Mental health services still lacking

Barb
Barb Sweet
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Seven-year-old recommendations haven't all been implemented

Seven years after an inquiry report into failings in the mental health system, Eastern Health is still trying to get a mobile crisis unit up and running.

Mentally ill people are still being detained in lockups, and there's a lack of services in rural areas, according to briefing notes obtained by The Telegram.

Seven years after an inquiry report into failings in the mental health system, Eastern Health is still trying to get a mobile crisis unit up and running.

Mentally ill people are still being detained in lockups, and there's a lack of services in rural areas, according to briefing notes obtained by The Telegram.

The 2003 inquiry report dealt with the police shooting deaths of two mentally ill men - Norman Reid of Little Catalina and Darryl Power of Corner Brook.

The inquiries into their cases began separately, but they were eventually combined and overseen by Judge Donald Luther. Both shootings occurred nearly a decade ago.

Power, armed with two knives and a hammer, was shot and killed by the Royal Newfoundland Constabulary (RNC) Oct. 16, 2000. His death was deemed to be suicide-by-cop.

Reid, 43, armed with a hatchet, was killed in a standoff with the RCMP Aug. 26, 2000.

The 2003 inquiry report contained several recommendations, including:

That controls be placed on the detention of the mentally ill in lockups or holding cells.

That mobile health units for the mentally ill be established by regional health boards.

That home-care services be provided to mentally ill people.

Briefing notes prepared for incoming Health Minister Jerome Kennedy last fall - documents obtained by The Telegram through access to information laws - reveal gaps in services eerily similar to the problems outlined in the Reid/Power inquiry report.

The failings, as related to Kennedy, are:

That few specialized services exist outside the St. John's area.

There are too few supportive housing alternatives - as opposed to hospitalization - for people with major mental illness and addictions.

The mobile crisis response capacity is limited and lockups are still being used to detain people awaiting assessment under the Mental Health Act.

Home support services are not in place as a substitution for - or in order to avoid - the need for acute care.

Longer-term home support is only available on a limited basis.

There are not enough public awareness and education programs about mental health and addictions.

Reid was well known to police. He lived in a house in Little Catalina without electricity or running water and was in and out of the Waterford Hospital, often failing to take his medication.

In 2003, mental health experts suggested to The Telegram he might still be alive if a mental health worker had shown up at his door in August 2000, rather than the police.

But because of a lack of services, police have long been left to respond to mental health crises.

The mobile crisis response unit was seen as a way of addressing this problem.

According to Eastern Health - the largest health authority in the province, and now responsible for the Bonavista area - the mobile crisis response project ran into trouble with the recruitment of nurses. It is hoped a unit will be up and running by February or March, but it will operate only within 45 kilometres of St. John's.

As for using the St. John's lockup to detain mentally ill people, both Eastern Health and the Royal Newfoundland Constabulary say that since Eastern Health opened a short-stay psychiatric unit at the Waterford, use of the lockup for this purpose has become a "rare" occurrence.

Eastern Health said it could happen in an "exceptional circumstance" for reasons of safety or court process. Also, occasionally a person who has been brought to the lockup doesn't seem to have mental health issues until they are placed in the cells.

An on-call psychiatrist would be available in both such cases.

Western Health, which covers the Corner Brook area, doesn't have a mobile health crisis unit either.

Information was not available from the other two health authorities.

George Skinner, who became executive director of the Canadian Mental Health Association Newfoundland and Labrador Division three months ago, said services have gotten better since the Reid/Power inquiry report, but added after reviewing Kennedy's briefing notes, "The sad reality is there is still a long way to go."

He said the stigma surrounding mental illness and the expansive geography of the province both have a major impact on programs.

"There's no doubt that people in outlying areas and, even to some degree, in St. John's don't have the necessary supports to deal with their illness on discharge," Skinner said.

He said the wait times for psychologists and psychiatrists remains a big concern and people can't afford to wait six or nine months to see someone.

But Skinner is encouraged by the fact that there is now greater awareness of the gaps in the system, and because the federal government formed a mental health commission two years ago.

The provincial health minister seems committed to improving mental health and addictions services, as well, he said.

Skinner's organization has a new program starting in February that will send three caseworkers into Her Majesty's Penitentiary in St. John's to work with prisoners who have mental illness.

"It's a major step forward," Skinner said, adding it's among the first such services in the country.

Inmate participation will be voluntary.

bsweet@thetelegram.com

Organizations: The Telegram, RCMP, Waterford Hospital Canadian Mental Health Association Newfoundland and Labrador Division

Geographic location: Eastern Health, St. John's, Corner Brook Bonavista

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Recent comments

  • Peter
    July 02, 2010 - 13:20

    The old system could compel acute patients to take medication in the ER.

    Current situations have outpatients with a myiad of doctor prescribed medications (for other physical conditions), not to mention the hazards of self or prank medications.

    The ER has to establish ASAP potentially damaging, if not fatal, (physical AND psychological) drug interactions.

    MEDICAL observation Units in the ER (with Security Guards) are essential.

    The Act also has to have Constutional Boundaries for litigation and compensation for erroneous treatment. For example Mr. Reid could not afford lights (should be a Human Right, Churchill Falls or no Churchill Falls), yet it cost $$$$$$ for lawyers et. al. to find out why?

    Only the (alleged) patient should have the benefit of compensation not the apparent family who only sues after the fact.

    Finally, the Medical community, Doctors, nurses, etc. have to let go their monopoly on the mind. Trained therapists and counsellors, often do a great deal more - especially with prevention - and are much cheaper!

  • Peter
    July 01, 2010 - 20:03

    The old system could compel acute patients to take medication in the ER.

    Current situations have outpatients with a myiad of doctor prescribed medications (for other physical conditions), not to mention the hazards of self or prank medications.

    The ER has to establish ASAP potentially damaging, if not fatal, (physical AND psychological) drug interactions.

    MEDICAL observation Units in the ER (with Security Guards) are essential.

    The Act also has to have Constutional Boundaries for litigation and compensation for erroneous treatment. For example Mr. Reid could not afford lights (should be a Human Right, Churchill Falls or no Churchill Falls), yet it cost $$$$$$ for lawyers et. al. to find out why?

    Only the (alleged) patient should have the benefit of compensation not the apparent family who only sues after the fact.

    Finally, the Medical community, Doctors, nurses, etc. have to let go their monopoly on the mind. Trained therapists and counsellors, often do a great deal more - especially with prevention - and are much cheaper!