Navigating mental health services
Accessing appropriate mental health care may not be a simple or straightforward process, especially for immigrants and refugees who may not understand how various services are structured. Sometimes even health and social service providers can have difficulty navigating the system and the pathways of care. As a result, primary care is often used as the entryway to the health care and mental health system. Access to care is further complicated by local or regional differences in service availability and the process through which services are accessed. In some provinces/territories, for example, separate mental health services may not be connected to each other or set up systematically.
The pathways for accessing mental health services or getting referred include:
- Primary care providers (e.g., walk-in clinic, assigned family physician)
- Community-based care (e.g., mental health and addiction clinics, residential services)
- Emergency services when in crisis (e.g., emergency departments)
- Private care (e.g., private psychotherapists)
-
Collaborative provincial programs. For example:
- The Mood Disorders Association of British Columbia (MDABC) model of care offers a “one-stop shop” for psychiatric assessment and follow-up services for family physicians; this improves efficiency and reduces costs per client visit.
- The Rapid Access Addiction Medicine (RAAM) is an integrated care model in Ontario that is led by a psychologist and family physician in consultation with community partners; this eliminates wait times (same-day treatment), reduces alcohol-related emergency department visits and increases client connections to additional community services.
- The Queens Family Health Team in Nova Scotia offers co-location of mental health and primary care services; this improves the ability to deal with complex cases and client encounters and provides access to mental health counselling services for clients in a familiar environment.
Research on accessing mental health services provides some insight into how many people, and who, are accessing services. For example, in 2018, the number of who reported needing some help for their mental health in the previous year was estimated to be 5.3 million (17.8%), of which 1.2 million (22%) reported that their needs were only partially met and 1.1 million (21%) declared their needs were fully unmet (Statistics Canada, 2018). The need for counselling was the need most likely to be unmet (34%). A similar study found that 19.2% of the respondents cited features of the health care system itself as a barrier to an unmet mental health care need (Sunderland & Findlay, 2013).
Immigrants and refugees are less likely than the general population to access mental health services (Durbin et al., 2014, 2015; MHCC 2016; Ng & Zhang, 2022). Providers need to be familiar with the different parts and functions of the mental health system in order to provide effective assistance. The resources available for immigrant and refugee populations vary by province or territory and can also change year to year depending on government support. Health care providers therefore need to stay up to date on the current availability of mental health supports.
The following resources can help health care providers and/or clients connect with the services that best meet their needs:
- Navigating Mental Health Services in Toronto. A Guide for Newcomer Communities, developed by the Community Resource Connections of Toronto, is intended both for people dealing with mental health problems and illnesses and for their friends and families. It provides information to help them understand the mental health system.
- The Alberta Health website Addiction and mental health information and services provides links to information and resources on mental health, substances and addiction in Alberta.
- The British Columbia Mental Health & Substance Use website provides information on mental health services and resources offered across the province, including educational resources, prevention programs, early intervention initiatives and recovery and treatment options.
- An overview of mental health services in Nova Scotia is available from the Government of Nova Scotia website.
Newcomers who need mental health care often face a number of difficulties accessing care. Even when they do receive care, the quality and type of care might not be what they expect, what they want or appropriate to their needs and understandings (Thomson et al., 2015).
To improve access to, and the quality of, mental health care, the Mental Health Commission of Canada published a Mental Health Strategy that outlines the key recommendations for improving care for immigrants, refugees and ethno-cultural and racialized groups.
This Canada-wide initiative provides six strategic directions:
-
1
Promote mental health across the lifespan in homes, schools and workplaces, and prevent mental illness and suicide wherever possible.
-
2
Foster recovery and well-being for people of all ages living with mental health problems and illnesses, and uphold their rights.
-
3
Provide access to the right combination of services, treatments and supports, when and where people need them.
-
4
Reduce disparities in risk factors and access to mental health services, and strengthen the response to the needs of diverse communities and Northerners.
-
5
Work with Indigenous communities to address their mental health needs, acknowledging their distinct circumstances, rights and cultures.
-
6
Mobilize leadership, improve knowledge and foster collaboration at all levels.
(MHCC, 2012)
All health systems need to use the recommendations and best practices from the Mental Health Strategy to ensure collaborative care, reduce fragmentation and reduce isolation for both providers and clients. For optimal results, efforts have to come from beyond the health sector, including education, justice, corrections, social services and finance (MHCC, 2012).