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Terms of Reference

Advisory Council for Equity, Diversity, Inclusion, Indigeneity and Accessibility (EDIIA) in Clinical Care

Purpose

The mandate of this cross-divisional committee is to promote, advise and advocate for greater integration, collaboration and academic scholarship in clinical innovation (and associated research, education and CPA activities) as this applies to Equity, Diversity, Inclusion, Indigeneity and Accessibility in relation to mental health care.

Vision

Equity, diversity, inclusion, Indigeneity and accessibility values and principles will be embedded in the Department of Psychiatry’s clinical endeavors.

Areas of Responsibility

The Advisory Council for Equity, Diversity, Inclusion, Indigeneity and Accessibility (EDIIA) in Clinical Care is a crosscutting committee addressing clinical care concerns about equity, diversity, inclusion, Indigeneity and accessibility and attending to social responsibility concerns related to clinical care across the Department of Psychiatry and for the populations and communities we serve.

The Council will organize its work across 3 areas of responsibility:

  • A. Advise on EDIIA clinical initiatives, targets and measurement:  Recommend and promote meaningful clinical initiatives, targets and measurement methodologies related to EDIIA in clinical care, and advocate for uptake across sites and divisions. The impact of our advisory work is intended to improve access to clinically relevant resources, and to improve the social and structural determinants of health impacting the populations and communities we serve.

  • B. Advocacy: Identify, facilitate and coordinate actionable initiatives to address mental health discrimination, anti-Black racism, anti-Indigenous racism, Islamophobia, and all forms of racism and discrimination, as it relates to mental health care.

  • C. Encourage community-building and information sharing: Share information and relay new developments regarding clinical EDIIA initiatives within the Department of Psychiatry and also liaise with EDIIA initiatives at the Temerty Faculty of Medicine, University of Toronto, Toronto Academic Health Science Network (TAHSN) sites, other universities, and relevant community-based organisations.

Foundations, Principles and Values

  1. It is understood that any form of marginalization, exclusion or oppression negatively impacts individuals and groups

  2. Voices of equity-deserving groups must be sought out as many will have been silenced; relational safety is a process and will be necessary to engage participants to understand needs, empower and create space for groups to act on EDI issues. Relevant stakeholders will be included in implementing change in this area – including community, consumer survivors, and advocacy work. 

  3. Leadership is focused on the advancement of the mandates not the leader. Acts of EDIIA leadership may come from anyone within the group, organization, or system provided they advance the mandate and embody the principles and values below. Models of leadership should embody EDIIA principles and may change as the committee’s work evolves.

  4. Diverse ideas and debate are welcome and necessary to advance the goals of the committee.

  5. Decisions will be value and principle –based. Where there are conflicting values, they will be articulated and prioritized to prevent intractable conflict (eg. Getting to Yes).

  6. Values include respect, listening, compassion, equity, cultural humility and decency.

  7. The committee will use an anti-oppression lens on diversity and inclusion and an intersectionality equity-based framework including sex, gender, sexual orientation, age, race, ethnicity, disability, physical and mental illnesses, socioeconomic status, language, religion, geography, immigration status, mindful engagement with Indigeneity, etc.

  8. Initiatives should involve stakeholder engagement to co-create needed change, e.g. community stakeholders, Division and hospital leads, people with lived experiences and their families

Membership

Committee membership will consider needed skills, representation and diversity, experience and knowledge, eg. experience with community programs, advocacy, education, lived experience, and system transformation. Priorities to be determined annually and may change with time, with ability to invite additional participants ad hoc – as per projects undertaken. 

Representatives are encouraged to be members of equity-deserving groups such as women, Indigenous peoples, visible minorities, and LGBTQ2SIA+.

Resource persons can be invited to attend meetings to provide information to the committee, however, will not have voting privileges.

