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The province is working towards achieving a high performing mental health and addictions system. But we need your help to better understand and measure how we are performing and where we all can improve.

As you know, Ontario lacks a standardized, province-wide system of evidence-based performance measurement for our sector. While data exists that seeks to measure performance at a number of levels, it varies widely across the sector and falls short of being able to provide Ontarians with a clear picture of what needs to be improved.

This is why Ontario’s Mental Health and Addictions Leadership Advisory Council, with support from Addictions & Mental Health Ontario, Canadian Mental Health Association Ontario, Centre for Addiction and Mental Health, Institute for Clinical Evaluative Sciences and the Ministry of Health and Long-Term Care’s Strategic Policy Branch, has been developing a new data and performance measurement framework. Once completed, the framework will be the new standard by which the performance of the mental health and addictions sector in Ontario can be evaluated.

A task group comprised of experts in health systems data and performance measurement, experts in health and public policy and leaders from mental health and addictions community agencies and hospitals began work on this new framework in the summer of 2015. The task group found that service providers at all levels faced a number of barriers and capacity issues that prevented the collection, sharing and analysis of sector-related data in a meaningful way.

In order to address these problems, two pressing needs for the mental health and addictions sector became apparent:

  • The sector needs a logic model to establish a common vision and common understanding around performance measurement, including the collection, analysis and reporting of data.
  • The sector needs a scorecard with a common set of performance indicators that are evidenced-based and focused on health outcomes.

Since its inception, the task group has been working to draft the logic model and scorecard of performance indicators; indicators that can be standardized across hospitals and community-based mental health and addictions organizations, and can provide high quality, comparable data.

Now, the task group is asking for your input. Please review the draft logic model and scorecard and consider the following questions:

  • What are your general impressions of the logic model and scorecard?
  • What are the critical gaps?
  • As a service provider, what are the considerations for data collection and reporting?
    (i.e. What supports are needed to adequately report on these performance indicators?
  • What is needed at an agency- regional- and provincial-level?)
    As a service user, what information do you want to know about the performance of the
    mental health and addictions sector?
    (i.e. What do you want to know is working well or not working well about the sector?)

Your feedback on these discussion questions will inform the final logic model and scorecard of performance indicators.

Please send your feedback online by March 31, 2016.

We are also hosting a series of webinars to gather feedback across the mental health and addictions sector. We welcome participation from service providers and service users, including people with lived experience and the consumer/survivor community. The dates of the webinars are as follows, please click on the webinar of your choice to register.

Webinar #1: Consultation with Community StakeholdersThursday, February 18, 1:30 pm-3 pm

Webinar #2: Consultation with Local Health Integration Network (LHIN) Stakeholders
Friday, February 19, 9:30 am-11 am

Webinar #3: Consultation with Hospital Stakeholders
Friday, March 4, 9:30 am-11 am

Once these consultations have taken place and recommendations taken into account, the task group will then present an updated logic model and scorecard to the Mental Health and Addictions Leadership Advisory Council for its approval.

Together, this logic model andscorecard of performance indicators will form a new framework for measuring the performance of the mental health and addictions sector in Ontario and provide the standardized, high quality and comparable data needed to improve the health outcomes of Ontarians.

We look forward to connecting with you on this important initiative.

For more information, contact:

Paul Kurdyak, Core Senior Scientist and Lead, Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences,

Sean Court, I/Director, Strategic Policy Branch, Ministry of Health and Long-Term Care,

Uppala Chandrasekera, Director, Public Policy Canadian Mental Health Association, Ontario,

For more information, please see the communique attached below.


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First off Dylan...I LOVE your profile picture. That is so funny!

I did type some of my answers down until I also found the link after and did my answers on the website survey. I was wondering if I should post some of my suggestions that I submitted to the survey, here on this post to see if it might interest others to look through and then they might want to answer the survey themselves?

Last edited by Registered Member

Oh what the heck...

These are some of my suggestions that I submitted regarding the draft logic model and scorecard  for the new data and performance measurement framework ....

Comments back to survey that I sent in...
I am not sure if I would call them gaps so much as "areas of concern" for me. Being a person with lived experience and also a family member and also a lived experience/systems level advocate ...I look at this with those three filters.

1) The indicator for "Effective" is years of life lost which is imperative but the other indicator is suicide. What about accidental overdose given the explosion of opioid deaths?

