Our history

Beginning in the 1990s, issues of access to and the development of service systems that are welcoming to individuals with complex mental health and addiction needs emerged as a priority across the province of Ontario. Programs and agencies now incorporated into the Central West LHIN began to address these issues through a variety of initiatives that have continued to the present day.

In 2007/08, William Osler Health Centre (WOHC) received Health Accord funding from the Ministry of Health and Long-Term Care to develop services targeted to meet the needs of people with concurrent disorders (i.e., co-occurring mental health and substance use needs). During the same period, Local Health Integration Networks were established across the province with a mandate to facilitate improved access to and integration of services across Ontario's healthcare system. In particular, there emerged a stated goal to use performance improvement technology to create a health services delivery system that uses existing resources more efficiently while also being more welcoming, accessible, and integrated for everyone, but particularly for those with complex needs.

Individuals and families with multiple complex needs, including those of concurrent disorder, are recognized as experiencing poorer outcomes and incurring higher costs in many clinical domains than the rest of the population and are typically over-represented in the criminal justice, primary health care, homelessness and child protective service systems. In fact, individuals with both mental health and substance use needs are sufficiently prevalent in all mental health, addiction, trauma-focused and broader health and social services settings that they can considered an expectation, rather than an exception, in the populations served by these programs and organizations.

Given this, an opportunity was identified to plan for and establish the newly funded concurrent disorders-related service differently than had been done in the past. Rather than plan for and establish a concurrent disorders-focused service solely within WOHC, it was decided by WOHC leadership, with the support of the Central West LHIN, to use the allocated resources to establish a capacity-building initiative in which all interested Central West LHIN service providers could participate. The initiative would focus on improving the entire Central West health services delivery system's capacity to meet the needs of people with concurrent disorders in ways designed by and decided upon by the participating organizations. Representatives from mental health, addiction, health and social services agencies came together in May 2008 and agreed to form the Central West Concurrent Disorders Network as the first step in this capacity-building initiative.

Network members agreed that the first step in their work together needed to be an assessment of the current level of capacity and capability within the system to meet the needs of people with both mental health and substance use problems. It was felt that by getting a clear understanding of the current system's capacity and capability, Network members would then be well positioned to determine what specific initiatives were needed to increase the system's capacity over time. Through the rest of 2008, Network members developed and implemented a process to assess individual program and/or overall organization concurrent disorders capacity and capability. To do so, the Network selected and used a self-assessment tool and process called the COMPASS, developed by Drs. Minkoff and Cline.

After reviewing the results of the COMPASS self-assessment process, Network members identified a range of initiatives on which to work together build capacity in the Central West LHIN to better respond to the multiple needs of people living with co-occurring mental health and substance use needs or problems. These initiatives are described in the section "What we are working on."