Filling the Gaps in Addiction and Mental Health (AMH) Chief Addiction and Mental Health Officer Alberta Health

Chief Addiction and Mental Health Officer Who is that guy? 2

The “System” Today 3

Sessions Scheduled Zone Grand Rounds (Psychiatrists) Alberta Medical Association (Physicians) Strategic Clinical Network (Researchers) Alberta Health Services staff (mostly regulated professionals) Addictions staff (mostly unregulated professionals) Provincial Advisory Council (service users and family members) Homeless Shelters and other non-governmental service providers (e.g. AAMIMH NGO’s) 4

Creating Connections: Alberta’s Addiction and Mental Health Strategy 5 priorities: 1.Build healthy and resilient communities 2.Foster the development of healthy children, youth and families (includes seniors) 3.Enhance community-based services, capacity, and supports 4.Address complex needs 5.Enhance assurance Explicitly mandates cross-sectoral and cross-ministerial action 5

Work Underway or Completed Low risk drinking guidelines Tobacco Reduction Act, 2013 The Mental Health Capacity Building in Schools Initiative Tertiary Care Framework Adolescent Concurrent Treatment Program Consensus Development Conference on Improving Mental Health Transitions ID for the Homeless Program Community Support Teams supporting adults with developmental disabilities Mental Health First Aid Training for adults who interact with youth 6

GAP-MAP: 9 System Level Findings 1.Existing services do not provide sufficient care to meet the needs of Alberta adults. 2.Services are mainly operated on a reactive, acute care model that requires Albertans to seek care at physician offices and specialty clinics 3.System resources are heavily invested in providing inpatient, residential and crisis services 4.There is wide variation in the costs of providing acute inpatient care for different conditions 5.System resources are heavily invested in providing care for adults 7

6.Programs and services require assistance for continuous improvement 7.System resources are heavily invested in providing care for mental health problems and may be under-invested in addictions services 8.Supportive services for addiction and mental health problems are not well-integrated into addiction and mental health care 9.Neither AHS nor the Government of Alberta uses standardized nomenclature to define specialty addiction and mental health programs and services 8 GAP-MAP: 9 System Level Findings

There are regional service provision differences We need to improve the way we capture, use, analyze and report data (population, system and costing) System planning is currently ad hoc. Need to focus on use of system-wide case identification, volumes, management and outcomes information Practice standards are not consistent on aligned causing cost variations across the system 9 GAP-MAP – Other Implications

Percentage of Alberta Adults Reporting Service Needs Gap-Map Survey 6,000 Albertans

Percentage of Alberta Adults Reporting Different Reasons for Unmet Service Needs Gap-Map Survey 6,000 Albertans

Proportional Costs of AMH Services: 6% or less of Alberta Health spending overall Gap-Map Survey 6,000 Albertans

Tier Model – Creating Connections – Alberta’s Addictions and Mental Health Strategy 13 An Integrated Practice Mental Health & Addiction Service Model

GAP-MAP – Population Heath Pyramid 14 Problem severity (acuity, chronicity, complexity) Healthy population At risk Meet screening criteria Seen in primary care Diagnosed Access specialty services Service intensity Service extensity (numbers served) High costs Low costs AHS performance reporting

What Service Users See 15 The “System” Today

What Do You Think? 16

Discussion Questions 1.Does this broad view of what's going on in addiction and mental health today align with your experience? –What is missing that is significant from your perspective? 2.Thinking about this broad picture, what are the top priority gaps (2 or 3) that are most important to tackle in the next 3 to five years? –At a systems level? –At a delivery model level? 3.What are top 3 to 5 priority system changes that need to be made in order to improve Alberta’s addiction and mental health system? Send your responses to: 17