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Improving health care through research

The Next Innovation

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The Next Innovation                                                                                                     

By James Hughes – Guest Blogger

Our foundation hosted a workshop recently at which numerous remarkable Canadian innovations and initiatives in the mental health field were showcased. One featured the school superintendent for Red Deer, Alberta who, following a number of deeply saddening student suicides, led the adoption of a school board wide mental health screening tool. Every one of the almost 4000 children in the high schools managed by the school board was screened using evidence based assessment tools loaded into an ipad. Those who screened for mild or moderate mental illness were referred to evidence based online tools the school board had licensed from Europe. Those who screened for serious illness with suicidal ideation were immediately met by school staff (the parents were met as well) and referred to professional resources for follow up. About 1% of the children were at serious risk thus about 40 kids and families were met within 24 hours of the results coming in. The superintendent noted that half of these kids were not known by either the school or the parents to be facing any serious difficulties whatsoever.

Another initiative highlighted was a telephone based coaching service based in Halifax that is serving thousands of families whose kids (usually 6 to 12 years old) have significant behavioural challenges or anxiety. Professionally trained coaches work systematically with parents to equip them through a structured process over a dozen weeks to stabilize the specific problems the children are experiencing. The evidence has shown that the coaching service is effective not only from symptoms and functionality standpoints but is cost effective as well.

Strong evidence from Canada and abroad also shows clinical and cost effectiveness of supported employment programs for adults, early psychosis intervention, psychotherapy, assertive community treatment, integrated service delivery and others.

So, why are these programs and others like them, which improve outcomes for patients and can produce financial returns for government, not implemented across our healthcare systems? Only 1 in 4 young Canadians gets access to the mental health services they need. The quality of the services the lucky few receive is very uneven. Outcomes are not event tracked.  A presenter at the workshop told us that Canada is world class in creating innovations but has near failing grades in scaling up innovations across systems. What is blocking the progress of bringing proven knowledge and evidence based practice to all those who have or are at risk of mental illness?

This is the million dollar question but there are millions of Canadians suffering with mental illness whose voices have yet to be fully organized, channelled and amplified so that they may truly be heard by the politicians who, despite the best of intentions, seem to be deaf to their plight. It was patients that led the charge that transformed cancer and HIV care. Perhaps this is innovation that needs to be created next: the effective patient and family vehicle that transforms mental health care in Canada. I know the philanthropic sector would be supportive of such a potentially transformational initiative as this.

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James Hughes is the President of the Graham Boeckh Foundation (GBF). GBF’s mission is to catalyse transformational change in the mental health services with a view to improving the lives of those with or at risk of mental illness.

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