Medical Practice Variations in Mental Health and Addictions Care

  • Elizabeth Lin
  • Zeynep Or
  • Magali Coldefy
  • Karen Urbanoski
  • Dallas Seitz
  • Corine Carlisle
  • Peter Szatmari
  • Paul Kurdyak
Living reference work entry
Part of the Health Services Research book series (HEALTHSR)


This chapter provides an overview of the practice variations in care delivery for mental health and addictive disorders and some of the system-level funding and structural factors that contribute to such variation. Practice variations are described for five populations, along with their expected clinical picture and service needs:
  • Children and adolescents

  • The elderly

  • Severe mental illness

  • Mild/moderate illness

  • Substance use disorders

These variations occur in a system-level climate which has been transformed over the past decades because of a fundamental change in how appropriate care is defined. Specifically, Western countries have been shifting from institutional to more community-based care – a process labeled “deinstitutionalization.” National differences in how services are funded and organized in light of deinstitutionalization are described. Pending gold-standard outcome indicators such descriptions allow more in-depth examination of what the potential drivers for system change are and how different funding and structure configurations might be compared and evaluated.


Mental Health Primary Care Mental Illness Mental Health Service Anxiety Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Elizabeth Lin
    • 1
    • 2
  • Zeynep Or
    • 3
  • Magali Coldefy
    • 3
  • Karen Urbanoski
    • 4
  • Dallas Seitz
    • 5
  • Corine Carlisle
    • 6
  • Peter Szatmari
    • 7
  • Paul Kurdyak
    • 8
  1. 1.Institute for Clinical Evaluative SciencesTorontoCanada
  2. 2.Provincial System Support ProgramCentre for Addiction and Mental HealthTorontoCanada
  3. 3.Institute for Research and Information in Health EconomicsParisFrance
  4. 4.Health Systems ResearchCentre for Addiction and Mental Health, University of TorontoTorontoCanada
  5. 5.Providence Care – Mental Health ServicesGeriatric Psychiatry, Queen’s UniversityKingstonCanada
  6. 6.Youth Addiction & Concurrent DisordersCentre for Addiction and Mental Health, University of TorontoTorontoCanada
  7. 7.Child and Youth Mental Health CollaborativeCentre for Addiction and Mental Health, Hospital for Sick Children, and University of TorontoTorontoCanada
  8. 8.Health Systems ResearchCentre for Addiction and Mental Health, Institute for Clinical Evaluative SciencesTorontoCanada

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