Friday, June 25, 2010
Please don’t tell me that the people in charge of services on the Island for people with mental illness really think that it’s us to blame for the sad condition of mental-health services.
Dr. Robert Miller, medical director for mental health and addiction services at Vancouver Island Health Authority, wrote in a letter to the editor last week that the reason mental health and addiction services are inadequate is because the public makes that choice.
Really? I can’t recall a time when the health-care system has ever consulted Canadians around funding decisions of any kind. I take Miller’s point that our country underspends on mental health services, but I don’t remember a public conversation in which we agreed to that.
Miller, who’s also head of psychiatry for VIHA, rightly raises in his letter the fact that Canada spends a smaller proportion of its health-care dollars on mental health and addiction care than other western nations. Just eight per cent of the health-care budget for Vancouver Island goes to mental health and addiction services. Countries like Australia and the United Kingdom are spending 12-15 per cent.
We did elect the governments who have brought us to this point, it’s true. Maybe that’s what Miller means. But I can’t recall an election when any of the major political parties even put forward a platform around mental health services, let alone worked it as an election issue.
I suppose we taxpayers do deserve the blame for tolerating political parties that can’t even be bothered to talk about mental health. But it’s a pretty big stretch to translate that as meaning the public has made a choice to deny better care to those with mental illness. (Or that we’d ever want public opinion to dictate something as important as who gets good health care.)
And we couldn’t be party to any of the decision-making around health care even if we wanted to. VIHA and B.C.’s other four health authorities have no public accountability, or meaningful public access to their meetings.
Miller’s June 19 letter was the latest in a trio of missives that have appeared in the paper over the past month from doctors and directors at VIHA.
The first letter - from outgoing VIHA mental-health director Alan Campbell - was prompted by a Times Colonist editorial June 9 headlined “A terrible failure on mental illness,” written after the tragic stabbing death of 15-year-old Justin Wendland. Campbell wrote that the health authority had for the last three years increased funding for mental health and addiction services by $6 million a year in Greater Victoria.
His letter brought a shot across the bow from Dr. Andre Masters, a psychiatrist and outspoken critic of cuts to mental health services. Masters took considerable exception to Campbell’s assertion that spending was up.
Then came Miller’s letter, which seemed to be an attempt to make peace between the two sides by shifting the blame for cuts off of VIHA and onto the public.
I’m not buying it. This has nothing to do with the public making a choice. It’s all about the health authority looking for savings in the same old places, and a budget so tight that improving wretched services on one part of the Island can only be done by taking valued services away somewhere else.
Mental-health services are chronically underfunded and the first to be cut because governments know they can get away with it. For all kinds of reasons, mental illness has never had the political cachet and sophisticated lobby of physical illnesses, and was deliberately segregated from the rest of the Canada’s health-care system from the start.
Mental illness can’t be “cured” in that nice, clean way that we prefer, like a broken leg or an ailing heart. Even diagnosing it can be tricky, and the results of treatment unpredictable.
It’s stigmatized and poorly understood. It generates just enough scary media stories of unexpected violence to leave the public with the gross misconception that to be mentally ill is to be dangerous and out of control.
Mental illness knocks the wind out of the best of families in no time flat. Even friends and family members tend to take a step back when the diagnosis is mental illness, instead of stepping up to help the way they would have had the diagnosis been breast cancer or hip surgery.
So when cuts come, they hit a group of people that already feels ashamed, hopeless and unworthy. The axe falls, and nobody has the strength to scream.
Who’s to blame? The decision-makers who take advantage of that helplessness to reduce care to people too broken to fight back.