This quality standard is underpinned by the principles of respect, equity, and recovery. As described by the Mental Health Commission of Canada, “recovery refers to living a satisfying, hopeful, and contributing life, even when a person may be experiencing ongoing symptoms of a mental health problem or illness.” The commission elaborates that “recovery journeys build on individual, family, cultural, and community strengths and can be supported by many types of services, supports, and treatments.”
People with schizophrenia have the right to receive services in an environment that promotes hope, empowerment, and optimism, and that embeds the values and practices of recovery-oriented care. Many intersecting factors—including biological, psychological, social, economic, cultural, and spiritual considerations—may affect a person’s mental health and well-being.
People with schizophrenia and their families, caregivers, and personal supports should also receive services that are respectful of their rights and dignity, and that promote shared decision-making and self-management. Further, people should be empowered to make informed choices about the services that best meet their needs. People with schizophrenia should engage with their care providers in informed shared decision-making about their treatment options. Each person is unique and has the right to determine their own path toward mental health and well-being.
Homelessness and poverty are two examples of economic and social conditions that influence people’s health, known as the social determinants of health. Other social determinants of health include employment status and working conditions, ethnicity, food security and nutrition, gender, housing, immigration status, social exclusion, and residing in a rural or urban area. Social determinants of health can have strong effects on individual and population health; they play an important role in understanding the root causes of poorer health. People with a mental illness or addiction often live under very stressful social and economic conditions that worsen their mental health, including social stigma, discrimination, and a lack of access to education, employment, income, and housing.
People with schizophrenia often also encounter beliefs and attitudes that stem from negative stereotypes about mental illness. Stigma, or the perception of stigma, can negatively affect a person’s recovery, their ability to tell friends and family about their illness, and their willingness to seek help. Stigma may also impact a person’s ability to access health care services.
People with schizophrenia should be provided services that are respectful of their gender, sexual orientation, socioeconomic status, housing, age, background (including self-identified cultural, linguistic, ethnic, racial, and religious backgrounds), and disability. Equitable access to the health system also includes access to culturally safe care.
Language, a basic tool for communication, is an essential part of safe care and needs to be considered throughout a person’s health care journey. For example, in predominantly English-speaking settings, services should be actively offered in French and other languages.
Services also need to be responsive to the specific needs of people who are marginalized, underserved, or members of other at-risk subgroups (e.g., lesbian, gay, bisexual, transgender, and queer or questioning populations; immigrant, refugee, and racialized populations; specific cultural groups; or survivors of sexual abuse or violence). While this quality standard addresses care for people who have already been diagnosed with schizophrenia, the importance of having responsive services that ensure all Ontarians with schizophrenia can receive a diagnosis cannot be understated.
Care providers should be aware of the historical context of the lives of Canada’s Indigenous peoples and be sensitive to the impacts of intergenerational trauma and the physical, mental, emotional, and social harms experienced by Indigenous people, families, and communities.
A high-quality health system is one that provides good access, experience, and outcomes for everyone in Ontario, no matter where they live, what they have, or who they are.