Nova Scotians want to lead healthy, flourishing and productive lives. To reach this goal, they must be able to experience positive mental health life free from the harms, risks and injuries associated with substance use and gambling. Mental health is not just about the absence of illness; it includes our emotional, psychological and social well-being. Without mental wellness, hope and the possibility of recovery, individuals and their families are challenged to live healthy lives and contribute to their communities in a meaningful way.
NSHA Mental Health and Addictions (MHA), together with the IWK, is committed to designing a responsive, accessible, effective public system, grounded in evidence and easy to navigate, while keeping the recovery, wellbeing and positive mental health of individuals, their families and communities at the centre of this work.
In October 2017, MHA released the document, Milestones on Our Journey: Transforming mental Health and Addictions in Nova Scotia. It is intended to serve as a framework to further guide the development and implementation of a provincial model for Promoting Positive Mental Health, Care and Support in Nova Scotia.
The milestones document outlines our strategic actions in four priority areas:
- • Mobilizing leadership and fostering collaboration
- • Promoting positive mental health
- • Improving access, treatment and co-ordination
- • Advancing provincial system supports
We have made progress in all four areas:
- • Mobilizing leadership and fostering collaboration includes the principle of equitable access to quality care, characterized by the same standard of care for people living with mental health disorders and harmful substance use/gambling regardless of where you live. MHA strengthened relationships over the past year with Primary Health Care, Emergency Program of Care, Public Health and government departments such as Justice, Education and Early Childhood Development, and Community Services. In 2017 a physician lead for Addictions Medicine was established to help advance the integration of mental health and addictions, among the other valuable insights they provide.
- • Promoting positive mental health – We have created a new provincial structure for health promotion to support the implementation of an action plan centred on community engagement and responding to community needs. The transition to this new structure was implemented April 1, 2018, and is characterized by:
o Specially trained practitioners located in communities across Nova Scotia that work at the local, zone and provincial levels; and
o Broad efforts that aim to improve health and address the social determinants of health, and can focus on individuals, communities, organizations and public policies
- • Improving access, treatment and co-ordination has been achieved by partnering with the IWK to provide timely, effective MHA support to children and youth through emergency departments in all parts of the province, and additional services in schools through the Schools Plus Program. CaperBase Outreach Services, an interdisciplinary team of health professionals who work with youth, families, schools and other community partners to create solutions, opportunities and supports, expanded in Cape Breton. Plans include offering the same support for youth in Annapolis Valley, South Shore and South West areas, as well as Colchester-East Hants, Cumberland and Pictou areas.
MHA has identified access and navigation as a priority area. We recognize the need to transform how we listen to and understand the needs of individuals, their families and communities and match those identified needs with treatment and support options.
The implementation of an opioid action plan resulted in more than 250 new opioid use disorder treatment spaces in public clinics and continues to facilitate capacity building. Another part of the plan has been the creation of a successful Take Home Naloxone Program that co-ordinates the distribution of free life-saving kits through provincial community pharmacies. Pharmacists train people in how to safely use the kit and how to avoid overdose. Twenty-seven hundred free kits have been distributed through 282 community pharmacies and three community organizations; 20 overdose reversals have already been reported (likely significantly underreported).
The MHA provincial 24/7 telephone crisis line has also been enhanced over the past year. Callers can now wait on the line for the next available crisis intervenor or leave a message for a call back. This has not only expanded the caller’s options but allows better data capture to determine how long individuals are waiting. MHA explored the use of technology and e-mental health solutions in 2017. A pilot program to trial and evaluate a potential application for virtual care was completed, with the goal of expanding alternate and effective ways to receive care and support.
Through this program:
o 153 clients were offered secure online appointments
o 63 clients accepted the appointment
o 49 of the 63 completed the appointments
Through the evaluation process, 94 per cent of clients reported they would use the virtual care application again; 87 per cent reported overall satisfaction with the initial visit and 89 per cent reported overall satisfaction during follow up. Nine providers were involved in the initiative.
Advancing provincial system supports – In October 2017, four Accreditation Canada surveyors visited 25 Mental Health and Addictions (MHA) community-based services and inpatient care and support sites. This represented the first time NSHA MHA was surveyed as a provincial program. Service Excellence Standards were used to measure compliance and quality of services, and whether the Required Operating Procedures were met.
Measurements extended over the following domains:
- • Population Focus
- • Accessibility
- • Safety
- • Worklife
- • Efficiency
- • Client-Centred Services
- • Continuity
- • Appropriateness
MHA community clinic services and supports achieved an overall score of 96 per cent; inpatient care and support achieved an overall score of 93.7 per cent. Planning is underway to develop a plan on any unmet criteria.
Our work has just begun in building a responsive MHA system that champions:
- • self-care and family care
- • healthy communities
- • the best possible evidence-based care and support for mental health disorders and harmful substance use/gambling
- • close collaboration with health care partners, organizations and agencies that make a positive difference in the lives of Nova Scotians every day