Helping people with mental health disabilities access ODSP: An expert report on the complexity of mental health treatment in Ontario [2018]

People with mental health disabilities face particular barriers in accessing Ontario Disability Support Program (ODSP) benefits. A new report by a group of medical experts from University of Toronto’s Collaborative Mental Health Care Working Group will help applicants establish their eligibility for ODSP benefits.

To qualify as a person with a disability under ODSP rules, an applicant has to show that they have a “substantial” physical or mental impairment that results in a “substantial restriction” in their ability to attend to their personal care, function in the community or function in the workplace.

Many unfounded assumptions and stereotypes exist with respect to people with mental health disabilities. Often these assumptions are relied on by ODSP, and by the Social Benefits Tribunal when hearing an appeal, to decide that a person’s disability is not “substantial enough” and to therefore deny them disability benefits.

For example, applicants are often expected to be undergoing certain types and levels of treatment such as psychiatric care, taking prescribed medication or requiring hospitalization. Sometimes, they are expected to be suicidal or to have episodes of crisis. As well, medical opinions from family physicians are often treated as unreliable.

The Collaborative Mental Health Care Working Group’s report debunks these assumptions, providing vital information on the nature of mental health disabilities and how they are treated in Ontario’s healthcare system.

The report explains why many people with mental health conditions do not seek treatment and, if they do, are mainly managed by primary care health care providers (such as family doctors) who are trained to treat a broad range of mental health conditions. The report notes, for example, that the absence of a specialist referral does not reflect the severity of a patient’s mental health condition.

The report also explains why treatment history can be an unreliable predictor of the severity of a person’s disability. The treatment of mental illness and addictions is complex and influenced by many factors such as: limited availability and access to specialized treatment and outpatient care, especially for those who are low income and disadvantaged; the stigma of treatment; intolerance to the side effects of medication; limits to the effectiveness of medication; and variations in prescribing medication.

The expert working group’s report can be used as helpful evidence to support applicants with mental health disabilities and legal clinic caseworkers to show substantial disability and therefore qualify for ODSP benefits. The expert report is also an important general reference for those assisting people with mental health disabilities, and anyone who wants to know more about mental health disabilities and their treatment.

Read the report here