More money, earlier intervention, better institutions called for in mental health report

A report on mental health and addictions that was two years in the making was finally released to the Newfoundland and Labrador public Friday.

The report, called Towards Recovery: A Vision for a Renewed Mental Health Addictions System for Newfoundland and Labrador, was compiled by an all-party committee. It includes 54 recommendations that the committee determined could improve mental health and addictions services across the province.

It recommends increasing spending from 5.7 per cent of the health-care budget to nine per cent over five years, something the Minister of Health, John Haggie, said could be achieved by juggling priorities.

Other suggestions include replacing the Waterford Hospital and Her Majesty's Penitentiary.

Over the last two years, the committee heard from people suffering from mental health issues, as well as their families, health authorities, health care providers and the public. A special focus was put on the experiences of young people ages 16-25 as they moved from the child mental health system to adult services.

Here is a look at some of the recommendations, which are placed under five common themes:

Access to services

Some of the more concrete recommendations have to do with timely access to health and addictions services, which the committee says has been a longstanding problem.

Wait times, access to technology and integrating mental health services into existing health systems are also highlighted.

The report recommends replacing the Waterford Hospital, the aging mental health facility in St. John's, but it suggests that new models of mental health services should be taken into consideration during the planning.

"While it is recognized that some type of infrastructure and in-patient services are needed, having them all located in one psychiatric hospital is not the answer," the report reads.

"The Provincial Government must investigate options for replacing the existing hospital with in-patient services as well as more services provided in community and closer to home."

When it comes to those in correctional facilities who need help, the report states that Her Majesty's Penitentiary in St. John's needs to be replaced.

"The physical state of Her Majesty's Penitentiary is negatively impacting the mental health of inmates and staff," it reads. "Therefore, government must prioritize the completion of a new facility."

Quality of care

The authors of the report wrote that many of those interviewed expressed frustrations at the process of seeking help, often feeling like they were being passed from one provider to another.

One suggestion is to increase the number of doctors and nurse practitioners involved in addictions medicine by creating a clinical program director of addictions medicine in the family practice program.

The well-being of staff and avoiding burnout is also highlighted, along with the need for proper training and mentoring for those working in mental health and addictions.

Policy and programming

The committee heard about challenges faced by Indigenous people, seniors, women, gays, transgendered and other groups.

With regards to Indigenous peoples, the report recommends ensuring psychiatrists provide regular visits to Labrador coastal communities, establishing four to six dedicated mental health beds in Labrador and recruiting two permanent full-time psychiatrists for the Labrador region.

The committee also suggests that a 3.3 per cent  increase in spending to nine per cent of the total health care budget in the next five years would put the province more in line with the national average.

Promotion, prevention and early intervention

This part of the report focuses on stopping the development and progression of mental health issues — by supporting parents and schools when it comes to counselling youth. 

Some of the recommendations centre on removing the stigma around mental health and addictions, addressing poor housing and utilizing new technology so people can access services in their own homes.

Community supports

The final theme of the report centres on how regional health authorities can work with non-governmental wellness programs and groups like U-Turn, which provides help to those battling drug and alcohol addiction.

Recommendations centre on getting community agencies to work with health authorities on strengthening existing partnerships, as well as getting the two to share non-confidential information and work together on the evolving needs of people who use their services.

All-party consensus

Minister of Health and Community Services John Haggie said he was pleased to see members of three different political parties come together to make the report happen.

"It actually wasn't as challenging as it could have been," he said. "I think there was very little difficulty reaching consensus on the problems, and really minimal difficulty on reaching consensus on the solutions."

Haggie said in order for certain points to be implemented it's going to take more money. However, he thinks funds can be moved around so that existing finances can be used.

"We will need to slice the healthcare pie differently and we need to do that in a way that will increase funding for mental health and addictions as a proportion of total health spending."

New Democrat MHA Gerry Rogers is hopeful those new expenditures will be reflected in the April 6 provincial budget.

"The minister of finance and the premier know about the work that has been going on through the committee," she said. "So there has to be some response in this particular budget to the recommendations in the report. They have to."

Breadth of the report

After the report was released, Stella's Circle CEO Lisa Browne said she was pleased to see how far-reaching the report was, instead of just having a narrow focus on the healthcare system.

"I really like the breadth of the recommendations," she said. "It's more than just health, it touches on a number of things; Housing, corrections, the criminal justice system and schools — so I think that integration is really critical."

Dr. Janine Hubbard, president of the province's psychology association, said she was happy to see a focus on children and youth.

"We've known for years that 50 per cent of mental health issues emerge prior to the age of 14, so [we're] really encouraged by the idea of emphasis on early identification, early treatment."​

Executive Director of Choices for Youth Sheldon Pollett said he was pleased by the emphasis on increasing rapid access to services.

"One of the things we know about those challenges is the sooner you can respond in an appropriate, healthy proactive way, the more likely they're going to get their needs met," he said. "Which will reduce further trauma and further consequences of these unmet needs."

The full report can be viewed below: