Intersections with age

a) Younger people

The Ontario Secondary School Teacher’s Federation (OSSTF/FEESO) expressed con-cern that mental health services for children and youth are not mandated in Ontario, which leads to inconsistent and fragmented approaches. Younger people (under 25 years of age) who took part in the consul-tation said that they could not get mental health or addiction services because they were too young for adult services, too old for paediatric services, or did not meet the program criteria because they had multiple

disabilities. One youth worker described how a youth addiction treatment program denies service to youth who have been involved in child protective care.

The Children’s Hospital of Eastern Ontario (CHEO) said that by ratifying the International Convention on the Rights of the Child, Canada is obliged to ensure that children realize their rights to the highest attainable standard of health. CHEO said that Canada must strive to make sure no child is deprived of his or her access to such health care services (Article 24.1).

CHEO said that it is a serious of breach of children’s rights to have no legislation on children’s mental health. In its Mental Health and Addictions strategy, the Ontario Ministry of Health and Long-Term Care (MOHLTC) has targeted increased service delivery for children and youth, with a focus on early detection and intervention.

b) Older adults

The Advocacy Centre for the Elderly (ACE) spoke of significant issues of discrimination facing older adults with mental health issues and addictions. Estimates are that one in five persons over age 65 has a mental health disorder.⁷³

ACE is frequently contacted by older adults and substitute decision-makers because older adults in long-term care have been given medication, particularly anti-psychotic medication, without informed consent.

ACE voiced concern about the high rate of anti-psychotic drug use in long-term

care homes for residents with dementia compared to use among older adults with dementia living in the community.⁷⁴ ACE raised concerns about the side-effects and long-term effects of this type of medication.

ACE also said that, in contrast to people covered by the Mental Health Act, people in long-term care do not have the same access to legal rights advisors if they are found incapable to consent to treatment.

Other issues regarding long-term care are described in the section on Housing (Section 11.1.).

Others told us how discrimination based on age combines with discrimination based on disability, particularly in the area of employment. They said it is much harder to find and keep employment when dealing with the symptoms of aging and disability.

Although I have over 30 years of experience in administrative/secretarial/

clerical along with about 25 years of organization/event planning/public relations/promotions/media ... I cannot find appropriate work due to the fact [that] I am presently only able to work 25 – 30 hours per week and I’m [around] eight years out of the work-force. Add that to the fact I’m only seven years away from the usual retirement age of 65, and many people just don’t want to hire me.

– Survey respondent

Recommendation:

6. The Government of Ontario and organizations providing services to people with mental health and addictions should work to identify and eliminate discrimination based on disability in their services, as well as discrimination based on age, sex, race and related grounds, gender identity, sexual orienta-tion and other Code grounds. This may require a process of examining policies, practices and decision-making processes and removing barriers that lead to discrimination for Code-protected groups (see the OHRC’s Guidelines on developing human rights policies and procedures for more information).

OHRC commitments:

C4. In its work on its strategic priorities (e.g. policing and anti-racism, Aborigi-nal Peoples’ human rights, family status, disability and education), the OHRC will build in a focus on human rights, mental health and addictions.

C5. The OHRC will further examine the issue of the level of rights advice provided to older adults in long-term care who are deemed to be incapable of making treat-ment decisions. If this has the potential to violate the Code, the OHRC will, where appropriate, raise concerns with the responsible parties, do public interest inquiries, intervene in legal cases and/or launch Commission-initiated applications.

Accommodation for employees with mental health illness in the workplace

… isn’t just about hurt feelings, loss of dignity or a feeling of being treated unfair. It is about survival. It can be the straw that breaks you or it can be the hand that saves you. Not being accommodated meant that I had to use all my energy just to cope with the barriers that I identified at work, just to get through the day. At the end of the day, I was so exhausted that I could hardly drive home.

– Written submission

Under the Code, housing providers, employers and service providers have a legal duty to accommodate the Code-related needs of tenants, employees and service users. They must make sure that organiza-tions are designed inclusively, and remove any barriers that may exist, unless that would cause undue hardship. The duty to accommodate could involve making changes to organizations’ policies, bylaws, practices and decision-making processes to allow for equal opportunity for people from Code-protected groups. The people seeking

accommodation and the organizations providing accommodation both have responsibilities to participate in the process.

In many cases, people with mental health issues or addictions will not need accom-modation to get or keep their housing or employment, or to access services, but in other cases the duty to accommodate will arise. In these situations, the principles of dignity, individual accommodation, integration and full participation must apply.

Unless it were to cause undue hardship, the duty to accommodate could involve, for example, sound-proofing a rental unit for someone who is sensitive to sound due to posttraumatic stress disorder, allowing an employee time off from work to attend counselling, or making a service deadline flexible because the applicant has been in hospital.

We heard that there is much confusion around the duty to accommodate, for everyone involved. Many people with psychosocial disabilities are unaware of their rights to accommodation. People may be reluctant