Objective: To investigate patterns and predictors of help seeking and met/unmet needs for mental health care in a national population health survey. Method: Participants were respondents to the 2012 Canadian Community Health Survey on Mental Health (CCHS-MH; n ¼ 25,133). We used regression to identify the diagnostic and sociodemographic predictors of the use of informal supports, primary care, and specialist care, as well as perceived unmet needs. Results: Eleven percent of Canadians reported using professionally led services for mental health or substance use in 2012, while another 9% received informal supports. Two-thirds of people with substance use disorders did not receive any care, and among those who did, informal supports were most common. Seventy-four percent of people with mood/anxiety disorders and 88% of those with co-occurring disorders did access services, most commonly specialist mental health care. Men, older people, members of ethnocultural minorities, those not born in Canada, those with lower education, and those with higher incomes were less likely to receive care. Unmet needs were higher among people with substance use disorders. Conclusions: Gaps in services continue to exist for some potentially vulnerable population subgroups. Policy and practice solutions are needed to address these unmet needs. In particular, the convergence of research pointing to gaps in the availability and accessibility of high-quality services for substance use in Canada demands attention. Abré gé Objectif : Rechercher les modèles et les prédicteurs de la recherche d'aide et des besoins satisfaits/non satisfaits de soins de santé mentale dans une enquête de santé dans la population nationale. Mé thode : Les participants étaient des répondants de l'Enquête de 2012 sur la santé dans les collectivités canadiennes-Santé mentale (ESCC-SM; n ¼ 25 133). Nous avons utilisé la régression pour identifier le diagnostic et les prédicteurs sociodémographiques de l'utilisation des soutiens informels, des soins de première ligne et des soins de spécialistes, et des besoins non satisfaits perçus. Ré sultats : Onze pour cent des Canadiens disaient utiliser les services dispensés professionnellement pour la santé mentale ou l'utilisation de substances en 2012, alors qu'un autre 9% recevait des soutiens informels. Deux tiers des personnes souffrant de troubles liés à l'utilisation de substances ne recevaient aucuns soins, et parmi ceux qui en recevaient, les soutiens informels étaient les plus communs. Soixante-quatorze pour cent des personnes souffrant de troubles anxieux/de

Background People who use substances experience high levels of substance-related stigma, both within and outside of health care settings, which can prevent people from help-seeking and contribute further to health inequities. Recognizing and respecting how political, social, economic, and historical conditions influence health and health care, cultural safety, with origins in addressing Indigenous racism, is a potential strategy for mitigating stigma and marginalization in health care. Using a participatory research approach, we applied the concept of cultural safety to develop a model of safe primary care from the perspective of people who use substances. Methods People who use or used substances were involved in all phases of the research and led data collection. Study participants (n = 75) were 42.5 years old on average; half identified as female and one quarter as Indigenous. All were currently using or had previous experience with substances (alcohol and/or other drugs) and were recruited through two local peer-run support agencies. Concept mapping with hierarchical cluster analysis was used to develop the model of safe primary care, with data collected over three rounds of focus groups. Results Participants identified 73 unique statements to complete the focus prompt: “I would feel safe going to the doctor if …” The final model consisted of 8 clusters that cover a wide range of topics, from being treated with respect and not being red-flagged for substance use, to preserving confidentiality, advocacy for good care and systems change, and appropriate accommodations for anxiety and the effects of poverty and criminalization. Conclusions Developing a definition of safe care (from the patient perspective) is the necessary first step in creating space for positive interactions and, in turn, improve care processes. This model provides numerous concrete suggestions for providers, as well as serving as starting point for the development of interventions designed to foster system change.

