Nykiforuk Candace I J, Thomson Mathew, Curtin Kimberley D, Colman Ian, Wild T Cameron, Hyshka Elaine
School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada.
Clinical Research Coordinator, Clinical Epidemiology Department, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada.
Int J Ment Health Syst. 2024 Feb 15;18(1):8. doi: 10.1186/s13033-024-00624-y.
There is a need to improve mental health policy in Canada to address the growing population burden of mental illness. Understanding support for policy options is critical for advocacy efforts to improve mental health policy. Our purpose was to describe support for population-level healthy public policies to improve mental health among policy influencers and the general public in Alberta and Manitoba; and, identify associations between levels of support and sociodemographic variables and relative to the Nuffield Bioethics Intervention Ladder framework.
We used data from the 2019 Chronic Disease Prevention Survey, which recruited a representative sample of the general public in Alberta (n = 1792) and Manitoba (n = 1909) and policy influencers in each province (Alberta n = 291, Manitoba n = 129). Level of support was described for 16 policy options using a Likert-style scale for mental health policy options by province, sample type, and sociodemographic variables using ordinal regression modelling. Policy options were coded using the Nuffield Council on Bioethics Intervention Ladder to classify support for policy options by level of intrusiveness.
Policy options were categorized as 'Provide Information' and 'Enable Choice' according to the Nuffield Intervention Ladder. There was high support for all policy options, and few differences between samples or provinces. Strong support was more common among women and among those who were more politically left (versus center). Immigrants were more likely to strongly support most of the policies. Those who were politically right leaning (versus center) were less likely to support any of the mental health policies. Mental health status, education, and Indigenous identity were also associated with support for some policy options.
There is strong support for mental health policy in Western Canada. Results demonstrate a gap between support and implementation of mental health policy and provide evidence for advocates and policy makers looking to improve the policy landscape in Canada.
加拿大需要改进心理健康政策，以应对日益增长的精神疾病人口负担。了解对政策选项的支持对于改善心理健康政策的宣传工作至关重要。我们的目的是描述艾伯塔省和曼尼托巴省政策影响者和普通公众对改善心理健康的人群层面健康公共政策的支持情况；并确定支持水平与社会人口统计学变量之间的关联，以及相对于纳菲尔德生物伦理干预阶梯框架的关联。
我们使用了2019年慢性病预防调查的数据，该调查招募了艾伯塔省（n = 1792）和曼尼托巴省（n = 1909）普通公众的代表性样本以及每个省份的政策影响者（艾伯塔省n = 291，曼尼托巴省n = 129）。使用李克特式量表，通过省份、样本类型和社会人口统计学变量，采用有序回归模型描述了对16项政策选项的支持水平。政策选项使用纳菲尔德生物伦理委员会干预阶梯进行编码，以按干预程度对政策选项的支持进行分类。
根据纳菲尔德干预阶梯，政策选项被归类为“提供信息”和“允许选择”。对所有政策选项都有很高的支持，样本或省份之间差异不大。女性以及政治倾向更偏左（相对于中间）的人更普遍地给予强烈支持。移民更有可能强烈支持大多数政策。政治倾向偏右（相对于中间）的人不太可能支持任何心理健康政策。心理健康状况、教育程度和原住民身份也与对某些政策选项的支持有关。
加拿大西部对心理健康政策有强烈支持。结果显示了心理健康政策支持与实施之间的差距，并为希望改善加拿大政策格局的倡导者和政策制定者提供了证据。
