The Ontario Mental Health Reporting System (OMHRS) contains data on adult mental health hospitalizations including in hospital or in psychiatric hospital. Records in OMHRS are updated at admission, discharge, for significant changes in health status and quarterly. OMHRS contains a broad array of information from scores and scales for assessment of patients’ mental health and status.
OMHRS includes mental health data from Ontario facilities with designated adult mental health beds and from 3 facilities outside of Ontario that submit data on a voluntary basis. It also includes records from child/adolescent mental health beds from 2 psychiatric hospitals, and it may include records for patients younger than 18 who were admitted to an adult mental health bed.
Reported mental health data from OMHRS should be complemented by child and youth mental health bed access from DAD and mental-health related emergency department visits from NACRS.
Diagnostic Codes
Mental illness-related hospital admissions or emergency room visits are identified based on most responsible diagnosis or primary diagnoses being coded as Mental and Behavioural Disorders in the International Classification of Diseases and Related Health Problems 10th Revision (ICD-10), or a secondary diagnosis of intentional self-harm, or a primary mental illness diagnosis in OMHRS under the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used to classify psychiatric disorders. Each psychiatric diagnosis is assigned two diagnostic codes using the International Statistical Classification of Diseases and Related Health Problems (ICD). One for the ICD-9-CM version and one for the ICD-10-CM version. Prior to 2016, OMHRS used the ICD-9-CM version of the DSM-IV-TR. Between 2016 and 2018, OMHRS used the ICD-9-CM version of the DSM-5. The change between the DSM-IV-TR and DSM-5 means that some psychiatric diagnoses have moved to different diagnostic categories.
Psychiatric diagnostic codes in OMHRS should be considered a true diagnosis. Where diagnostic codes are not available for a record, which might be the case for a short admission, or for a patient who has not yet been discharged, provisional diagnostic categories are be considered a best guess for psychiatric diagnosis are can be used as a reference for diagnosis.
The sections below identify the specific ICD-10 and DSM-IV codes used to identify hospital admissions and emergency department visits related to overall mental illness and to specific disorders.
Mental Illness
| OMHRS | DSM-IV: - All
- Excluding 290.x and 294.x (dementia)
|
| DAD & NACRS | ICD-10: Primary diagnosis field equals F04−F99 (excludes dementia) Or secondary diagnoses fields equal - X60−X84: Intentional self-harm
- Y10−Y19: Poisoning undetermined
- Y28: Contact with sharp object, undetermined intent
when primary diagnosis is not F04−F99 |
Mood Disorders
| OMHRS | DSM-IV - 293.83: Mood Disorder due to General Medical Condition
- 296.x (all 296 codes): Major Depressive and Bipolar Disorders
- 300.4x: Dysthymic Disorder
- 301.13: Cyclothymic Disorder
- 311.0: Depressive Disorder, Not Otherwise Specified
Or Provisional Diagnosis 6 (Mood Disorders) |
| DAD & NACRS | ICD-10 - F30–F34: Manic, Bipolar Affective, and (Recurrent) Depressive Disorders
- F38: Other Mood (Affective) Disorders
- F39: Unspecified Mood (Affective) Disorders
- F53.0: Mild Mental and Behavioural Disorders Associated with the Puerperium, not elsewhere classified (Post-partum Depression)
- F53.1: Severe Mental and Behavioural Disorders Associated with Puerperium, not elsewhere classified (Post-partum Psychosis)
|
Schizophrenia and Other Psychotic Disorders
| OMHRS | DSM-IV - 293.81: Psychotic Disorders with Delusions related to Other Conditions
- 293.82: Psychotic Disorders with Hallucinations related to Other Conditions
- 295.x (all 295 codes):Schizophrenia
- 297.x (all 297 codes): Delusional Disorders
- 298.x (all 298 codes): Psychotic Disorders
or Provisional Diagnosis 5 (Schizophrenia and other Psychotic Disorders) |
| DAD & NACRS | ICD-10 - F20-F29: Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders
|
Anxiety Disorders
| OMHRS | DSM-IV - 293:84: Anxiety Disorder related to Other Conditions
- 293:89: Other Transient Mental Disorder related to Other Conditions
- 300: Anxiety Disorder NOS
- 300.0x: Panic and Anxiety Disorders
- 300.1x: Dissociative, Conversion, and Factitious Disorders
- 300.21 - 300.23, 300.29: Phobias
- 309.21: Separation Anxiety Disorder
- 313:23: Selective Mutism
Or Provisional Diagnosis 7 (Anxiety Disorders) Or Provisional Diagnosis 15 (Adjustment Disorders) |
| DAD & NACRS | ICD-10 - F40: Phobic Anxiety Disorders
- F41: Other Anxiety Disorders
- F93.0 - F93.2: Separation, Phobic or Social Anxiety Disorder in Childhood
- F94.0: Selective Mutism
|
Personality Disorders
| OMHRS | DSM-IV - 301.x (excluding 301.1, 301.3): Personality Disorders
Or Provisional Diagnosis 16 (Personality Disorders) |
| DAD & NACRS | ICD-10 - F60–F62: Specific and Mixed Personality Disorders
- F68.0 - F68.8: Other Adult Personality Disorders
- F69: Unspecified Adult Personality Disorders
|
Eating Disorders
| OMHRS | DSM-IV - 307.1x: Anorexia Nervosa
- 307.50: Eating Disorder NOS
- 307.51: Bulimia Nervosa
|
| DAD & NACRS | ICD-10 - F50.0: Anorexia Nervosa
- F50.1: Atypical Anorexia Nervosa
- F50.2: Bulimia Nervosa
- F50.3: Atypical Bulimia Nervosa
- F50.8: Other Eating Disorders
- F50.9: Eating Disorders, Unspecified
|
Substance Use Disorders
| OMHRS | DSM-IV - 291.x (all 291 codes, excluding 291.82): Alcohol-induced Disorders
- 292.x (all 292 codes, excluding 292.85): Other Substance-induced Disorders
- 303.x (all 303 codes): Alcohol
- 304.x (all 304 codes): Substance Dependence
- 305.x (all 305 codes): Substance Abuse
- 312.31: Gambling Disorder
or Provisional Diagnosis 4: Substance-related disorders |
| DAD & NACRS | ICD-10 - F10-F19: Mental and behavioural disorders due to psychoactive substance use
- F55: Abuse of non-dependence-producing substances
- F63.0: Gambling Disorder
|