Table 6 Themes and actionable policy recommendations arising from the facilitated virtual policy dialogue
| Theme | Actionable policy recommendation | Key points and equity considerations arising from small-group discussions |
|---|---|---|
| Funding | Increase public investment in the MHSUH workforce and promote sectoral coordination, particularly between the public and private sectors |
MHSUH services in Canada are severely underfunded, creating inequities that significantly impact marginalized and vulnerable groups: Canada needs to achieve funding parity between MHSUH services and physical health services to address these equity issues Preventative MHSUH care should be prioritized and fully funded Public investment is required to address the disparity in remuneration between MHSUH providers (e.g. between providers in public/private sectors and peer support workers) Public investment in the training and recruitment pipelines would help address the increasing MHSUH needs of the population, similar to what some Canadian jurisdictions have done for personal support workers Explicit policy addressing the relationship between the public and private sectors to create more seamless care, provide better integration, optimize synergies and avoid inefficiencies that result from lack of coordination |
| Regulation and recognition | Standardize regulation across the country to promote equitable access to services and remove barriers to practice, particularly around inter-jurisdictional practice and virtual care |
Regulatory barriers hindering inter-provincial virtual care and mobility of regulated practitioners need to be addressed; this would allow the delivery modality (virtual or in-person) to be optimized, recognizing that each modality has potential equitable access implications, and enable the workforce to be where it is needed with more efficient deployment Pandemic has highlighted the importance of regulation in contributing to equitable access to services since much public and private funding is limited to regulated providers Focus on promoting collaboration between providers with complementary scopes of practice to provide patients with comprehensive MHSUH services |
| Burnout and well-being | Create enabling environments for MHSUH provider well-being and retention to address burnout |
Recruitment strategies to increase supply of providers should include a focus on enhancing the diversity of the MHSUH workforce Learn from experiences of other groups of providers who have developed or identified promising practices (e.g. law firms that are identifying metrics contributing to employee burnout) Uniform adoption of standards and positive practices to improve psychological health and safety of MHSUH providers in both public and private sectors, including consideration of unique harms that may occur when providing virtual services The existing peer support community of MHSUH providers with lived MHSUH experience is hidden due to stigma, creating lack of access to care and burnout: MHSUH practitioners should be able to speak freely about their own MHSUH concerns and seek the support of peers without fear of being stigmatized |
| Workforce data | Develop comprehensive and standardized datasets describing the MHSUH workforce for better workforce planning |
We need a clear definition of what is classified as the MHSUH workforce because job titles and descriptions vary across the country Data should be collected in a standardized way across the country to allow for comparison across jurisdictions and provider groups and contribute to systematic workforce planning Data sharing needs to be established so that data does not stay in silos Data collection challenges are particularly prevalent for unregulated MHSUH providers Better data is required to understand who is in the MHSUH workforce to allow Canada to stratify its MHSUH workforce by different identifiers (e.g. race, ethnicity and gender): we cannot manage what we do not measure, and we currently do not measure any of these diversity or equity demographics of the workforce |
| Cultural competence | Equip MHSUH workforce to provide culturally appropriate and person-centred care |
The MHSUH workforce needs to develop the knowledge, skills and competencies to address MHSUH across the continuum of care and services—from promotion and prevention to treatment of serious and concurrent illness Measuring equity and diversity demographics of the MHSUH workforce will contribute to building the capacity of the workforce to provide culturally appropriate and person-centred care More research is needed to identify the barriers to providing culturally appropriate services and identify the core competencies required to provide services for a range of equity-seeking groups, recognizing that different skills are needed to work with different groups Toolkits should be developed to assess MHSUH service teams to understand whether the range of competencies are represented and build on skills already present Interventions to increase cultural competence need to include a diversity of voices and be community-led |