2) The indicator for "Safety" is limited to physical restraints but is it worth trying to explore a way to capture (harm) critical incidents that happen in hospital and/or addiction residential care or wherever 'harm' may happen in the trajectory of care. That may be too big an area at this time but thought I would mention

3) For "wait times" there any way to capture the 'quality of wait time?". For example the difference between being on a wait list and just waiting in empty space compared to providing peer support or some extension of 'service' that mitigates that wait by adding in some type of 'caring' while waiting?

4) For 'client centered' the first suggestion I would make is that you rename that to "Person centered" and reflect that throughout the work. As long as we are referred to as clients, patients, consumers allows us to become 'less human'. The biggest failure in the system has been the objectifying and the biggest/easiest win is to humanize wherever possible.

I really like the 3 indicators for 'client' centered but wonder if there is a way to add a 4th which would be a 'customer service' lens. Did people smile? Were they warm and attentive? Did I feel safe? (I realize that one may be a bit harder to define but it is different than being overtly stigmatized and/or discriminated against)
HUGE thanks for having family/caregivers as an indicator.

5) On the logic model I like that you have stated 'evidence based decision making and practice' compared to the language of best practice. So I guess my overall input on this would be an acknowledgement of the wider parameters of what evidence should be. (Lived and family experience is evidence base-experiential evidence) Is there a way to put that into context? I also wonder if it would benefit this initiative to 'speak to' the need of melding medical/clinical modalities with the social change/social justice modalities so there is room to capture emergent, innovative, allowing an iterative process and some malleable parameters through developmental evaluation(s).....

Betty-Lou Kristy

Lived Experience/‘Family’ Advocate- Mental Health, Addiction, Trauma & Bereavement

I posted my comments which I won't post here because at times were a little harsh.  I found the scorecard a little "lacking", and started off with the first column of Equity and the 5th category of (sex) that it was extremely limiting for mental health and addictions.  Then I moved on to (income by neighbourhood) which leaves out many of us on SA and homeless persons.  We can be pretty mobile people, moving place to place if we don't have secure housing.  Having lived experience I am rarely treated with equality, so I wanted  to make sure they get the first column right.  I had lots more to say too...

I am wondering about the vision of mental health reform and how it is being framed by the leadership council to help advance reform, data, logic; to and with the ministry.  background on leadership council is here:

I know they have a super tough job, yet how is dialogue being managed between the multiple and yah multiple, levels and "stakeholders?"  ------service/persons/community/staff/local system planners.

Will Hall's article, in Mad in America is one of the useful documents to draw on, to guide our talk of system change.  Here it is.

A New Mental Health System? Interview with Jim van Os


With one of the highest mental health spending rates in Europe, the Netherlands is undergoing a dramatic rethinking of how to provide mental healthcare, a rethinking now gaining momentum throughout the region. In a recent interview with Dr. van Os on Madness Radio — one of the most prestigious scientists in the world, in the top 1% of most-cited researchers, and a member of the Royal Dutch Academy of Sciences — I got a glimpse of what is starting to emerge. Changes in The Netherlands have potential to influence mental healthcare worldwide.

Meaningful change can't just "improve the standard of care." It must recognize that the entire standard is based on faulty measurements. First, there needs to be a a new definition of health. Van Os points to how the antiquated definition of health as "absence of symptoms of disease" leads to massive overtreatment and disregard for meaningful outcomes in individual lives — Not just in mental health, but across healthcare. He points to Huber and colleagues, writing in the British Medical Journal, who describe a new consensus emerging to define health as the "ability to adapt and self manage in the face of social, physical, and emotional challenges." (In our popular education work on medication at the Freedom Center and The Icarus Project, we came up with a similar definition in the context of "harm reduction" for mental health: health as the capacity to be empowered.)

Under the current standard of care we can, for example, demonstrate the very poor relief from psychotic symptoms realized through anti-psychotic medication use, and show how more selective use of medications — and avoidance of long term use — results in better treatment outcomes. But when we rethink the concept of "health" itself, and move beyond measuring the absence of disease symptoms, we start to address something far deeper and more meaningful. We get at what the Hearing Voices Movement and mental diversity mutual support groups, led by patients around the world, have been pointing to: we can live with so-called symptoms and define recovery in human terms that embrace individual differences, and foreground the agency and empowerment of the person involved. A new definition of health builds a bridge across the "disease model" that has resulted in a separation of the movement from medical practice. ...

see the rest of the article here:



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Yes Emma, how do we know we are getting there?

Is there some kind of discussion paper that was behind the logic/indicator document to help frame the vision?

This is especially important when organizational dashboards are drivers of everyday practice.  I can see: restraint, service flow, OCAN agreement between client/worker as indicators, yet....

Are there some mental health system planners, here at EENetconnect, who could help us out here?


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