Vancouver Coastal Health expands help navigating mental-health services, cuts long-time advocates

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      The city’s largest provider of addiction and mental-health services is introducing a shift in the way it helps people access systems often criticized as prohibitively confusing.

      “These will be peer-navigator positions,” said Andrew MacFarlane, director of mental health and addiction for Vancouver Coastal Health (VCH). “The major outcome is going to be around health-care access, minimizing the barriers for clients to access health care.”

      In a telephone interview, MacFarlane said primary benefits of the change from “advocates” to “navigators” include an expansion of services to more locations and a focus on youth.

      “I’m really excited about this program and I see a real growth opportunity,” he told the Straight.

      According to a February 1 internal memo, VCH has issued a contract to the Canadian Mental Health Association’s (CMHA) Vancouver/Burnaby branch which, beginning in April 2015, will see it offer services covering health benefits, access to health care and community support systems, income security, and residential tenancy.

      “CMHA-VB’s new Peer Navigation Program is a client-centred and recovery-oriented model that will improve the quality of life and progress in recovery of clients,” the memo reads. “It is expected the new model will provide greater access to a wider range of clients, including youth and young adults and those with substance use and addiction across the Vancouver Community of Care.”

      The navigator program’s launch comes at the expense of existing advocacy services that people in Vancouver have relied on for decades.

      It means Kettle Friendship Society (at Commercial Drive and Venables Street) and MPA Society (at West 7th Avenue and Fir Street) will no longer be performing advocacy work. Kettle has had to eliminate two full-time positions and MPA has let six employees go.

      The cuts at Kettle will happen on March 31 and affect services offered for nearly 30 years. Executive director Nancy Keough told the Straight that means there’s a potential impact on some 1,500 people who in 2014 made more than 7,000 visits.

      “My office is next door to the advocacy office and there are lineups every morning,” she said. “We’ve helped people with concurrent disorders, like addictions, brain injuries, and physical disabilities, liaise with various government bodies and other service providers to help access housing, financial support, applying for disability benefits, and a whole slew of things—whatever people come in the door with.”

      Keough said she’s now waiting to see what CMHA’s navigators offer. “We have a lot of concern,” she added.

      MPA Society advocacy services were discontinued on January 13. Executive director David MacIntyre told the Straight he’s also disappointed. But he described CMHA as a “strong service provider” and cautioned against criticizing a new program still taking shape.

      “This is a new direction away from advocacy as we have known it,” MacIntyre explained. “But we, at this point, are not really aware of what the new service is going to look like. So I can’t say what is going to be missed.

      “Hopefully they will be releasing information on what the program will be so we can have a better understanding of the impact of VCH’s decision,” he added.

      MacFarlane emphasized the benefits of recruiting navigators who have in the past struggled with a mental health or addiction issue of their own.

      “We received feedback from the community around opportunities for peers, we looked at how our peers are involved, and now these are designated peer positions to help support other mental-health and addiction consumers access health services,” he said.

      MacFarlane gave assurances people relying on Kettle and MPA advocacy services will not be left without support.

      “The focus for the MPA and Kettle was on income security, residential tenancy, and housing,” he said. “We wanted a broader scope for the work of these peer navigators.”

      The change within VCH coincides with a February 4 announcement where the province unveiled two new initiatives B.C.’s health minister said will improve access to youth mental-health and substance-use services.

      The first is a map that lists approximately 350 facility locations alongside contact information and brief descriptions of services are offered. The second is an expansion of a new intake process.

      On January 7, the Straight published an in-depth report on the challenges and wait-times faced by Vancouver residents trying to gain access to mental-health services. That article included a number of statistics obtained from VCH and B.C. Housing revealing the extent to which those agencies are overwhelmed.

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      Feb 6, 2015 at 3:39pm

      I worked at the Kettle as an advocate for years. When I worked there, the program was staffed by self-disclosed consumers and survivors of mental health services. It was a very fine paraprofessional crew with some of the best advocates in town.

      I view with some cynicism that the new positions, also filled by consumers/survivors, are deemed "peer" positions. Generally, "peer" is shorthand for less respect, less autonomy, and lower wages (often stipends). We used to call it the "peer support ghetto." I would love to think that this program change is different, but I doubt it.

      Rosemary Collins

      Feb 6, 2015 at 5:09pm

      So Vancouver has just lost 6 mental health advocates. Advocacy funding has been declining steadily over the past few years due to provincial and federal funding cuts. Now Coastal Health is also cutting funding to this vital service that vulnerable and marginalized people rely on to cope with increasingly complicated (and often inaccessible) health, social and economic support systems. Cuts to advocacy services means that those remaining advocates, whose caseloads are already overwhelming, will now be swamped with new clients seeking the advocacy support they once received from The MPA Society and The Kettle. System navigation services are an excellent complement to advocacy, but they cannot replace it. Coastal Health is doing people who live with mental illness a grave disserve and we will all pay the price, one way or another, as clients fall through the cracks and their health and personal circumstances deteriorate. It is a sad day for our health region and for people who live with mental illness.


      Feb 8, 2015 at 8:52pm

      Make no mistake. These cuts to advocacy services are going to undermine the ability and capacity of individuals with mental health issues to access the services they require. This decision is also going to undermine the integrity of Vancouver Coastal Health's mental health services. This is going to have disastrous and tragic results for so many. One can't help but note that by making services harder to access, it is going to make it easier to drop caseloads and cull staff from within. This is likely also one of the agendas.

      While CMHA BC does provide some services, it does not do any systemic, or advocacy work. It provides no services to children and youth whatsoever. Replacing paid, experienced workers with volunteers is abhorrent and bad public policy.

      Here is what CMHA-BC does now:

      This is their child & youth page. Notice that it is empty.

      Annette Murray

      Feb 10, 2015 at 10:08am

      Unfortunately this article fails to point out the crucial difference between system navigation and advocacy.

      The role of system navigators is to help people connect with the system. Unlike advocates, they cannot assist with advice and help in dealing with government laws and regulations when these bar just claims.

      Emily Williams

      Feb 13, 2015 at 5:30am

      CMHA does not do advocacy, they are a federal body. Peer to peer support is integral for the health and well being of consumers and new patients in the system. This move is a massive mistake and will just make more sensitive consumers wary of seeking help from others and takes away the humanity of that care for them, they need full support with any human basics, housing, food, clothing, hygene, social interaction, expression, and community. I have been advocate, patient, and carer. This was my life, for those who cannot speak I will. This is again undermining the people who are actually offering positive care and attention to our most vulnerable. I am very disheartened to read this today.