This page describes the mental health and addictions information found in CIHI’s data holdings, by type of care.
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Hospital Mental Health Database
The Hospital Mental Health Database (HMHDB) contains data on inpatient separations for mental illness or addiction from general and psychiatric hospitals. This pan-Canadian database includes demographic, administrative and diagnosis information. The HMHBD brings together data from 4 sources: the Discharge Abstract Database, the Hospital Morbidity Database, the Ontario Mental Health Reporting System and the Hospital Mental Health Survey.
Ontario Mental Health Reporting System
The Ontario Mental Health Reporting System (OMHRS) contains comprehensive information on individuals receiving services in designated adult inpatient mental health beds in Ontario, in both general and psychiatric hospitals. In addition, OMHRS contains information on individuals receiving inpatient mental health services in Newfoundland and Labrador and in Manitoba. Information from OMHRS is used in clinical decision support and in CIHI’s analysis and reporting on mental health services.
OMHRS data is derived from clinical assessments based on the Resident Assessment Instrument–Mental Health (RAI-MH©), a standardized clinical instrument used to regularly assess those receiving hospital mental health care. Developed by interRAI, Ontario’s Ministry of Health and Long-Term Care and the Ontario Hospital Association, the RAI-MH assesses mental and physical health, social supports and service use, and provides information for care planning, outcome measurement, quality improvement and case-mix funding applications. Collectively, this information can help improve care planning and decision support in mental health services.
Discharge Abstract Database/Hospital Morbidity Database
The Discharge Abstract Database (DAD) is a national database that contains information on separations from acute care facilities, including discharges, deaths, sign-outs and transfers. Over time, the DAD has also been used to capture other data, such as day surgery, chronic care and rehabilitation data. It includes demographic, clinical, administrative and service-specific data elements.
Quebec does not submit data to the DAD; Quebec’s acute inpatient separations are reported to the Hospital Morbidity Database (HMDB). The Quebec Ministry of Health and Social Services submits a data file to CIHI annually. This data file is then merged with the DAD to create the national DAD–HMDB data file.
Mental health and addictions data in the DAD/HMDB
- ICD-10-CA diagnosis codes
- CCI intervention codes
- Facility Type
- Patient Service (e.g., psychiatry)
- Provider Service (e.g., psychiatry)
- Discharge Disposition (e.g., absent without leave)
- Institution From
- Institution To
- Mental health items:
- Change in Legal Status From Admission
- Previous Psychiatric Admission
- Number of ECT Treatments
- Legal Status Upon Arrival to the ED
- Legal Status at Admission
- Type of Restraint
- Frequency of Restraint Use
- Special Projects/Ancillary Information
National Ambulatory Care Reporting System
The National Ambulatory Care Reporting System (NACRS) is a national database that contains information on emergency and ambulatory care, including day surgery and outpatient clinic visits. Client visit data is collected at the time of service in participating facilities. NACRS includes demographic, clinical, administrative and service-specific data elements.
Mental health and addictions data in NACRS
- ICD-10-CA diagnosis codes and/or pick-list codes:
- Canadian Emergency Department Information System (CEDIS) Presenting Complaint List (PCL)
- Canadian Emergency Department Diagnoses Shortlist (CED-DxS)
- CCI intervention codes and/or pick-list codes:
- ED Intervention Pick-List
- ED Investigative Technology Pick-List
- Number of ED Investigative Technologies Performed
- Management Information System (MIS) Functional Centre (FC) Account Code
- Provider Service (e.g., psychiatry)
- Visit Disposition (e.g., left after triage)
- Referral Source Prior to Ambulatory Care Visit
- Institution From
- Institution To
- Mental health indicators:
- Legal Status Upon Arrival to ED
- Type of Restraint
- Frequency of Restraint Use
National Rehabilitation Reporting System
The National Rehabilitation Reporting System (NRS) contains client data collected (at admission, discharge and, optionally, follow-up) from participating adult inpatient rehabilitation facilities and programs across Canada, including specialized facilities and hospital rehabilitation units, programs and designated rehabilitation beds. The minimum data set includes ICD-10-CA diagnostic codes for most responsible and comorbid health conditions, as well as clinical data on function and cognition.
Mental health and addictions data in the NRS
A predefined pick-list of ICD-10-CA diagnosis codes (which includes a sub-set of mental and behavioural disorder codes) is available to record comorbid mental health and addictions conditions that affect inpatient rehabilitation care. Although the primary reason for most admissions is physical rehabilitation, approximately 25% of episodes of care have at least one mental health and addictions comorbidity recorded. Comorbid health condition codes (e.g., depression) are recorded when they are believed to affect a patient’s inpatient rehabilitation stay. This may be of interest to individuals examining particular patient populations (e.g., stroke patients).
Provider types may also be recorded for each episode of care. Options relating to mental health and addictions include psychiatrist, psychotherapist and psychologist. Occupational therapists are also listed, but their main role within inpatient rehabilitation does not tend to be related to mental health.
