Inaction on rural mental health can prove costly

Mental health is not a destination, it’s a process. And the process could be smoothed considerably if the province offered appropriate treatment in a timely manner.

Compared to other branches of the health-care system, Manitobans with mental illness face considerable challenges: public stigma, an often complex framework of supports for mental-health care and a shortage of mental-health specialists.

There are other barriers, as well. Some treatments, such as psychiatric care, are covered by Manitoba Health. Others, such as sessions with a psychologist or an occupational therapist, are not.

The toll imposed on Manitobans by common mental illnesses — such as depression, anxiety and other severely limiting conditions — is heavy. That can include an inability to seek help or attempts to self-medicate through drugs or alcohol.

Mental illness affects Manitobans in all walks of life, in some cases magnifying the effects of unemployment and poverty. It can be difficult for family and friends to know how to help or advocate for their loved one to get support. And once patients have been referred to a mental-health professional and/or received a diagnosis, the wait times for getting treatment can mean the condition worsens before the person gets treatment.

Manitoba isn’t alone. A report issued by Children’s Mental Health Ontario found that youth in that province are waiting more than a year for services. The report added that the toll on their caregivers could mean a loss of more than $400 million to Ontario’s economy, thanks to loss of work and absenteeism.

According to a 2016 estimate by the Conference Board of Canada, the economic effect of depression alone on the country’s economy was $32 billion.

Solutions to mental-health problems aren’t a question of simply having more money for the services — though that certainly helps. Not everyone has additional insurance for mental-health services not covered by Manitoba Health.

And while a national pharmacare program would improve access to medication for those with anxiety disorders, ADHD or depression, these medication treatments are best conducted with long-term medical and therapeutic support and followup.

In March 2018, Virgo Planning and Evaluation Consultants in Toronto issued a report entitled “Improving Access and coordination of Mental Health and Addiction Services: A Provincial Strategy for all Manitobans.”?That report identified several concerns related to mental health for people across the province.

Respondents to Virgo researchers reported concerns related to individuals needing to travel outside of their communities to access services, “particularly in rural, remote and northern communities, as well as on reserves.” Several respondents also identified concerns with mental-health services being centralized in major urban centres, particularly Winnipeg and Brandon.

The report also noted there are not enough qualified clinicians to meet all the needs of those with mental-health issues in our province and that recruitment and retention of mental-health professionals were most challenging in — again — rural and remote regions.

“A significant number of positions were noted as unfilled for a considerable length of time, a factor said to influence both access (e.g. wait times) and coordination (e.g., helping clients transition),” the report read.

Manitoba, however, is taking steps in the right direction.

The average wait time to see a psychiatrist in Manitoba is six to nine months; the Manitoba government promised earlier this year to increase the number of psychiatrists practising in the province. (As of 2017, there were 179 psychiatrists practising in Manitoba.)

A residency program in Brandon is one way it hopes to do that, even as the number of psychiatrists graduating from the University of Manitoba increased from 21 in 2013-16 to 37 in the past three years.

More recently, Families Minister Heather Stefanson announced $8.7 million in new funding for mental health and addiction-related initiatives, partly to help sexually exploited youth. These initiatives should help identify and address mental-health needs for many who are getting no care at all, and could well save lives. Unfortunately, much of this funding has been earmarked for Winnipeg services.

The province is to be commended for initiatives that target gaps in the mental health-care system, but more is needed, particularly outside of Winnipeg.

Mental illness is not a choice, but recovery is. People who choose to recover should find Manitoba offers hope through services that are adequate and prompt — and for rural and northern Manitobans, available beyond the Winnipeg Perimeter.

Winnipeg Free Press & The Brandon Sun