“This is a crisis”: Mental health and the 2015 Election

How the parties plan to address the province’s mental health and addiction crisis.

The grassroots organization at the heart of the province’s mental health movement says the parties vying to form government in Monday’s provincial election need to do better in their promises on mental health and addiction.

On Thursday the Community Coalition for Mental Health (CC4MH)—an alliance of community and labour groups, students, and individuals working to end stigma and raise awareness of mental health issues—released a policy document outlining key issues and perspectives they would like to see added to or elaborated on in the platforms and promises being put forth by politicians and parties.

“There is a lot more that can be done for mental health and addictions in Newfoundland and Labrador,” CC4MH Co-Chair Meaghan Barnhill told The Independent on Friday, explaining the organization’s Vote Mental Health campaign was launched to “encourage people to ask questions to their candidates and to vote for the one who has the best vision and action plan for mental health.”

Barnhill said “wait times are too long” in the province, and “people are suffering and not getting the help [they need] soon enough.”

She also said Newfoundland and Labrador’s health care system lacks preventative measures and is “behind the rest of the country in funding for mental health and addictions,” adding “stigma is still a barrier to services, especially when it comes to addictions.”

People with eating disorders also have “next to nothing in terms or treatment and support services here in the province [too], she said, “and that has to change.”

What they’re asking for

The CC4MH has identified five “pillars”, or top priorities in terms of mental health and addictions policy. Let’s have a look at them and see how the parties stack up in their election platforms:

1. A 25 percent annual increase in funding of community-based services until current spending levels are doubled.

“Community-based services and supports are essential components of a mental health care and addictions system, and must be enhanced. Enhancement of these services and programs with additional resources is needed,” the Vote Mental Health document reads. “Individuals need greater sources of information, referrals, access to services, and all in a timely fashion – in all regions of the province. Families, caregivers, peers, and advocates are also significant supports for persons with mental illnesses and mental health issues. Their participation must be acknowledged, respected, and valued by the health care system.”

Community Mental Health Services Election 2015Currently many of the community-based organizations on the front lines of the mental health crisis in N.L. are understaffed, under-resourced and underfunded, leaving them in a precarious state of affairs to deal with often life-or-death situations.

All three parties are promising to develop strategies to improve mental health and addictions services, but only the NDP have committed to “immediately increase the number of community mental health workers, focusing on communities that are currently the most underserved,” and to “ensure all mental health and addiction services are based on the recovery model and practised with a harm reduction approach.”

2. Creation of residential treatment beds in Newfoundland and Labrador that specialize in eating disorders.

“Eating Disorders is a growing crisis in Newfoundland and Labrador. With very few services available and the only access to residential treatment centres being out of province, action is needed,” the policy document reads. Until treatment beds for people with eating disorders are created in this province, “we are asking that government work to secure more beds in the Homewood Health facility in Ontario designated for Newfoundlanders and Labradorians.”

Eating Disorders Election 2015Only the Liberals addressed this in their platform. Specifically, they would “work in consultation with stakeholders to establish an adult inpatient unit for the treatment of eating disorders.” They have also committed to “establish regional adolescent health clinics” that, among other things, offer “counselling for physical and mental health in such areas as bullying, sexual orientation, eating disorders, and unhealthy relationships.”

As part of their “Healthy Living” plan, in their platform the PCs say they will “promote balanced food choices, and work with mental health professionals to ensure our healthy eating strategy is sensitive to those who suffer from eating disorders and body image issues.”

The NDP do not specifically mention eating disorders in their platform.

3. Replace the Waterford Hospital.

“The province needs a new centre for clinical, research, and educational excellence in mental health and addictions. Acute care services are key components of an effective mental health care and addictions system while the most effective services are often delivered in the community. However, there is also a need for quality services to be delivered through hospitals, both out-patient and inpatient.”

