What Serena Kataoka and Karyn Graham have shared with us through their actual experience is striking because of their discriptions of struggle with mental health and being homeless. We have created devided systems of care – Homelessness, Mental Health, Addictions, rather than a population based approach.
For sure, these divided systems have come a long way, over decades to take a whole system, integrated approach. Yet a whole system – inter-ministry, inter government - municipal, provincial, federal--driven approach laid out by the mental health commission 11 years ago, https://sencanada.ca/content/s...rep/rep02may06-e.htm has a long, long way to go. While we have some very good stand alone examples of integrated care, they remain as pockets.
Homelessness has been around a long time, no one is pretending there are instant answers, rather we have to keep stock and think through how we got here and how historically core everyday services – housing/health/social -that helped individuals and families were broken or not built well enough to help people.
I think of my brother in the 70’s who fit the profile of drugs, mental health, no place to go, who yes was helped by shelters and the mental health system, but who needed a more focused, whole person approach. This might well have helped us as a family as well, in our own broken approaches of help for him.
Principles like these (developed by researchers/practitioners and the people being helped) outlined below can help us more directly shift our system/philosophy of care
Housing First principles:
1 Immediate access to housing with no housing readiness conditions
2 Consumer choice and self-determination
3 Recovery orientation
4 Individualized and person-driven supports
5 Social and community integration
Recovery Principles:
• life goals,
• consumer involvement,
• diversity of treatment options,
• consumer choice,
• individually-tailored services,
• inviting environment.
While I think Karyn, that the CAMH people could actually demonstrate to you many good examples of progress in care approaches over the years, I think we need to bring focus on accountability for care on our Local Health Integration Networks http://www.lhins.on.ca/ where the system plans are being developed. I’m not saying go join a committee, but I see it as the venue that shifts the focus from individual organization’s approach and instead has potential to promote actual cooperation on an individual’s care.