Graduate Theses & Dissertations

relationship of policy aims and implementation
Background: Ontario’s Ministry of Health and Long Term Care (MOHLTC) claims people with mental illnesses/addictions need improved care/overuse emergency departments. MOHLTC expects Coordinated Care Planning (CCP, teams of mental/physical health professionals, social workers and informal caregivers) to improve care and lower emergency department returns/healthcare costs. CCPs are directed by policies, Smith’s “problematics,” or Deleuze’s “expressions,” supposedly reflecting “contents”/“everyday worlds.” Research Question: How do Ontario health/allied professionals come together with a person with mental illness/addictions and informal caregiver(s) to address health needs through a CCP? Method: 1) Analyzed CCP policies; generated questions about creation/implementation. 2) Interviewed eight professionals about interpreting/enacting policies. 3) Connected interview data to policies. Findings: Opportunities for fragmentation exist in gaining consent; determining eligibility; persons in care, informal caregivers and professionals’ participation; person-centeredness; “shame-free” environments; health literacy; records of medications. Conclusion: CCP participants need to minimize fragmentations which takes time, space, money; creates contradictions in lowering costs/improving care. Author Keywords: Addiction, Dual Diagnosis, Health Care Policy, Institutional Ethnography, Integrated Health Care, Mental Illness

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