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Key Components of an Integrated System: Peer Support 

From: Submission to the Select Committee on Mental Health and Addictions. Presented by Paul Garfinkel, June 3, 2009.

Ontario should provide targeted funding to LHINs for peer and family initiatives. These programs should be evaluated and their effects on treatment costs documented.

Over the last ten years the role of consumer survivor initiatives (CSI) and family support initiatives has been promoted in policy and research efforts in Ontario. In Making it Happen, consumer survivor self-help, consumer initiatives and family self-help were identified as key ingredients in a reformed mental health system. In the last 10 years, new research has shown the importance of these programs to the mental health and addictions system.

A recent review of research shows that CSIs reduce hospital use, lead to improvements in the health system, and provide employment. In one study, participants in the study went from an average of nine hospital days (in previous nine months) to only two hospital days after participating in a CSI for 18 months. The same study reported that participants in CSIs experienced greater reductions in symptom distress, improvements in social support and quality of life. Another study reported that the role of CSIs in assisting clients’ transition from hospital to the community saved the health care system more than $12 million because of shorter hospital stays (Canadian Mental Health Association, Ontario, Centre for Addiction and Mental Health, Ontario Federation of Community Mental Health and Addiction Programs, Ontario Peer Development Initiative (hereafter CMHA / CAMH / OFCMHAP / ODPI), 2009; Standing Senate Committee on Social Affairs, Science and Technology, 2006).

CSIs serve primarily those with serious and persistent mental illness: in one study 64% of CSI participants had a mood disorder, 33% had schizophrenia and 90% were taking psychotropic medication (CMHA / CAMH / OFCMHAP / ODPI, 2009). They have an important role in reducing the stigma attached to living with a mental illness and have become an important element in system planning regionally and provincially. CSIs have addressed stigma in part by employing individuals with serious mental illnesses. Alternative businesses alone employ over 800 individuals across Ontario. Many of these individuals were out of the workforce for many years and were told that they were permanently unemployable (CMHA / CAMH / OFCMHAP / ODPI, 2009).

The effectiveness of consumer survivor initiatives warrants their inclusion in a provincial strategy and the allocation of stable, permanent funding. These critical partners in the mental health and addictions system need to be accessible across Ontario and involved in system planning and design at a regional level. Adequate and comparable funding as compared to other community mental health and addictions programs will provide the resources for CSIs to stabilize and mature.

Families who care for relatives who have mental health or substance abuse problems contribute significantly to the care and recovery of individuals. The majority of individuals who have been hospitalized for a mental illness are discharged to the care of their family. Research in Ontario has shown that families are regularly involved in the lives of individuals with mental illness; many live together and those that don’t have daily or weekly contact. This care and support can take the form of crisis intervention, system navigation, treatment monitoring, and assistance with daily living (Family Mental Health Alliance, 2006). In some cases this care costs families money, approximately 58% of families report paying out-of-pocket expenses to care for someone with a mental illness. Family require better education and support in their role of caregiver, consistent availability of peer support and recognition of their role in the treatment and recovery of their loved one (Family Mental Health Alliance, 2006).

In Submission to the Select Committee on Mental Health and Addictions:

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