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Position statement: Parity of Esteem

Position

The Board of Health for Public Health Sudbury & Districts actively supports the concept of parity of esteem, which is defined as equally valuing mental and physical health, for the wellbeing of all in our community. We will intentionally utilise the term public mental health to acknowledge mental health as an explicit goal in addition to the goal for physical health and well-being.

To advance mental health opportunities for all throughout the Public Health Sudbury & Districts service area, the Board further commits to:

Background

Like physical health, mental health and well-being are influenced by the social, economic, and physical environments in which people work, live, and play. We also know that populations with socio-economic disadvantages are disproportionately affected by mental health problems and challenges.

People who experience mental illness and addictions are more likely to die prematurely than the general population. Mental illness can cut 10 to 20 years from a person’s life expectancy. [1] The disease burden of mental illness and addiction in Ontario is 1.5 times higher than all cancers put together and more than seven times that of all infectious diseases. This includes years lived with less than full function and years lost to early death. [2][3]

The 2018 Ontario Public Health Standards (OPHS) identifies mental health in its mandate. Local public health must address mental health, focusing on mental health promotion, prevention, and early identification and referral. Within OPHS, the role of public health “is to support and protect the physical and mental health and well-being, resiliency and social connectedness of the health unit population . . . reaching all . . . with a special focus on those with greater risk of poor health outcomes”. [4]

Public Health Sudbury & Districts supports the concept of parity of esteem, or equally valuing mental and physical health. We support the assertion that our work in mental health will be more sustainable and effective if it is supported by organizational policies that acknowledge mental health as an explicit goal, while recognizing that it is also fundamental to physical health and well-being.[5] There is no health without mental health.

The Public Mental Health Action Framework is Public Health Sudbury & Districts’ roadmap that will assist us in putting into practice parity of esteem. The goals and outcomes for public mental health are and will be overarching and cross sectoral within our responsibilities. As outlined in the Framework, we will need to be intentional in our current work, in identifying how to further leverage what we are already doing and systematically identify new areas for public mental health initiatives. There is a role for everyone.

Commitments of Public Health

Our Public Mental Health Action Framework articulates our five commitments to concepts and investments to improve mental health opportunities for all throughout the Public Health Sudbury & Districts service area.

  1. Mental Health for All: Public Health Sudbury & Districts is committed to ensuring that public mental health practice be relevant for everyone, regardless of mental illness diagnoses, with appropriate adaptations. Mental health and mental illness are distinct but related concepts. These concepts intersect and coexist in individuals and populations.[6] Persons with serious mental illness or addiction can experience good mental health. Persons with no mental illness or addiction can experience poor mental health or difficulty coping.
  2. Social Determinants of Mental Health: Public Health Sudbury & Districts is committed to understanding mental health from a social determinants of health perspective and to working to improve equity in mental health. The social determinants of mental health are understood to be the same as those determining physical health. They are the societal factors that underpin and drive individual-level risk and protective factors for disease.[7]
  3. Anti-stigma and Discrimination: Public Health Sudbury & Districts is committed to understanding and shining a light on systemic and often hidden prejudice in support of opportunities for mental health for all. Many who live with mental health and addictions problems have reported experiencing discrimination at work, from family and friends, within imagery found in the media, while attempting to secure housing, within health services or the justice system. Living with mental health problems or addictions can be accompanied by self-stigma and shame that is further reinforced by societal reactions.[8][9]
  4. Voices of People with Lived Experience: Public Health Sudbury & Districts is committed to privileging the voices of those with lived experiences and their families and carers. This will take place through collaboration with people with lived experience, connections with family and carers, transparency and accountability.
  5. Hope, Belonging, Meaning and Purpose: Public Health Sudbury & Districts is committed to informing our public mental health practice with the aspiration to build hope, empowerment, and resilience in individuals and communities. This commitment draws us to understand and support mental health from a more holistic and community-based perspective. A perspective that considers mental wellness equally with physical, spiritual, and emotional wellness. We acknowledge the perspective of The First Nations Mental Wellness Continuum Framework.

References

[1] Chesney, Goodwin and Fazel (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry, 13: 153-60.

[2] Centre for Addiction and Mental Health. (2018). Mental Illness and Addiction: Facts and Statistics. Retrieved from https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics

[3] Ratnasingham et al. (2012). Opening eyes, opening minds: The Ontario burden of mental illness and addictions. An Institute for Clinical Evaluative Sciences / Public Health Ontario report. Toronto: ICES.

[4] National Collaborating Centre for Healthy Public Policy. (2014). Defining a population mental health framework for public health. Retrieved from http://www.ncchpp.ca/docs/2014_SanteMentale_EN.pdf

[5] Keleher, H., Armstrong, R. “Evidence-based mental health promotion resource.” Report for the Department of Human Services and VicHealth, Melbourne (2005). Retrieved from https://www.researchgate.net/publication/236672093_Evidence-Based_Mental_Health_Promotion_Resource

[6] Canadian Institute for Health Information. (2007). Improving the health of Canadians: exploring positive mental health. Retrieved from https://www.cihi.ca/en/improving_health_canadians_en.pdf

[7] Shim, R., Koplan, C., Langheim, F. J., Manseau, M. W., Powers, R. A., & Compton, M. T. (2014). The social determinants of mental health: An overview and call to action. Psychiatric annals, 44(1), 22-26.

[8] Ministry of Health and Long-Term Care. (2011). Open minds, healthy minds: Ontario’s comprehensive mental health and addiction strategy. Retrieved from  http://www.health.gov.on.ca/en/common/ministry/publications/reports/mental_health2011/mentalhealth_rep2011.pdf

[9] Faculty of Public Health and Mental Health Foundation. “Better Mental Health for All. A Public Health approach to mental health improvement.” (2016). Retrieved from https://www.fph.org.uk/media/1644/better-mental-health-for-all-final-low-res.pdf

 

 

 

 

 

This item was last modified on July 25, 2019