Reflections on the Canadian Community Mental Health Report

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A new report has been launched on behalf of community-based mental health organizations from across the country. The Mood Disorders Society of Canada (MDSC) is responsible for the Canadian Community Mental Health Organizations Roundtable Report, with findings that can help inform our understanding of mental health treatment in Canada and locally. 

The report is based on consultations with 48 community-based mental health organizations. Part of its purpose is to detail the challenges these groups face in their daily work, particularly when it comes to funding and staffing issues. Also included in the report are recommendations intended to address these issues. One such recommendation is for specific funding to be allocated to community mental health organizations to address the core funding issues that most of these organizations face. Other recommendations include integrating these organizations into the broader health system, allowing for more collaboration between mental health professionals and medical professionals. 

I have no shame in admitting that I am unqualified to comment on the merits of this report’s findings. Yes, I have a graduate level education in mental health counselling, but I don’t pretend to know more about the field than the high level professionals whose primary responsibilities involve researching mental health best practices. I do however, have observations as someone who has seen people struggle to access mental health services. 

I have known people who, in absolute desperation, visit a local hospital to access mental health services, only to wait days to speak to a crisis team who ultimately blows them off. I have had more people than I can count on two hands and two feet ask me, upon learning of my mental health education, where the best “place to start” is when it comes to accessing mental health services for themselves or a loved one. When I was a student completing my placement as a counsellor, my placement teacher and I felt compelled to call a crisis line for immediate assistance for a suicidal client, only to have him not taken seriously on the phone. We were shocked that as two mental health professionals calling, our client still wasn’t taken seriously. We gave up and called an ambulance, though it is doubtful that that arrangement helped any more than the crisis line call.

Lack of funding is absolutely a huge piece of the puzzle. Mental health education is expensive (mine cost about $60,000), and the professionals who work in the field expect to be paid fairly for their work. However, funding is not the whole story. The mental health field is disorganized and confusing. Some service providers such as psychologists are far more expensive because of their experience and diagnosing abilities, while others such as psychotherapists and counsellors are less costly, but offer a different range of services. Some service providers are covered by private insurance plans, while others are not. Psychiatrists are covered under OHIP, but require a lengthy referral. Crisis lines are often a hit-or-miss in terms of the help provided, and there are many to choose from. Hospitals can provide psychiatric services, but they are understaffed, and many complain about the service provided. The police will respond to a crisis situation if requested, but officers typically lack the proper training to help. These options are utterly confusing for someone already in a difficult mental state!

If I suddenly come down with the symptoms of a heart attack and fear I may have minutes to live, my next move is clear. I have one viable option, which is to pick up a phone and dial 9-1-1. What happens next will also be clear – an ambulance will come, paramedics will provide primary care, and I will be taken to a nearby hospital and triaged with high priority. In a similarly dangerous situation, if I am holding a knife to myself, the options at my disposal are far less clear. In fact, there are precisely seven options in my non-exhaustive list above. Even more worrisome is that countless anecdotal reports suggest that some options may be a gamble, in the sense that the service quality is poor. 

When it comes to mental health both locally and nationally, I propose that it is time for the powers that be to organize mental healthcare into a more uniform system. Yes, this will require additional funding, but money is not the only component required. This is a problem that will also require brains. Only time will tell if our politicians are properly equipped. 

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