Mental health and policing: Picking up the pieces in a broken system.

A key theme of this article is the need to view the intersection of public safety and public health through a new lens to break down the traditional information silos of the many agencies that serve vulnerable populations and the impact of inadequate community-based mental health services that contribute to the increasing number of calls to police in responding to people in or approaching a mental health crisis. The manifestation of this crisis in the community is that the police are too often the first port in the storm. This article suggests the system is broken and needs fixing. Implementing a population health approach to identifying the high utilizers in the community and building a case for sustained funding, partnerships, resources, and accountability together with data sharing agreements, community partners and police collaboratively design and evaluate outcome approaches aimed at prevention and recovery to minimize contact with the police.

Predicting and testing a silo-free delivery system.

Given the scale and complexity of the challenge of addressing the aging population, increasing demand for complex and integrated care, this article sets out potential opportunities to predict a future without silos, based on international learnings. Examining another country's health and delivery systems, it is interesting to see the similarities and differences, so we offer some reflections applicable to Canada. These models are breaking down the silos. Imagine a setting where you could collaboratively co-design scenarios, debate, refine policy, and predict future population needs. Using a transformation lab setting, governments and policy-makers, providers, patients, families, and community support groups could collaboratively take the time to learn new ways of working together in a risk-free environment before becoming accountable for delivering targeted outcomes. It is time to implement provincial transformation labs to test local strategies and operational plans to co-design scenarios, use simulation, and test the choices using evidence-based tools.

Using simulation modelling to test the impact of future demand for end-of-life care.

Health systems globally are exploring new models of care to address the increasing demand for palliative, hospice, and end-of-life care. Yet few tools exist at the population level to explore "what if" scenarios and test, in a "cost avoidance environment," the impact of these new care models on policy, workforce, technology, and funding. This article introduces the application of scenario-based "what if" thinking and discrete event simulation in strategic planning for a not-for-profit hospice organization. It will describe how a set of conceptual models was designed to frame discussions between strategic partners about the implications and alternatives in implementing a new, integrated service model for palliative and end-of-life care.