Puzzle Pieces: Part 2

If tackling a complex issue is like building a puzzle, the most important step is to find all the pieces. How to start? Listen to people with experience.

In my last blog, I began to share findings from the work of the Community of Interest (COI) for Racialized Populations and Mental Health and Addiction. Last year, the COI explored how and why racialized communities in Ontario use the emergency department (ED) for mental health and addictions services. We decided to focus on ED use because it is a priority issue for individuals, communities, service providers and policy makers. The ED is a critical access point to the mental health system for many marginalized communities, including racialized groups. At the same time, the province is developing strategies to reduce avoidable ED visits as they increase health system costs. To learn more about this work and findings from our literature review and promising practice scan, please read my previous blog.

It was important to the COI to listen to people with lived experience. To make this happen, we held consultations with people who experienced racialization and mental health issues as well as with community-based service providers who work with racialized communities. We learned that people visited the ED more frequently when there were significant changes in the social determinants of health, such as loss of stable housing, employment, changes in family situation, or decreased access to mental health service providers due to a move to a new city. Participants in our consultation also shared concerns about use of force within the ED and often could not distinguish between hospital security and police officers. Some participants shared stories about positive experiences in the ED, and highlighted the importance of the hospital staff in shaping the overall visit.

All of these ideas came together at our think tank event. We shared what we learned from the literature, promising practices and our consultations, in addition to engaging participants in discussion and problem solving. Participants emphasized the value of looking beyond the health system particularly to the broader community sector to find solutions. They identified factors that can promote better collaboration between the hospital and community sectors, and opportunities for action within the ED itself.

An overview of all of the COI’s findings from this work will be released in the weeks to come. Please contact me if you would like more info or to be part of our journey.