National Trauma Registry Comprehensive Data Set
The National Trauma Registry Comprehensive Data Set (NTR CDS) is made up of detailed trauma/injury data that was collected at specific trauma hospitals across the country and submitted to CIHI. The registry was decommissioned in March 2014, but historical data is available from 1999–2000 to 2012–2013.
Mental health and addictions data in the NTR CDS
The NTR CDS includes the following:
- ICD-10-CA diagnosis codes: In addition to trauma codes, instances of depression, anxiety, addictions, etc., may be recorded
- CCI intervention/procedure codes: For example, electroconvulsive therapy, mental health counselling, mental health therapy
Community mental health
In 2012–2013, CIHI implemented a community mental health and addictions assessment in Newfoundland and Labrador using the interRAI CMH, a standardized assessment system for community mental health (CMH) settings. The interRAI CMH, like the RAI-MH, is used to assess individuals upon intake and in subsequent periods in order to examine changes in mental health. The interRAI CMH contains scales and elements covering the following:
- Mental status (e.g., mood disturbance, negative symptoms, degree of insight)
- Substance use
- Functional status (instrumental activities of daily living)
- Health conditions
- Service utilization and treatments
- Employment, education and finances
- Environmental assessment (e.g., living conditions)
- Diagnostic information
The interRAI CMH assessment generates outcome scales, quality indicators and Mental Health Clinical Assessment Protocols that are used in care, program and system planning, performance measurement and policy decisions.
Continuing Care Reporting System
The Continuing Care Reporting System (CCRS) is a longitudinal database that captures clinical, demographic and administrative information on residents in residential and hospital-based continuing care facilities in Canada using interRAI’s Resident Assessment Instrument–Minimum Data Set (RAI-MDS 2.0©).
Mental health and addictions data in CCRS
The assessment includes mental health and developmental disability history. Clinical information for residents who stay longer than 14 days is collected quarterly and annually using the RAI-MDS 2.0, including the following:
- Disease diagnoses (Alzheimer’s disease, dementia other than Alzheimer’s disease, depression, bipolar disorder, schizophrenia and anxiety disorder)
- Health conditions (delusions and hallucinations)
- Use of psychotropic medications and other medications
- Cognitive patterns (including indicators of delirium, memory/memory recall ability, cognitive skills for daily decision-making and change in cognitive status)
- Mood and behaviour patterns (including indicators of depression, anxiety and sad mood)
- Psychosocial well-being
- Special treatments, procedures and programs (participation in alcohol/drug treatment program, and Alzheimer’s or dementia special care unit)
- Intervention programs for mood, behaviour and cognitive loss
- Psychological therapy undertaken
- Use of devices and restraints
Several risk-adjusted quality indicators are also tracked, including Daily Physical Restraints, Cognitive Ability Worsened/Improved, Symptoms of Delirium and Mood From Symptoms of Depression Worsened.
Home Care Reporting System
The Home Care Reporting System (HCRS) is a longitudinal database that captures clinical, demographic and administrative information on clients receiving publicly funded home care services in Canada using interRAI’s Resident Assessment Instrument–Home Care (RAI-HC©).
Mental health and addictions data in HCRS
The assessment includes mental health and developmental disability history. Clinical information for long-term supportive care and client maintenance is collected using the RAI-HC, including the following:
- Disease diagnoses (Alzheimer’s, dementia other than Alzheimer’s disease and any psychiatric diagnosis)
- Health conditions (delusions and hallucinations)
- Lifestyle (drinking/smoking)
- Health status indicators (conditions or diseases that make cognition, mood or behaviour patterns unstable)
- Use of psychotropic medications (antipsychotics/neuroleptics, anxiolytics and antidepressants)
Additional information is also available for potential home care clients in Ontario. The interRAI Contact Assessment Canadian Version — Screening Level Assessment for Emergency Department and Intake From Community/Hospital is an intake and screening tool for clients being evaluated for home care services. Mental health and addictions–related information within this tool includes
- Expected residential/living status
- Self-reported mood
- Tobacco use
- Conditions/diseases that make cognitive, activities of daily living, mood or behaviour patterns unstable
- Acute change in mental status from person’s usual functioning
- Mental status indicators, including hallucinations and/or delusions
- Emergency department preliminary screener
National Prescription Drug Utilization Information System
The National Prescription Drug Utilization Information System (NPDUIS) contains de-identified prescription claims-level data collected from publicly financed drug benefit programs in Canada. In addition, the database contains supporting contextual information for drug claims data, including formulary information, drug product information and information on policies of public drug plans in Canada.
Mental health and addictions data in NPDUIS
Drug classes used in the treatment of mental health and addictions may include the following:
- Hypnotics and sedatives
- Psychostimulants, agents used for attention deficit hyperactivity disorder (ADHD) and nootropics
- Psycholeptics and psychoanaleptics in combination
- Anti-dementia drugs
- Drugs used in addictive disorders
Health Workforce Database
The Health Workforce Database (HWDB) contains information on 30 groups of health care professionals. For 9 professional groups, record-level data on supply, distribution, demographics, education and employment characteristics is available. For the other 21, aggregate data is available on supply, demographics and education.
