reducing the number of children living in poverty by 25% over the next 5 years. Strategies included an increase to the Ontario Child Benefit, a refocusing on education and early learning, and a review of the social assistance program. The final report of the Commission for the Review of Social Assistance in Ontario was released in October. Recommendations include streamlining social assistance by combining OW and ODSP, offering one standard rate and then supplements for disability, families and children. It was recommended that the new program would be delivered by municipalities and First Nations for better integration with other human services, and expanded opportunities for linkages with local employers. The report focuses on removing disincentives for people to seek employment through providing disability benefits, extended health benefits and children’s benefits to all low-income families and individuals. They also recommended accelerating the next phase of Ontario’s Comprehensive Mental Health and Addictions strategy with a focus on adult’s mental health and pathways to employment. It is unclear to what extent these recommendations will be implemented but in the early hours of Kathleen Wynne’s position as Premier-delegate she indicated that a review of these recommendations would be a priority. I would encourage each of you to make your views known to your local MPP, and to advocate for a more humane social assistance system for our patients, before these recommendations get buried under other crises of the day.
The OPA Council has also been discussing the increasing prevalence of problem gambling and the current government’s stance on allowing the expansion of casinos across Ontario. There is good evidence that increased access to gambling increases the risks for problem gambling and the OPA is advocating for our political leaders to stop the expansion of casinos. Other issues that we are paying attention to is the changing funding models for hospital based psychiatry including use of the RAI-MH, and the shift of resources from hospital to communities through community sessionals and sessionals for Family Health Teams. We have been experimenting with social media as a way to stay more connected with our colleagues across the province and engage in a dialogue about further ways to advocate for improved access and care for our patients. We welcome your input into future directions for the OPA and look forward to seeing you at our annual conference in April.
Sarah Jarmain, MD, FRCP(C)
President, Ontario Psychiatric Association