Let’s Talk: About the Wellness of Mental Health Systems

For “Let’s Talk” Day, January 31, 2018, the new Chairperson of the PEI Advisory Council on the Status of Women, Yvonne Deagle, invited outgoing Chairperson Mari Basiletti to share the following reflections on mental wellness that Mari developed through her work on the PEI Advisory Council on the Status of Women and her forty-year career as an occupational therapist in mental health.

Let’s Talk about Mental Wellness and Mental Health Services

January has been Mental Wellness Month on PEI, featuring messages in the media about battling SAD (Seasonal Affective Disorder), spending quality time with our families, and encouraging us all to speak up publicly about mental illness. The cold, dark month of January is an appropriate time to discuss mental wellness strategies for driving away the dark winter of our hearts. It is also a good time to talk about the wellness of our mental health system and services. So, let’s talk today.

Words to describe mental wellness, compiled by past chairpersons of the Advisory Council in 2017.

Positive Developments

During the last few years we have been hearing a lot about the state of mental health and addictions services on PEI. There have been stories from the public in the news about gaps in services, unmet needs, and long waiting lists for some mental health and addiction programs, especially for youth.

On the positive side, there have been a number of announcements from Health PEI about new initiatives and programs. Moving Forward Together, Prince Edward Island’s Mental Health and Addictions Strategy, covering the period from 2016 to 2026, was launched in 2016. The plan is a working document for future direction. It promises that: “All people in Prince Edward Island will have equal opportunity to achieve and maintain the best possible mental health and well-being throughout their lifetime.” This is an admirable goal and there are already a number of new initiatives and improvements to existing programs in the works.

Some recent mental health initiatives include:

  • Insight Program, a mental health day program for youth 13-18
  • Behavioural Support Team for children 4-12
  • Access to the Strongest Families program
  • Mental Health Walk-in Clinics
  • SMHRT – Seniors Mental Health Resource Team
  • In-School Student Well-being Teams

In addictions some new programs include:

  • CAST – Coping and Support Training for school age youth
  • Strength Program in-patient treatment for youth
  • CRAFT Groups for support of families with loved ones with addiction problems

Recent mental health initiatives include day programs and in-patient programs for youth, walk-in clinics so that people can receive a boost of counselling just when they need it, behavioural support teams for children, expanded seniors mental health teams, and student well-being teams rolling out in families of schools. New initiatives in addictions include coping and support training for school-aged youth, an inpatient program for youth, and support groups for families with loved ones with addiction problems.

Plans are being made to replace Hillsborough Hospital with a new campus that will include an adult day treatment program. Last week Health PEI announced new psychiatrists have successfully been recruited to PEI and this month also announced that more psychologists will be hired to assess children with learning difficulties, with the goal of reducing the waiting list for assessments from three years to one year or less. It will be important to analyze the data from new and pilot programs to ensure the enduring success of programs that make a positive impact on gaps in service and waiting lists.

Mental Health Walk-in Clinics, January 2018

CLICK to visit the website for this week’s hours 

Richmond Centre (for individuals 16 and older)
Telephone: (902) 368-4430
1 Rochford Street, CharlottetownMcGill Centre (for individuals 16 and older)
Telephone: (902) 368-4911
55 McGill Avenue, Charlottetown

Prince County Hospital
Telephone: (902) 888-8180
65 Roy Boates Avenue, Summerside

Lennox Island Health Centre (for Lennox Island residents only)
Telephone: (902) 831-2711
15 Eagle Feather Trail, Lennox Island

O’Leary Health Centre
Telephone:(902) 853-8670
14 MacKinnon Drive (adjacent to Community Hospital), O’Leary

Westisle High School (for students, age 16 and older at this school only)
39570 Western Road, Elmsdale

 

Mental Wellness and the Social Determinants of Health

The Mental Health Commission of Canada (MHCC) reports that one in five Canadians will experience mental health problems in any given year. Mental health problems affect more people than major physical disorders. One out of three workplace disability claims are due to mental illness, and 500,000 Canadians in any week are unable to work due to mental illness. Mental illness is responsible for great economic and social costs in our country.

Yet in Canadian provinces, the average provincial expenditure on mental health services is only about 7% of health care budgets. In Prince Edward Island it makes up 6.8% of the provincial health care budget. The Canadian Mental Health Association and other advocacy groups have been calling for an increase in mental health expenditures to at least 9% of the health budget.

Social and economic issues have a profound effect on our mental health and wellness. The social determinants of health, as recognized by the World Health Organization (WHO) include income, education, job security, early childhood development, food security, housing, social exclusion/inclusion, health services, aboriginal status, race, disability, and gender.

