B.C. manifesto for better mental health calls for province to prioritize prevention and support in the community

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      The B.C. chapter of Canada’s largest mental-health advocacy group wants this province to do a major rethink of how it cares for people with a mental illness or addiction issue.

      Today (October 11), the Canadian Mental Health Association (CMHA) published what it’s calling a “manifesto for better mental health and addiction care in British Columbia”.

      The document, just two pages long, lays out a concise plan that above all else emphasizes a need for prevention and early intervention.

      “We currently pay for a system of care in the most expensive ways possible,” it reads. “People wait too long for care and too many people get their care from emergency departments and from police.”

      In a telephone interview, CMHA’s B.C. director of public policy, Jonny Morris, said that greater resources deployed to prevention and early intervention will result in a cascade of benefits throughout the mental-health-care system.

      “It's about scaling up, broadening access, and enhancing and strengthening early intervention so that we can divert people from finding themselves in crisis,” Morris told the Straight. “Without shoring up an emphasis on prevention and early intervention, we're not going to treat ourselves out of the complexity of the problem.”

      What exactly that looks like is the subject of conversations that should begin with the manifesto, he said. But possible examples include expanding anxiety-prevention programs in B.C. schools or a provincial-housing strategy that includes initiatives specifically for people with a mental-health challenge.

      “Recovery is better done closer to home,” Morris said. He emphasized the call for a rethink of mental-health services does not break from Canada’s long move away from long-term institutionalization.

      “Hospitals have a role,” he said. “But where healing and recovery take place is in the community. So what we are emphasizing here, is the need for a safety net in the community—keeping people employed, keeping people housed, keeping people connected to support in community—is critical for people's journey toward health.”

      The manifesto itself, unveiled today at a news conference at CMHA’s B.C. headquarters in downtown Vancouver, consists of a five-point plan.

      A renewed focus on prevention and early intervention is point number one and also a theme that runs through the document.

      “We must spend smart and invest wisely in effective community-based services and supports designed to prevent mental illness and intervene quickly with the early signs of mental health and addictions problems,” it reads. “We must work together to make sure people do not have to wait for months to receive a basic level of mental health and/or addictions help. People should be able to ‘ask once and get help fast.’”

      The manifesto’s second point calls for a buildup of addiction health care.

      At the press conference, Morris noted that 2016 will see a record number of overdose deaths in B.C.

      According to the B.C. Coroners Service, in 2015, there were 505 fatal overdoses in the province. During the first eight months of 2016, there were 488. Before 2015, the all-time high for illicit drug-overdose deaths in B.C. was set all the way back in 1998, when there were 400.

      The CMHA’s B.C. manifesto calls for a strengthening of recovery options that are “closer to home”. It also argues in favour of a provincial-housing strategy, describing a need to “ensure more people living with mental health and/or addictions problems have a safe place to call home”.

      The document goes on argue for the provincial government to improve how it responds to people experiencing a mental-health crisis, and for the province to take more of a leadership role via the development of a “province-wide plan for mental health and addictions”.

      Apprehensions the Vancouver Police Department makes under the B.C. Mental Health Act have increased dramatically in recent years.
      Travis Lupick / VPD

      The CMHA's plan for B.C. comes as the City of Vancouver and neighbouring districts such as Surrey struggle with a mental-health crisis.

      As previously reported by the Straight, the number of combined emergency mental-health visits recorded annually by Vancouver General Hospital and St. Paul’s Hospital was projected to surpass 10,000 before the end of 2015. That’s up from 6,520 in 2009. (In 2016, monitoring changed from a calendar year to a fiscal year, making comparisons difficult.)

      One indicator that the VPD uses to track its work in this area is the number of apprehensions it logs under the B.C. Mental Health Act. That legislation allows officers to take a person into custody if they are deemed to pose a threat to themselves or others, and outlines how officers should assist health-care workers with mental-health patients, when required.

      From 2010 to 2014, VPD apprehensions under the act increased between 10 and 33 percent each year, from 2,276 to 4,418.

      In 2015, VPD mental-health apprehensions levelled off when there were 4,713. This year, the VPD projects it will log 4,766 (based on data covering the first six months of 2016).

      Morris said that with the manifesto, the ultimate goal is to see mental-health and addictions issues receive the same level of attention and resources as physical sickness and injuries, again, with the goal of preventing the most serious cases from developing in the first place.

      “Equal terms,” he said. “And for us to really shore up this emphasis and focus on early intervention.”

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