Message from the Chair and President: CAMH Annual Report 2004

CAMH Annual Report

Jamie Anderson and Dr. Paul Garfinkel visiting the Integrated Rehabilitation Unit.

After-effects of SARS

Just over a year ago, the Centre for Addiction and Mental Health (CAMH), along with all other health care facilities in the Greater Toronto Area, faced an unprecedented crisis. In the space of a few days at the end of March, hospitals went from business as usual to a near-complete lockdown, while staff scrambled to understand and cure a highly communicable and life-threatening illness.

Undoubtedly, as we reflect back on the past year, SARS was a significant event in 2003. In hindsight, it is of note not only for the risk and anxiety we faced, but also because our collective plight highlighted the extent of our interconnection. Hospitals became acutely aware of how much we rely on one another, given that patients move frequently from one site to another. Outside the health care arena, communities of students, religious groups and many others were affected by quarantines. Further, the entire city suffered from isolation, as travellers, wary of endangering themselves, simply chose not to come here. SARS touched us all.

Like a sudden fire, SARS compelled us to act. We changed our infection control policies and practices, screened everyone who came to our doors and, once the crisis was over, enacted new ways of protecting our clients and staff in an emergency.

While crisis compels us to act and act quickly, changes that are harder to make are ones that don't result from crisis, but from a slow and dawning realization that things could and should -- and must -- be better.

Time for a review

Four years ago, CAMH undertook a review of who we collectively were and how we operated as an organization from a diversity perspective. When the final report was released, we were braced for bad news. Yes, we could say we had some remarkable programs in place for staff and clients, programs that took into account race, ethnicity, sexual orientation, age, ability, religion, family and marital status, and socio-economic status. Yet for every stellar example of what we were getting right, there were other instances where discrimination, harassment and exclusion were allowed to fester.

It was abundantly clear that we needed to improve the way our employees felt about working at CAMH and the way we dealt with our partners in the community. But most of all, we needed to take a hard look at our cultural competency in the area of clinical care.

Before we could look outside our walls, we had to act decisively to address major concerns inside our walls. We had to start making things right for our employees. To do this, we created a Diversity Programs Office. At the same time, we developed a diversity policy to help guide our business both inside and outside.

In our provincial services, diversity was clearly identified as a priority. A diversity plan was developed to provide the framework within which we work with other service providers in Ontario, to increase their capacity to offer services that address diversity issues.

Today, we can say with confidence and pride that our workplace is more inclusive, and that our diversity policy and practices measure up exceptionally well with policies and practices in other hospitals throughout the Greater Toronto Area, in terms of comprehensiveness, accountability and expectations.

At CAMH, whether we are working with clients, hiring staff, providing training, doing research, deciding on contract bids, conducting staff performance reviews, building budgets, organizing health promotion programs or strategies, making Board decisions, or initiating any other important activity, we are committed to making diversity part of our thinking. We want to ensure that all people are included, validated and represented in all aspects of our organization. We expect nothing less.

As the largest addiction and mental health organization in Canada, we have embraced the opportunity to provide leadership, creating and developing programs that focus on clinical care, research and health promotion in partnership with outside agencies, organizations and governments. This will ensure that everyone responds effectively to the diverse cultural and linguistic needs of all clients and stakeholders in the health care arena.

The importance of highlighting diversity

"Why diversity?" we are often asked. Why diversity in the face of so many other urgent priorities?

Imagine you were experiencing hallucinations, feeling extreme anxiety or using illicit drugs to get through the day, and could not find a place that offered help where the staff understood you. There is a pretty good chance that your pain would go untreated and you would become increasingly afraid, isolated and marginalized. Addiction and mental health problems are infinitely more subtle and complex than most physical ailments, and can only be conveyed in a therapeutic environment of shared understanding. As a leader in this field, we cannot allow ourselves the luxury of treating people with a one-size-fits-all package. Nor would we want to.

We are part of a global community: substance use and mental health problems span the world. By embracing diversity, we move from "us and them" to a much larger community that includes all of us: more of us helping, more of us being treated and more of us working to ensure the resources we need are there when our friends, family members and community members need a place to get help.

To those who ask, "Why diversity?", we offer three answers:

• We want to provide the best possible care and increase access to services. As a large health care organization, we want to provide our services broadly, to every single person who needs them. It is unacceptable to turn anyone away, for any reason, in his or her worst moments of pain and fear. Diversity is an essential ingredient to providing the best care to clients. Because we are located in one of the most diverse cities and one of the most diverse countries in the world, it is simply the right thing to do -- legally, practically and in terms of our professional responsibilities as caregivers.
• We want to employ the best people. To be where we want to be as an organization, we must employ people who embody excellence -- in terms of skills, experience, and the ability to learn and change as our organization learns and grows. This will happen only if we cast as wide a net as we can and draw the best people from a diverse pool of talent.
• We want to be leaders and to set the standard for other organizations, both public and private.

The remainder of this year's report highlights our diversity journey, sharing some successes and opening the doors to the areas we need to focus on in the future. For example, we have not paid enough attention to our diversity practices in research, and have learned that research is only as good as the questions we are asking. Asking the right questions is one place to start. Being sensitive to differences, in every interaction we have, is another.

Celebrating other accomplishments

While we work to address our limitations, we can also take a moment to celebrate that CAMH was recognized in late 2003 for some of our groundbreaking research, by having two published research projects named best science papers of the year by the prestigious magazine Science.

Looking ahead, we are excited as we proceed with the redevelopment of our Queen Street site. Your support, feedback and participation are critical to our common goals and success. Consider yourself invited to join us in building not only a community but also a future, where well-being, acceptance, healing and interdependence join like hands to help us hold our community together.

Jamie Anderson
Chair, CAMH Board of Trustees

Paul Garfinkel, MD, FRCP(C)
President and CEO

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