Many of the stories the PEI Advisory Council on the Status of Women hears about unmet needs and gaps in services come from women, who as caregivers often carry most of the burden of the concerns about the mental health issues affecting their children, other family members, or themselves.

The PEI Advisory Council on the Status of Women reviews provincial health services as part of its Equality Report Card. The 2015 Equality Report Card pointed out that the provincial wellness strategy fell short on addressing the social determinants of health. The 2015 Report Card also found that mental health and addictions services lack gender-sensitive and trauma-informed responses to women’s health needs. The Advisory Council is hopeful that the 2018 Equality Report Card will show progress on these issues in the past three years.

A workshop sketch: What does mental wellness look like? From a consultation with past Chairpersons of the Advisory Council in 2017.

In the meantime, many women and families in PEI are coping with numerous issues that appear on the list of social determinants of health, including employment challenges and working at jobs that do not pay a living wage. One-parent families headed by women often have to deal with poverty, food insecurity, and a lack of affordable housing. Indigenous women, women of colour, and women with disabilities are even more affected by negative social factors.

A study published in a recent edition of the Canadian Medical Association Journal found that if we wish to obtain a healthier Canada we need to spend more on income assistance, subsidized housing, early childhood education, and affordable childcare. It is clear that in addition to increasing the health budget for mental health services, increased funding and resources to address the social determinants of health will make a positive impact on the wellness of Islanders. Individuals and families will not be able to attain mental wellness if they can’t afford nutritious food, find decent housing, or deal with rising household costs.

The Importance of Community Mental Health

Community Mental Health
Souris
Souris Hospital
17 Knights Avenue
Souris, PE C0A 2B0
Telephone: (902) 687-7110
Fax: (902) 687-7119Montague
126 Douses Road
PO Box 3000
Montague, PE C0A 1R0
Telephone: (902) 838-0960
Fax: (902) 838-0961Charlottetown
McGill Community Mental Health
55 McGill Avenue
Charlottetown, PE C1A 7N8
Telephone: (902) 368-4911
Fax: (902) 368-6189

Richmond Centre
1 Rochford Street
Charlottetown, PE C1A 7N8
Telephone: (902) 368-4430

Summerside
Prince County Hospital
65 Roy Boates Avenue
Summerside, PE C1N 2A9
Telephone: (902) 888-8180
Fax: (902) 888-8173

Alberton
347 Church Street
Allan Shaw Building
Alberton, PE C0B 1B0
Telephone: (902) 853-8670
Fax: (902) 853-0420

O’Leary
O’Leary Health Centre
14 MacKinnon Drive
O’Leary, PE C0B 1V0
Telephone: (902) 853-8670
Fax: (902) 853-0420

In PEI, Community Mental Health services were established in each county in 1979 as an accessible mental health service that accepted self referrals, referrals from other community services, and referrals from physicians. Recently, women have sought advice from the PEI Advisory Council on the Status of Women after they have contacted Community Mental Health Services for an appointment and have been told that there is a long waiting list to see a mental health professional. They have also been told that if they want to get an expedited appointment they should obtain a referral from their doctor. Alternately, they can probably get an appointment sooner if they contact a private mental health professional for help, where there will be a fee for service.

These responses to requests for help point to the fact that we now have a three-tiered Community Mental Health system: Tier One with a long waiting list if you call Community Mental Health for an appointment without a doctor’s referral; Tier Two with a shorter waiting list if you have a doctor’s referral; and Tier Three with an even speedier appointment if you can afford to pay for private services. Many Islanders do not have a family doctor, and many individuals and families can’t afford to pay for private mental health services. Even if an individual does have a family physician, they may not wish to discuss personal problems, such as abuse, sexual assault, or family issues with their doctor, only to have to repeat it all over again to the mental health professional they are assigned to see. Doctors are already extremely busy. Is it the best use of their time to have to see a patient and make a referral to a service that does not require a doctor’s referral?

Mental health services are health services, and in Canada health services are a human right. We must adequately address the gaps and unequal access to mental health services, the need for more human and financial resources in mental health, and the impact of the social determinants of health on all citizens in our province. If we do not it will be impossible to reach the stated goal of the 2016 Mental Health and Addictions Strategy, Moving Forward Together, that “All people in Prince Edward Island will have equal opportunity to achieve and maintain the best possible mental health and well-being throughout their lifetime.”

With the improvements we’ve seen to fill service gaps and with promised investments in mental health services to come, Prince Edward Island is on a path towards improving mental heath services for all Islanders. Attention to gender-sensitive services and social determinants of health will only make systems better and more responsive – as more and more people accept the invitation to “Let’s talk” about mental wellness.

Mari Basiletti completed her term as Chairperson of the PEI Advisory Council on the Status of Women on January 22, 2018.

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