Membership will include the following categories (up to 25 people): 

  • a.    Trainees: Medical Students/Residents/Fellows 

  • b.    Junior and Senior Faculty within Department of Psychiatry, with experience in program development, Research, Education, CPA, and other health care and service providers

  • c.    Representatives from marginalized communities 

  • d.    Liaison with Leadership

  • e.    Patient and Service User voices / Community representation

Current Members

  • Co-Chairs of the Council

  • Vice Chair, Clinical Innovation (ex-officio)

  • Vice Chair, Mental Health and Addiction Equity and EDIIA (ex-officio)

  • Representation from Education and Social Justice portfolios (ex-officio)

  • Representatives nominated from each Division in the Department of Psychiatry, covering the TAHSN hospitals. The Council is working to get membership representatives from all sites and divisions, including Temerty Faculty of Medicine Hospital Partners and community-affiliated sites * (see list below)

  • Content experts and representatives with lived experience

  • At least two trainee representatives

* Current Department Divisions are: Adult Psychiatry and Health Systems; Child and Youth Mental Health; Consultation-Liaison Psychiatry; Geriatric Psychiatry; Forensic Psychiatry; Neuroscience and Clinical Translation; Psychotherapy, Humanities and Psychosocial Interventions

*The TAHSN sites are: Baycrest; Centre for Addiction and Mental Health (CAMH); The Hospital for Sick Children (SickKids); Sinai Health; Unity Health Toronto - St. Michael’s; Sunnybrook Health Sciences Centre; University Health Network (UHN); Women’s College Hospital

*Temerty Faculty of Medicine Hospital Partners are: Unity Health Toronto - St. Joseph’s; Michael Garron Hospital; North York General Hospital; Trillium Health Partners

*Community-Affiliated Hospitals and Sites are: George Hull Centre; Humber River Hospital; Ontario Shores Centre for Mental Health Sciences; Scarborough Health Network; Surrey Place Centre; The University of Toronto, Health and Wellness Centre; Waypoint Centre for Mental Health Care; Youthdale Treatment Centre

Communities of Practice / Working Groups

Areas of Communities of Practice will be identified by council members and convened to provide advice on specific equity issues or initiatives and need to be of a workable size. They may be comprised of committee members, non-members or both.  The co-chairs of the council are Ex Officio member of the working groups/communities of practice. The communities of practice report regularly to the chair of the committee.

Examples of Communities of Practice may include:
1.    Women’s mental health
2.    Cultural psychiatry 
3.    Indigenous mental health
4.    Global mental health
5.    LGBTQ2SIA+ mental health
6.    Black Mental Health
7.    Faith-based communities, spiritual traditions, & ways of life 
8.    Other: poverty and health, access to healthcare for people who are uninsured, advocacy  
*Members can identify a delegate for the meeting.

Schedule of Meetings

The Council will meet every month or at the call of the two co-Chairs. Communities of Practice and  Working groups will meet as often as needed. 

Term 

Committee membership is for 3 years, renewable once. Trainee membership is for one year, renewable once.

However terms may be staggered, or third terms applied, at the discretion of the Council for continuity purposes.

Reporting Relationship

The Council is advisory to the Executive Committee of the Department of Psychiatry.

Procedures for Decision Making

Generally, decisions are arrived at by consensus following discussion. When consensus is not established and a decision is required, the committee may conduct a vote, with a simple majority of those present at the meeting deciding the matter. A vote may be conducted during a meeting or by electronic means. Similarly, recommendations made by the communities of practice to the council will need to be endorsed by the majority of working group members (Quorum TBD). The council members have voting privileges at committee meetings and community of practice group members have voting privileges at CoP meetings.

Co-Chairs

The co-Chairs are selected by the Department of Psychiatry Executive and interview committee.

Administrative support

Administrative assistant provided through Department of Psychiatry, contact: danica.kwong@utoronto.ca

Approval

  • Department of Psychiatry Executive - Date of last approval: May 4, 2023

  • The Terms of Reference will be reviewed at least every 3 years.

Appendix - Advocacy Statements procedure

The Council can endorse or sign advocacy statements as a distinct group (ie. not on behalf of the Department of Psychiatry). If a Council member seeks for group endorsement of a letter or statement, they can request Administrative Support (from Danica Kwong) to circulate to the group for approval with a minimum 48 hours deadline for response. If no opposition or concerns are raised, Administrative Support will sign on behalf of the Council and add to the “Announcements and Statements” section of the Advisory Council website.