Our mental health system completely failed Erin O'neil
Treatment of severe illness requires dedicated funding, Mike Theilmann writes.
The tragic suicide last month of Ottawa social activist Erin O'neil is an indictment of Canada's current system for treating and helping individuals with severe mental illness.
Here in Ontario, the root of the problem goes back years to when the provincial government of the day closed down psychiatric institutions that provided dedicated care and treatment for such individuals. The mantra at the time was “care in the community,” supported by cost savings achieved by the closures.
But, as happens all too often with government promises, the money went elsewhere and treatment for the severely mentally ill suffered as a consequence.
The problem has grown more acute in recent years, partly as a result of the confusion in the public mind between mental health and severe mental illnesses. In the public mind, the two are lumped in one basket but are, in fact, very different. Mental health is more akin to physical health and can include conditions such as depression and anxiety disorders. They are serious but more amenable to treatment and therapy. Severe mental illnesses, however, such as bipolar disorder and schizophrenia, are the result of a complex interplay of genetic, biological and other factors. They are harder to address and require dedicated funding, treatment and support programs.
Ironically, campaigns to remove the stigma attached to mental health generally have had a negative impact on people suffering from severe mental illnesses. The success of these campaigns has meant more people are coming forward to seek help. This was compounded during the pandemic when there was a surge in the number of people, particularly young people, suffering from depression and anxiety.
"Hospital stays are curtailed to the point where they simply become a revolving door for repeat visits. Outpatient psychiatric care is overstretched and minimal.
A third factor is the opioid crisis. Treatment for addiction has been folded into the budget envelope available for mental health. The end result is that more and more budget dollars are going to programs targeting mental health and addictions and not to severe mental illnesses.
There was a glimmer of hope during the
2021 federal election when the Liberals made a campaign pledge to provide a Canada Mental Health Transfer of $4.1 billion to the provinces and territories over five years. Sadly, postelection, the pledge appears to have been abandoned and instead increased funding has been rolled into the overall health transfer payments to the provinces and territories.
The end result is no dedicated funding for the treatment and care of people suffering from severe mental illnesses, and what increased funding there is remains largely focused on mental health disorders such as anxiety, depression and addictions.
Another glaring omission is provincial privacy law. Right now, it is next to impossible for caregivers, often the main support for people with serious mental illnesses, to receive any information regarding their loved one's treatment. Their right to doctor-patient confidentiality trumps all other rights — even when it is obvious the loved one is not capable of making a rational decision about their care and well-being.
We are now in the situation where services for people with severe mental illnesses are grossly inadequate. Hospital stays are curtailed to the point where they simply become a revolving door for repeat visits. Outpatient psychiatric care is overstretched and minimal. There are not enough psychiatrists to provide ongoing treatment and clinical monitoring. Disability benefits fall far short of what is needed. Caregivers are shut out of the treatment cycle. And there are almost no long-term care residences for people with severe and psychotic mental illnesses.
This appalling state of affairs will continue until both the federal and provincial governments provide dedicated funding and treatment and support programs for those suffering from severe mental illnesses, and change privacy law.
Until they do so, they will continue to fail people like Erin O'neil and their families.