A National Action Plan for Mental Illness and Mental Health : A Call for Action
This consensus statement was drafted at the National Summit on Mental Illness and Mental Health held on October 3, 4, 2002. The consensus statement was ratified subsequently by each of the signatory organizations.
We envision a country where all Canadians enjoy good mental health. Canadians with mental illnesses*, their families and care providers must have access to the care, support and respect to which they are entitled and in parity with other health conditions.
We are committed to a National Action Plan that upholds the following principles:
1. Mental illness and mental health issues must be considered within the framework of the determinants of health and recognizes the important linkages among mental, neurological and physiological health.
2. Given the impact of mental health issues and mental illness (i.e. on the suffering of Canadians, on mortality, especially from suicide, on the economy, on social services such as health, education and criminal justice), Canadian governments and health planners must address mental health issues commensurate with the level of their burden on society.
3. Mental health promotion and the treatment of mental illnesses must be timely, continuous, inter-disciplinary, culturally appropriate, and integrated across the full life cycle and the continuum of care (i.e. physical and mental health; social supports and tertiary care to home/community care).
KEY ELEMENTS OF A NATIONAL ACTION PLAN
1. National Mental Health Goals. These goals would provide a framework to, for example, evaluate both processes and outcomes, set minimum standards, and assess systemic change.
2. A Policy Framework. The framework must provide for a comprehensive health promotion and service delivery plan, an enhanced research program, a surveillance and national data/information system, a public education strategy, a health human resources plan, and an innovations fund that embraces both mental illness and mental health promotion as well as the principles of recovery and citizenship.
3. Dedicated, Sustained and Adequate Resources tied to the National Mental Health Goals and specific outcomes.
4. An Accountability Mechanism, such as annual reporting on, for example, access, mental health status, systemic change and the application of best practices.
* NOTE: The use of the term "mental illness" in this "Call for Action" includes diseases, disorders, conditions or problems. It also includes the spectrum of addictions.
A CALL FOR LEADERSHIP AND ACTION
We, the undersigned, urge the federal, provincial and territorial governments to work together with federal leadership to recognize and act upon the compelling moral, social and economic case for mental health promotion and mental illness care.
Canadian Medical Association
Canadian Psychiatric Association
NATIONAL ORGANIZATIONS REPRESENTED AT THE OCTOBER 2002 SUMMIT
Autism Society of Canada
Canadian Academy of Child Psychiatry
Canadian Alliance on Mental Illness & Mental Health
Canadian Association for Suicide Prevention
Canadian Association of Occupational Therapists
Canadian Association of Social Workers
Canadian Coalition for Seniors Mental Health
Canadian Council of Professional Psychology Programs
Canadian Federation of Mental Health Nurses
Canadian Health Care Association
Canadian Medical Association
Canadian Mental Health Association
Canadian Psychiatric Association
Canadian Psychiatric Research Foundation
Canadian Psychological Association
College of Family Physicians of Canada
Mood Disorders Society of Canada
National Network for Mental Health
Native Mental Health Association of Canada
Joint Statement on Scopes of Practice (February 2003)
Canada's physicians, nurses, pharmacists and other health professionals recognize that a sustainable health workforce is a key challenge facing our health care system. In this regard, scopes of practice is an important issue that needs to be addressed.
The Canadian Medical Association (CMA), the Canadian Nurses Association (CNA) and the Canadian Pharmacists Association (CPhA) have approved the following principles and criteria for the determination of scopes of practice. The primary purposes of such determinations are to meet the health care needs of Canadians, and to serve the interests of patients and the public safely, efficiently and competently.
The CPhA, CNA and CMA believe that policy decisions taken in this area must put patients first. Secondly, they should be grounded in principles that reflect our commitment to professionalism, lifelong learning and patient safety. Thirdly, that there be recognition of the need for legislative and regulatory changes to support evolving scopes of practice. Moreover, we believe that health professionals must be involved in decision-making processes in this area.
Focus: Scopes of practice statements should promote safe, ethical, high-quality care that responds to the needs of patients and the public in a timely manner, is affordable and is provided by competent health care providers.
Flexibility: A flexible approach is required that enables providers to practise to the extent of their education, training, skills, knowledge, experience, competence and judgment while being responsive to the needs of patients and the public.
Collaboration and cooperation: In order to support interdisciplinary approaches to patient care and good health outcomes, physicians, nurses and pharmacists engage in collaborative and cooperative practice with other health care providers who are qualified and appropriately trained and who use, wherever possible, an evidence-based approach. Good communication is essential to collaboration and cooperation.
Coordination: A qualified health care provider should coordinate individual patient care.
Patient choice: Scopes of practice should take into account patients' choice of health care provider.
Accountability: Scopes of practice should reflect the degree of accountability, responsibility and authority that the health care provider assumes for the outcome of his or her practice.
Education: Scopes of practice should reflect the breadth, depth and relevance of the training and education of the health care provider. This includes consideration of the extent of the accredited or approved educational program(s), certification of the provider and maintenance of competency.
Competencies and practice standards: Scopes of practice should reflect the degree of knowledge, values, attitudes and skills (i.e., clinical expertise and judgement, critical thinking, analysis, problem solving, decision making, leadership) of the provider group.
Quality assurance and improvement: Scopes of practice should reflect measures of quality assurance and improvement that have been implemented for the protection of patients and the public.
Risk assessment: Scopes of practice should take into consideration risk to patients.
Evidence-based practices: Scopes of practice should reflect the degree to which the provider group practices are based on valid scientific evidence where available.
Setting and culture: Scopes of practice should be sensitive to the place, context and culture in which the practice occurs.
Legal liability and insurance: Scopes of practice should reflect case law and the legal liability assumed by the health care provider including mutual professional malpractice protection or liability insurance coverage.
Regulation: Scopes of practice should reflect the legislative and regulatory authority, where applicable, of the health care provider.
Principles and criteria to ensure safe, competent and ethical patient care should guide the development of scopes of practice of health care providers.
This document is based on a January 2002 policy developed by the Canadian Medical Association whicb has been endorsed by the Canadian Nurses Association and the Canadian Pharmacists Association. We welcome the support of other health care providers for these principles and criteria regarding scopes of practice.