Culturally-relevant counselling. Everyone can access mental health supports that are culturally sensitive, including for women, youth, newcomers, and gender-diverse neighbours. Healthy conflict resolution is considered a key part of our mental health and social services. We have eliminated waitlists for counselling services in the region and access to mental health support is covered by OHIP. We have seen a reduced need for crisis-oriented supports. In addition to counselling, neighbours regularly participate in social therapy including culinary, sports, and art in community with our neighbours.

Drug use & harm reduction. Drug use and mental health are addressed from a public health perspective, not as a criminal issue. Those in at-risk communities have convenient access to health services, including community health centres, mobile health support, drug testing, safe supply, and wound care. Public health efforts are informed by harm reduction principles. Supportive services including mental health, addictions, and skill development are integrated into shelters as well as assisted living facilities. Thanks to an increased awareness and the availability of supports, rates of HIV, hepatitis C, and other sexually transmitted and bloodborne infections have been reduced. Widespread drug testing is available anonymously and conveniently, mitigating the effects of the drug poisoning epidemic, and hundreds of lives have been saved as a result.

Increased healthcare access. Health care is accessible to anyone, including refugees and those without a fixed address. Health insurance is available to all neighbours, including pharmacare, dental care and eye care. Access to family doctors in one’s neighbourhood is no longer a major challenge in people’s lives. The types of healthcare clinics have expanded to include nurse practitioner-led facilities. New forms of family health teams have been able to adapt to the growing and changing needs of our neighbours. Pharmacists are able to provide an expanded range of services. When appropriate, doctors prescribe social interventions, nature interventions, and artistic interventions instead of pharmaceutical treatment. Average wait times in our hospitals’ emergency rooms have fallen significantly. Specialized supports are available across the region, not only in one area. Those who need intensive mental health services, respite care, or supportive care, can do so without leaving the social cohesion of their own neighbourhood. 

Supports for caregivers. Communities of care are not restricted to the formal healthcare system. Family and friends who care for one another are supported both financially, and with resources including training, scheduling, programming, that helps them take care of each other while being rooted in community. Social connection and social cohesion is intimately linked with good health outcomes. This approach helps reduce the degree of isolation and loneliness, and increase the feeling of belonging in the region. Respite programs are widely available to help ease the burden of care work.

Social and environmental determinants of health. We have made significant progress on reducing the disparities in health outcomes among different populations, by addressing the social determinants of health. Human health is understood in relation to the health of the animals and ecosystems who we share this land with, as well as the health of the water that comes from this land. We are prepared to respond to the next pandemic-level crisis with mutual aid networks, as well as robust standards for clean air, clean water, and sanitation. We have successfully reduced disease transmission by mandating clean air standards in all public spaces, including public services and businesses, and through public vaccination campaigns. Sick pay is sufficient to ensure neighbours don’t have to choose between going to work sick and staying home without pay.

Crisis support. There are resources for individuals escaping abusive relationships, including shelters, and people know where to turn to find a safe neighbour to talk to for support. Community care is a vital part of life, and we have multiple non-police emergency response services to call for support with vulnerable neighbours who may be in crisis. We are a community that has developed a culture of healthy conflict resolution. The Waterloo Regional Police Service has taken a more focused role, transitioning responsibility for community safety, crowd control, overdose response, school safety, and mental health crisis response to other organizations that are more suited to dealing with those specific issues. Our paramedic service is well-resourced, with average response times under 6 minutes and no “code zero” occurrences (i.e. when there are no ambulances available).

Health: measurable outcomes

• Availability of emergency rooms, urgent care clinics, and walk-in clinics (by neighbourhood)
• Reduction in 911 calls
• Levels of anxiety, mental well-being (survey)
• Number of emergency room visits for mental health & addictions (by neighbourhood)
• Number of people on waitlist for mental health care
• Number of people on waitlist for primary care physician
• Overall health outcomes (by neighbourhood)
• The gap between life expectancy and health outcomes in the richest and poorest neighbourhoods has significantly reduced. 
• Percentage of population that received influenza immunization in past year [Canadian Index of Wellbeing]
• Percentage of population with a regular medical doctor [Canadian Index of Wellbeing]
• Percent of children vulnerable, Physical Health & Well-Being [Early Development Instruments]
• Percent of children vulnerable, Emotional Maturity [Early Development Instruments]
• Out-of-pocket costs for healthcare, including mental health