Friday, July 02, 2010
It's still the back of the bus for mental health services
Alan Campbell couldn’t believe the kind of care and support his wife received after being diagnosed with breast cancer five years ago.
The speedy treatment. The kind words. The follow-up calls and offers of support. It was an amazing experience, says Campbell - and all the more striking when compared to the level of care his own clients typically see.
Campbell has spent the last 34 years working in B.C.’s mental-health system, most recently as director of mental health and addictions for the Vancouver Island Health Authority.
I’m sure he would have liked to have been finishing off his career this week reflecting on the tremendous gains made around mental-health care in his time. That’s certainly been the case for breast cancer and for many other major health concerns that we’ve tackled with fervour in the last three decades.
Alas, Campbell retired Wednesday from a field that is very nearly as underfunded, misunderstood and stigmatized as it was when he got into it in 1976. Had his wife been diagnosed with bipolar disorder or schizophrenia instead of breast cancer, her family’s journey through a fractured and overwhelmed mental-health system would have been very, very different from the experience they had at the tender hands of the B.C. Cancer Agency.
Why is that? Why does one disease get the resources it needs to do things exactly right, and another have to beg for leftovers at the back of the line?
Mental illness accounts or 20 per cent of all illness, yet its share of health-care spending on Vancouver Island is a mere eight per cent. Make that six per cent in B.C. overall.
“We haven’t figured out how to get behind mental health as a country,” says Campbell. “It’s not just a problem here. In other regions, other provinces, the same dynamic exists. When we compare ourselves to other countries, we don’t look good.”
Campbell’s final months at VIHA can’t have been fun, what with the outrage building in the local psychiatric community over the loss of even more mental-health services.
In recent weeks, a doctor with the Schizophrenia Affective Disorders Clinic, Dr. Adam Gunn, resigned over the cuts. Dr. Anthony Barale has closed his outpatient service at Victoria General Hospital for people with brain injuries, saying he can’t support a system that’s failing patients and their families.
Dr. Andre Masters noted those resignations in a letter to the editor last month, and says more are likely coming. VIHA’s Department of Psychiatry passed a motion last fall condemning everything about the way budget deliberations were handled at VIHA.
Yes, there’s an urgent need for more spending on mental-health services, says Campbell. But when his department takes that message forward, the answer is usually “no,” he adds.
“For every one of the five years I’ve been doing this job, we’ve put forward strong, well-reasoned cases for more funding,” he says of his department. “The only time we were successful was in getting money for the Mayor’s Task Force on Homelessness. My understanding is that our requests are given real consideration, but they just don’t fare well in the end.”
Nor does it go well when VIHA starts moving money around on the Island, taking funding away from places like Victoria and Nanaimo in order to provide more services in places like Port Hardy and Duncan. Mental-health services may be insufficient in Greater Victoria, but they’re downright dismal elsewhere on the Island, says Campbell.
The economy will eventually improve, of course, and brighter days will dawn for many of the health, education and social services under the knife right now.
But that won’t get to the fundamental problem plaguing mental-health services, which is that it’s buried at the bottom of the priority list for health spending even in the best of economic times.
Once upon a time, cancer treatment was poorly funded and misunderstood as well. But brilliant minds as far back as 1938 saw a way to address that problem, and the foundations of what would eventually become the B.C. Cancer Agency were put in place.
Its mandate and practices are everything that health care should be: Consistent and thorough; well-resourced; research-based; thoughtful. It’s a made-in-B.C. blueprint for doing things differently around mental health. So is the province’s new 10-year mental-health plan, if it’s able to become something more than just words on paper.