Health care professionals working in mental health and addictions
A diverse group of health care professionals provide services to individuals with mental illness and addictions, including licensed practical nurses (LPNs), registered nurses (RNs), nurse practitioners (NPs), registered psychiatric nurses (RPNs), occupational therapists (OTs), psychiatrists, psychologists and social workers. Although other health care professionals may also provide mental health and addictions services, only those for which CIHI collects data in the HWDB are included in the table below.
|Professional group||MHA-related data element(s)||Value(s) of interest|
|Registered nurses, including nurse practitioners,
and licensed practical nurses
|Place of Work||
Mental health centre
|Area of Responsibility||
|Registered psychiatric nurses||Place of Work||All employment values of an RPN may be relevant.|
|Area of Responsibility|
|Occupational therapists||Employer Type||
Mental health hospital/facility
|Area of Practice||Mental health|
|Psychologists and social workers||Not available||Aggregate data on the supply and demographics by province/territory.|
Scott’s Medical Database
Scott’s Medical Database (SMDB) provides information on the number of physicians and their distribution across the country, plus demographic, education and migration information. Because physicians can be uniquely identified, changes in physician type as well as physician movement among provinces and territories can be tracked over time.
Mental health and addictions data in the SMDB
Medical specialty of the physician is captured, including psychiatry. There is a specific sub-grouping for child and adolescent psychiatry within the pediatrics category. For details on the specialty groupings methodology, see Appendix C in Methodological Notes: Supply, Distribution and Migration of Physicians in Canada, 2016.
National Physician Database
The National Physician Database (NPDB) provides information on demographic characteristics of physicians, physician payments and physicians’ level of activity within Canada’s health care systems.
Mental health and addictions data in the NPDB Various reports on payments and utilization are available that provide information by groups and physician specialty categories. Of relevance to mental health and addictions are the following:
- The National Grouping System (NGS), which includes psychotherapy/counselling
- The physician specialty categories, which include psychiatry and neuropsychiatry
Age group and gender of the patient receiving the service are also collected, allowing for additional analysis of these demographics by the following NGS groups and specialties:
- Psychotherapy/counselling: Refers to individual psychotherapy; hypnotherapy; narco-analysis; diagnostic/therapeutic interviews; group and family psychotherapy and interviews; interviews for physical medicine; counselling for drugs, family, genetic, marriage and contraception; and case conferences on behalf of patients with allied workers, teachers, clergy, etc.
- Individual psychotherapy
- Group/family psychotherapy
Canadian Management Information System Database
The Canadian MIS Database (CMDB) is the national data source for financial and statistical information about hospitals and health regions. It collects day-to-day health service operations data according to a standardized framework known as the Standards for Management Information Systems in Canadian Health Service Organizations (MIS Standards).
Mental health and addictions data in the CMDB
The information available in the CMDB related to mental health and addictions services is specific to hospitals and residential facilities. Facility types in the CMDB that are relevant to mental health and addictions services include
- General hospitals
- Mental health and substance abuse hospitals
- Residential care facilities
- Mental health residential facilities
- Addiction treatment residential facilities
- Combined mental health and addictions treatment residential facilities
Data on staff earned hours and compensation, workload, staff activity, operational costs and the provision of services is available at the facility, regional health authority/local health integration network and provincial/territorial levels. While Quebec does not submit data to the CMDB, the province’s data has been mapped to the MIS Standards and certain data can be made available. Data from Nunavut is not available in the CMDB.
Accounts are set up in the CMDB to receive data in community mental health services areas as well as community addiction services. However, the data received to date is neither complete nor feasible for use in comparable analyses at this time.
Canadian Patient Cost Database
The Canadian Patient Cost Database (CPCD) contains patient-level cost data from more than 60 hospitals in Nova Scotia, Ontario, Alberta and British Columbia. Detailed costs are submitted to CIHI at the individual encounter level for inpatient, outpatient, long-term care, complex continuing care, and mental health and rehabilitation services.
The CPCD data can identify which days of the patient’s stay were the most expensive and can identify what types of health care costs and which functional centres (business areas) of the hospital contributed the most to the total patient encounter cost.
Mental health and addictions data in the CPCD
Cost data is available for individuals receiving mental health or addictions services in some Ontario facilities that submit data to OMHRS and in some facilities in Nova Scotia, Ontario, Alberta and British Columbia that submit data to the DAD.
Canadian Patient Experiences Reporting System
The Canadian Patient Experiences Reporting System (CPERS) collects data on patient experiences during inpatient hospital stays via the Canadian Patient Experiences Survey — Inpatient Care (CPES-IC). Results are reported to participating jurisdictions via the CPES: Comparative Results secure online tool. 4 provinces (New Brunswick, Ontario, Manitoba and Alberta) are currently submitting data to CIHI, with several others expressing interest.
Mental health and addictions data in CPERS
As part of the socio-demographic information collected through the CPES-IC, there is a question on self-reported mental or emotional health: “In general, how would you rate your overall mental or emotional health?”