All parties agree the Waterford Hospital needs to be replaced, but when and how is a matter of contention. One of the most outspoken voices in the province on this matter is Mark Gruchy, former CC4MH Co-Chair, former President of the Canadian Mental Health Association N.L. and current NDP candidate for Cape St. Francis. Earlier this year Gruchy wrote a column for The Independent about the Waterford Hospital in which he called it “the symbolic embodiment of everything that has gone wrong with our society’s conceptualization of mental illness and mental health for generations.” He said it is “a spiritual blight on the soul of Newfoundland” and “is harming people with mental illness in this province.”

Waterford Hospital Election 2015Only the Liberals are promising to immediately build a new Waterford Hospital “without delay”, while the NDP say they will replace the existing one “once a comprehensive plan is devised, based on extensive consultation with all stakeholders and best practices, for modern mental health facilities that include an acute care mental health facility.”

The PCs have reneged on past promises to build a new mental health facility, and in a recent leaders’ debate Premier Paul Davis stressed that improving mental health care in the province is more than just “bricks and mortar”. He also said that in light of the province’s additional need for a new penitentiary in St. John’s and a new courthouse and hospital in Corner Brook, “we can’t afford to build all of these facilities under today’s revenues.”

Gruchy told The Independent last week that the bricks and mortar argument is a “red herring”.

“The actual replacement itself is going to be a subject of debate [but] we cannot get lost in this false argument about bricks and mortar versus services,” he said. “It needs to come down…and it has to be replaced with something modern and fit for human beings that doesn’t have rodents in it [and] that’s amenable to the recovery model.”

NDP spokesperson Jean Graham explained the party’s decision to delay its commitment to construct a new facility, saying it wants to consult with “patients, their families, health professionals and academic experts” about which specific services under the recovery model will be required in the building, and which can be moved out into the community. “We might find, after the consultation, that a better model would be a smaller St. John’s-based hospital for acute [mental health] care, and greatly expanded community-based services, which would incidentally allow people to access treatment closer to their own homes and support groups. This might not be the case, of course, but we will never know unless we [do the research].”

Graham said it would take under a year “to determine the best options for mental health treatment in the province and make firmer plans from there.”

A major point of contention is how to build the new facility.

The Liberals have said that they will look at financing its construction using public-private partnerships, a move that has come under fire from the NDP and others who say using private money to build a public building will cost taxpayers more money in the long run.

But Liberal health critic and Burgeo-La Poile incumbent Andrew Parsons says the need for the new facility is too great not to move on it right away.

“As a member of the all-party committee I didn’t go to one session where I didn’t hear on multiple occasions that the Waterford had to be replaced,” he recently told The Independent. “Whether you’re a person requiring services, a person giving services, a family member — we heard it on multiple occasions, talking to the physicians in the Waterford, talking to everybody all over the province. It was huge. So that’s one of the commitments we made, that the Waterford has to be replaced and we’ve laid out the steps of how we would do it and the timeline.”

The Liberal platform says the party will “plan and define the scope of work” in 2016 “so construction can begin in 2017.”

4. Enhance services for the incarcerated & replace Her Majesty’s Penitentiary. 

“There is a need to enhance the mental health care and addictions services available to persons who are incarcerated. Her Majesty’s Penitentiary is in need of replacement. Prisons need to deliver quality mental health and addictions services consistent with those available in the community. This could contribute to continuity of care for persons who are incarcerated and help prepare them for their return to the community.”

Incarcerated Mental Health Election 2015The Progressive Conservatives are the only party who directly address mental health services for the incarcerated, saying they will “develop mental health and addictions support and programming” for people residing in penitentiaries.

5. Improve services for people residing in publicly funded institutions.

People living in “long term care facilities or…foster homes need to have access to mental health services and programs. Since they are vulnerable it is critically important to identify their special circumstances and support their needs.”

Publicly Funded Institutions Mental Health Election 2015Again, the PCs are the only party to specifically mention developing mental health services for people living in long-term care homes and foster homes.

“This is a crisis … we need these services now”

The CC4MH was formed in 2014 after NDP MHA Gerry Rogers helped build a grassroots movement to bring the province’s mental health and addiction crisis to the fore, and to create sufficient political pressure so that the problem could no longer be ignored. Over the past year and a half the coalition has drawn significant support to the call for decision-makers to fix what many have called a “broken” mental health care system.

