BC’s mental health system has many serious problems. Here’s a big one:
Those not in acute crisis are faced with few effective treatment options, long waits, and repeated failures.
Yes, we need more resources. However, we must use resources better.
We deliver too many “interchangeable units of mental health care” that tie up clinicians but provide limited benefits.
We must deliver the right care at the right time to the right person as part of a larger evolving plan.
This document explains the problem, its causes, and how to fix it.
The crisis in acute care, or lack thereof, is a separate but connected issue. The disasters in emergency/crisis care, the abuses supported by our archaic Mental Health Act, and the human devastation that is all too visible well beyond the DTES and Pandora are huge issues.
But here I’m concerned with a problem that affects far more people yet remains invisible. Until it affects you.
We Keep Doing the Same Thing
Over and Over Again
… and it’s Still Not Working!
It’s almost like we’re looking at this the wrong way.
Family doctors, psychiatrists, counsellors, psychologists, nurses, and social workers — all provide designated mental health services. They get paid (often by the government) to provide specific services.
People see these clinicians (chosen at random) and receive their services. From the clinician’s view, they’re done their jobs to the best of their abilities (and gotten paid), so they’re happy. All done.
From the government’s view, they’ve delivered X units of “mental health care” (think Soviet-era factory output), so they’re happy.
Oh, right. That’s what we forgot.
We keep paying for more interchangeable units of mental health care and getting too few results.
Let’s make better use of our valuable resources.
- Psychiatrists and psychologists could assess and treat complex patients instead of repeat superficial one-time assessments.
- Emergency departments could deal with emergencies instead of people who can’t access longitudinal care.
- “Write-only” documentation can be replaced by effective communication between clinicians.
- Family doctors could take the time to listen, diagnose, educate, and treat patients rather than rush them out the door.
- Services and groups could be utilized because they’re appropriate, not because they’re all that’s available.