Changing the Focus of Care for Mental Health and Addiction What are the challenges? Substance use and mental disorders are associated with significant human and economic costs: One in five adults experiences a mental disorder during a 12-month period; Approximately 300,000 British Columbians see a physician for depression or anxiety disorders each year; Hospital stays for patients with mental disorders are two and a half times longer than for other illnesses; 30 per cent of the days spent in acute-care hospitals are used by patients with a mental disorder; and 50 – 70 per cent of patients have concurrent mental and substance use disorders. The problem is often exacerbated by untreated physical illnesses, undiagnosed substance use disorders, unemployment and homelessness. Yet, these substance use and mental disorders are treatable. With appropriate care and support, people can manage their illness better, reduce their level of disability and achieve their full potential. How are these challenges being addressed? A key step in providing appropriate care and support to people with mental disorders is to provide more care in the community and to minimize time spent in institutions. The success of this shift will depend in large part on ensuring a continuum of services in each health authority that better integrates community, primary, secondary, and tertiary mental health and addictions care. Integrating mental health into the larger health care network will also be critical. More specifically, to revitalize mental health and addiction services, we are refocusing the mental health plan to concentrate on several major shifts: ensuring better integration of mental health and addiction services, for example, by providing a continuum of hospital- and community-based care; coordinating care among doctors, nurses, counselors, and other professionals; and improving the transition of youth to the adult mental health system; improving community-based options, such as education, supportive residential care, and home treatment; undertaking province-wide strategies to address problem areas, such as depression and anxiety disorders; developing innovative provincial tertiary or specialized care in key provincial locations; integrating care across all care networks, particularly for clients with extensive high-care needs, such as people with substance use and mental disorders; and ensuring quality service delivery by providing access to accurate, standard and timely information and promoting the use of best practices and evidence-based approaches. How is progress being measured? To ensure a focus on quality and effectiveness of mental health services, the ministries are monitoring two indicators that measure results of service changes for clients. Specifically, the 2003/04 indicators are monitoring the proportion of persons who received follow-up care after treatment of a mental disorder in hospital and the proportion of mental health services received by mental health clients within their own health authority. How much are we spending? An additional $220 million in funding is being added for mental health services by 2005/06 to bring total funding for mental health services to over $1.1 billion a year. Funding for Mental Health Services ($ millions) 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 855 924 1,005 1,067 1,086 1,124