Reporting Mental Health Performance across Canadian Provinces
Research questions are in the form of six identified mental health indicators which are to be measured in each of the five provinces using administrative data. We do not have hypotheses associated with each measure, so we have described what is to be done and have included a brief rationale for exploring each indicator.
1. To measure individuals treated for a mental health or addiction (MHA) problem whose first treatment contact is with an emergency department.
This indicator will identify the number of people who are visiting the ED for issues related to mental health or addiction whose visits are not preceded by previous ambulatory hospital contact. This is an important indicator since every effort should be made to avoid ED treatment as the first experience of mental health assessment and treatment. Minimal first contact in the ED is an important measure of access to care in the ambulatory sector.
2. To measure standardized mortality ratio of people who have been identified as having mental disorders.
The indicator will examine the excess mortality of people treated for MHA problems, standardized by age and sex. It is known that standardized mortality rates are high for groups of people with mental disorders. Mortality is an important outcome indicator to focus treatment efforts.
3. To measure suicide rates amongst people who have been identified as having mental disorders.
The indicator will examine the expected excess of deaths due to suicide among people treated for MHA problems compared to suicide rates among those not known to have a MHA problem. Suicide rates are known to vary across jurisdictions and thus this would be an important indicator for mental health service improvement.
4. To measure rates of suicide attempts amongst people who have been identified as having mental disorders.
The indicator will examine the possible excess of suicide attempts among people treated for MHA problems compared to suicide attempts among those not known to have a MHA problem. Suicide attempts constitute the most important risk factor for completed suicide.
5. To measure access to a regular family physician by people who have been identified as having mental disorders.
This indicator will identify individuals with mental disorder who have access to a regular family physician. Receipt of primary healthcare is an important facet of care for individuals with mental disorders. This indicator will allow cross-jurisdictional analysis of the degree to which primary healthcare is being provided to people with mental disorders.
6. To measure physician follow-up after hospital treatment for a mental health or addiction problem.
This indicator will identify timely follow-up care by physicians following discharge of patients from hospitals. Timely follow-up and care following discharge of patients from hospitals is an important measure of mental health service quality and has been selected as one of 10 indicators by an international mental health performance agency (IIMHL) as both feasible and valid.