In a seemingly bold and progressive step late last year, the B.C. government released a 10-year plan they labeled a “road map” aimed at helping people in our province with mental illness and addiction.
Although the title, Healthy Minds, Healthy People, sounds good and the overall aim is a positive one, this plan, like many other government-sponsored attempts, doesn’t address the kinds of systemic change needed for truly improving our province’s services for the mentally ill and addicted among us.
In reality, the document reads like most government propaganda—highlighting positive steps made in recent years by the provincial government and giving limited details about how ambitious goals will be met over the next decade.
I don’t want to sound overly negative. I think it’s great to have some focus on the cost and impact of mental health and substance use problems. These are serious health issues directly affecting about one in five people and costing the Canadian economy more than $50 billion each year in lost productivity alone. They need to be a priority in government planning and action.
Certainly, our provincial government’s plan has some noble goals—to focus resources on evidence-based best practices so that we can promote health and the social and emotional development of all British Columbians and improve mental health.
Over the 10-year road map, the goals include improving the mental health and well being of the entire population; improving the quality and accessibility of mental health and addiction services; and reducing the economic cost of mental health and substance use problems.
Specifically, the plan sets some lofty goals including:10 per cent more people reporting positive mental health; 15 per cent fewer young children who are vulnerable in terms of social-emotional development by 2015; 10 per cent fewer students using alcohol or cannabis before age 15 by 2014; 10 per cent fewer people engaging in risky drinking behaviour by 2015; 20 per cent more people receiving mental health and substance use assessments and planning interventions in primary care by 2015; and a 20 per cent reduction in the number of days mental health and substance use patients occupy inpatient beds while waiting for community services by 2018.
While these goals are certainly praiseworthy, I am sceptical about the specific planning in place to ensure or track their success in this relatively short time line. For one thing I would like to see a group independent of government and government funding provide an unbiased, realistic evaluation.
Many of the existing problems in the delivery of our current mental health services are not addressed in this proposal. We have several long-standing problems with the execution and coordination of mental health services in our province and communities. Very often there is poor communication between government services such as the mental health centre, or hospital and community based, private services like psychologists or other therapists who don’t work in government funded facilities.
Our current system is fragmented with little coordination or communication and long wait times. Currently, patients who are admitted to hospital often end up waiting in ER for several days and often leave in frustration without receiving treatment. If they actually get out of the ER and are admitted, there is often inadequate communication with families or community mental health providers who may be expected to do the follow up care. These problems are not new and are also not unique to our city.
All of these issues are solvable with some real administrative planning and structure and would not require much, if any, additional spending. Of course, more important than any of this is the provision of adequate housing and the elimination of childhood poverty.
Paul Latimer is Kelowna psychiatrist.