Objective:The purpose of this study was to evaluate how performance is defined, conceptualized, and measured in mental health and addiction service systems around the world.Method:We conducted a systematic scoping review of English-language scientific and gray literature published from 2005 to 2015. Eligible documents (n = 222) described performance measurement systems and outlined the theory or empirical evidence for indicators. We used a structured approach for data extraction and descriptive and thematic analysis, supplemented with stakeholder consultation.Results:We identified seven themes in the literature: similarity in performance domains across frameworks; the ability of frameworks to inform care quality at client, program/facility, and system levels; the predominance of indicators of process and outcome, over structure; the lack of evidence on the links between domains and/or indicators; common, but limited, evaluation of family/caregiver involvement; equity as a cross-cutting domain of performance; and limited attention to performance measurement in peer support services.Conclusions:The literature on performance measurement in mental health and addictions services is vast, and a wide variety of indicators is available to those designing a measurement system. Evaluations of commonly used performance indicators have yielded mixed evidence on their ability to discriminate high- and low-performing service providers, and their sensitivity to changes in policies and practices. As performance measurement efforts grow in scope and complexity, work will be needed to ensure that indicators are fair, appropriate, and suited to support quality improvement in services of different types.Objectif :Évaluer la façon dont le rendement est défini, conceptualisé et mesuré dans les services en santé mentale et en toxicomanie à travers le monde.Méthode :Nous avons mené un examen de la portée à l’aide d’une revue systématique des écrits scientifiques et de la littérature grise de langue anglaise publiés entre 2005 et 2015. Les documents admissibles (n = 222) décrivaient les systèmes de mesure du rendement et présentaient les théories ou les données empiriques concernant les indicateurs. Nous avons utilisé une approche structurée pour l’extraction des données, suivie d’une analyse descriptive et thématique en complément à une consultation des acteurs impliqués.Résultats :Nous avons identifié sept thèmes dans les écrits : similarité dans les domaines de rendement entre les systèmes; la capacité des systèmes à documenter la qualité des soins tant au niveau du client, du programme que de l’organisation; la prédominance des indicateurs de processus et de résultats sur ceux liés à la structure; le manque de données sur les liens entre les domaines et/ou les indicateurs; l’évaluation commune, mais limitée, de l’implication des familles et des proches-aidants; l’équité en tant que domaine transversal du rendement; et une attention limitée à la mesure du rendement dans les services de soutien par les pairs.Conclusion:L’ensemble des éc...

This report summarizes all unintentional illicit drug toxicity deaths in British Columbia (accidental and undetermined) that occurred between January 1, 2010, and June 30, 2020, inclusive. It includes confirmed and suspected illicit toxicity deaths (inclusion criteria below). Please note that data is subject to change as investigations are concluded. 1 Inclusion Criteria: The illicit drug toxicity category includes the following: • Street drugs (Controlled and illegal drugs: heroin, cocaine, MDMA, methamphetamine, illicit fentanyl etc.). • Medications not prescribed to the decedent but obtained/purchased on the street, from unknown means or where origin of drug not known. • Combinations of the above with prescribed medications. Note: 2020 data is up to the month of June. Due to the short time frame, rates, numbers and percentages should be interpreted with caution and are subject to change as investigations are completed. 2020 Summary • In June 2020, there were 175 suspected illicit drug toxicity deaths. This represent a 130% increase over the number of deaths seen in June 2019 (76) and a 2% increase over the number of deaths in May 2020 (171). • The June 2020 total represents the highest number of illicit drug toxicity deaths ever recorded in a month in B.C to date. • The number of deaths in each health authority is at or near the highest monthly total ever recorded. • The number of illicit drug toxicity deaths in June 2020 equates to about 5.8 deaths per day. The number of illicit drug toxicity deaths in 2020 equates to 4 deaths per day for the year. • In 2020, 68% of those dying were aged 19 to 49. In 2019 and 2018, 67% were in this age range. Males accounted for 80% of deaths in 2020 to date, slightly higher than in 2019 (76%) and consistent with 2018 (80%). • The townships experiencing the highest number of illicit drug toxicity deaths in 2020 are Vancouver, Surrey, and Victoria. • Fraser and Vancouver Coastal Health Authority have had the highest number of illicit drug toxicity deaths (228 and 205 deaths, respectively) in 2020, making up 59% of all such deaths during this period.

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