Vancouver Sun Op-Ed: Mental Health System Needs New Approach

By Jonathan Oldman, Executive Director, The Bloom Group
Published in The Vancouver Sun, October 9, 2013

The mayor has issued a call for urgent investments in Vancouver’s mental health services, citing Vancouver Police Department’s rise in mental health-related incidents and apprehensions.

For organizations with many decades of providing health services, housing, and social programs to individuals with mental illness and addictions, this trend does not come as a surprise.

We support the mayor’s and Vancouver Coastal Health’s call to the province for the provision of more longterm and crisis intervention services for the most seriously ill, particularly those also with addictions.

We also support both the mayor’s plan to establish a task force on mental health and addictions, announced last week at his Roundtable on Serious Mental Illness and Addiction in the city, and VCH’s ongoing work to rigorously and openly examine its entire spectrum of work in the Downtown Eastside.

However, these initiatives need to go further. It is essential to establish an ongoing process of comprehensive and transparent cross-sector coordination between all parts of the wider mental health system. Such large-scale social change requires a systemic approach that promotes collaboration between all system stakeholders and measurable progress toward shared objectives, as much as it requires new services.

Our current mental health system is made up of a wide spectrum of services and providers, overseen by a multitude of government departments, Crown agencies, municipalities, committees and working groups. The system includes many necessary dimensions: health care, housing and emergency shelter, welfare and benefits, law enforcement, youth and aboriginal services, and others. There is no shortage of plans, projects, studies and other initiatives, all flowing from the different entities.

While many individual services collaborate on a day-to-day basis, there is not enough coordinated overall planning, and no joint road map to success.

There is no set of data metrics that provides an overall report card on how the system is working, and crucially, how stakeholders can collectively apply learning to address the gaps, particularly given finite financial resources. In this environment, we try harder to meet the growing demands, but so often feel we are falling further behind.

The National Mental Health Commission of Canada, in its recent Mental Health Strategy for Canada, calls for an evolved approach in which we “establish a mechanism in every jurisdiction, with the full engagement of political leaders, to oversee development and implementation of governmentwide mental health policies, with links to a similar pan-Canadian mechanism.”

The good news – confirmed by the broad range of participants at the Mayor’s Roundtable – is the extent of the expertise and experience in our city. Vancouver already has the knowledge assets it needs to solve this complex challenge. And it’s worth remembering how much worse the situation would be without existing programs doing critical work to serve so many thousands of individuals.

We acknowledge the broader lack of access to effective treatment for many in the community. Additional services are clearly required (not to mention, protecting those programs already in place in this period of public sector fiscal pressure).

It’s time we match the innovation and best practice in service delivery, with innovation and best practice in system design and development.

A truly co-ordinated system that improves the continuity, effectiveness and quality of care should be a key legacy from the current debate. We hope it becomes a reality, for the sake of our city, and for all those living with mental illness and addictions.

Jonathan Oldman is executive director of The Bloom Group. He submitted this piece on behalf of Darrell Burnham, executive director of Coast Mental Health; Nancy Keough, executive director of The Kettle Friendship Society; David MacIntyre, executive director of the MPA Society; Karen O’Shannacery, executive director of the Lookout Emergency Aid Society; and Michael Anhorn, executive director, Canadian Mental Health Association, Vancouver /Burnaby Branch.