Gruchy was also instrumental in establishing the CC4MH, but has since left the organization and entered the political arena in an attempt to push for mental health justice from the inside. He says he joined the NDP because the party has repeatedly reached out to him over the past number of years “for purposes of forming their mental health strategy and how they go about dealing with mental health in the House [of Assembly].”

Gruchy says the health care system is in need of a major overhaul in terms of how mental health and addictions are not only addressed, but understood by decision-makers in the first place.

“My personal view is we need effective, autonomy-enhancing, dignity-respecting options, even the institutional ones, so that it becomes impossible for people to simply act on people as if they were objects,” he says.

“There is a need for institutional care, but it should be built to maximize autonomy as a central goal and value. It should be as light touch as possible and aimed at getting the person to a place where it is not needed at all as quickly as possible. Personally, I think concern that the application of control could cause damage should be constantly figuring into the process and therefore used very, very sparingly and with great circumspection and care. I am talking about ethics. This is an ethical issue, a moral issue.”

Gruchy also said he is aligned more closely with NDP values because the party advocates for social justice and lobbies hard for a social safety net strong enough to hold society’s most vulnerable people, including those living with mental illness and addiction.

“We all know that…the answers to these very complex social problems are not found in the bottom of a bottle of pills,” he said.

“When you have your first [mental health] problem the extent to which you get reintegrated in the world and get back on your feet is really significant with respect to the outcome to the prognosis. If you have somebody who keeps getting disrupted by something like bipolar disorder or schizophrenia, and they go through 20 years of this and are in an out of hospitals and are not getting help, not getting employment assistance and not getting housing assistance,” he continued, “and they don’t have inclusion, and they have all these things building up, what you’re going to see is that person is going to sustain a lot of damage and it gets harder and harder for them to function.

 This is a crisis and the CC4MH is calling for the parties to take a stand because Newfoundlanders and Labradorians cannot wait — we need these services now. — Meaghan Barnhill

“So the idea is to create a social state of affairs addressing issues like poverty, housing, root causes—all of this—where people don’t end up on a decline track, where people don’t end up starting to go downhill and then finding themselves down in a hole they can’t get out of, where they can’t get help, which is where a lot of people end up. They end up in inadequate housing with inadequate supports, cut off from society, by themselves,” he said.

“The idea is to maximize the number of people who don’t go down in that hole in the first place.”

An outcome of the CC4MH and the mental health movement was the formation of the all-party committee on mental health, due in large part to Rogers’ effort pushing for it in the legislature and generating support from the Liberals and eventually the PCs. The committee began its work earlier this year and conducted several community consultation sessions in late spring and early summer. It has developed a website to publish information it gathers, and to solicit feedback online.

In their platforms the Liberals and NDP have both promised to let the committee continue its work and to use its findings to inform the parties’ mental health and addictions strategies.

Barnhill said the CC4MH is non-partisan and will not be endorsing any political party. The focus, she said, is on what all parties will do to fix the health care system in terms of programs, services and infrastructure, so that people living with mental illness and addiction can finally get adequate support.

“All three [parties] have spoken on mental health,” she said. “We have arrived at a place where enough studies and information have been gathered that the coalition feels that whichever party forms government, we will accept no less than rapid action on the issue of mental health and addictions.

“The result of government not doing anything can vary from job loss, addictions, loss of supports, homelessness and in some cases, death/suicide,” she said. “This is a crisis and the CC4MH is calling for the parties to take a stand because Newfoundlanders and Labradorians cannot wait — we need these services now.”

Editor’s note: This article originally featured a black and white image of a person holding their face underwater and screaming; it was chosen to help convey the urgency of the province’s mental health crisis. However, a reader wrote to us to explain it can be interpreted as a “negative portrayal of people with mental illness,” and could further stigmatize people living with mental illness and addiction. Thank you, reader, for the important message. We agree and have gladly changed the story’s feature image. 

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