The Association Between Income Source and Met Need Among Community Mental Health Service Users in Ontario, Canada

Abstract

We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

Uptake of the MedsCheck annual medication review service in Ontario community pharmacies between 2007 and 2013

“…This finding was expected because about a third of recipients in the lower age group were receiving drug plan coverage because of low income or other social needs (e.g., Trillium, Ontario Works), a situation that is associated with mental health conditions. 26,27 Also particularly interesting, 15% of MCA recipients were 80 years of age or older, which is lower than expected given that an analysis using the same data holdings showed that 42.6% of Ontarians aged 75 to 89 years had 3 or more common chronic conditions. 28…”

“…This finding was expected because about a third of recipients in the lower age group were receiving drug plan coverage because of low income or other social needs (e.g., Trillium, Ontario Works), a situation that is associated with mental health conditions. 26,27 Also particularly interesting, 15% of MCA recipients were 80 years of age or older, which is lower than expected given that an analysis using the same data holdings showed that 42.6% of Ontarians aged 75 to 89 years had 3 or more common chronic conditions. 28 MCA recipients age 66 years and older were prescribed more medications on average than 2012 rates reported by the Canadian Institute for Health Information (CIHI); however, data from CIHI included all seniors, not just those on 3 or more chronic medications, so higher rates of prescription medication would be expected in MCA recipients.…”

Adequacy of Mental Health Services for HIV-Positive Patients with Depression: Ontario HIV Treatment Network Cohort Study

“…Second, we observed that low-income patients were less likely to use primary mental health services and patients with basic education only were less likely to use secondary mental health services. Unequal access to publicly funded mental health services provided by physicians has been reported for individuals with low socio-economic status in several Ontario studies [ 47 , 48 ]. A recent qualitative study revealed that patients with mental health or addiction issues and service providers both expressed concerns about the impact of socio-economic status on access to primary mental health care in Canada [ 49 ].…”

“…These patients might fall through the cracks of mental health system and encounter similar barriers as those with mental disorders and/or substance abuse issues. It is also possible that these vulnerable individuals may have trouble navigating through mental health care, even when healthcare is funded and available [ 47 , 48 ]. However, we did find that low-income patients were more likely to use antidepressants, possibly because the ODSP covers antidepressant use for conditions unrelated to depression.…”

Recommendations for Canada’s National Action Plan to End Gender-Based Violence: perspectives from leaders, service providers and survivors in Canada’s largest city during the COVID-19 pandemic

“…Table 2D, direct support staff P103 and survivor C76), as is the case for access to mental health services more broadly. 27 Enhance structural supports for VAW Participants' stories and recommendations highlighted the importance of developing the necessary infrastructure and funding streams within the NAP to support the full housing continuum specifically for VAW survivors-from emergency shelter to longterm supportive housing. 28 These limitations predated but were exacerbated by the pandemic, with the additional challenges in referral pathways and reduced availability of shelter and affordable housing.…”