The rhetoric from politicians on more support for our mental health-care system needs to stop. We need leaders to get together with the experts to build consensus around a vision for mental health in this province and then find a way to fund it immediately.
A friend recently had to endure some of the worst our system has to offer which unfortunately seems to be the norm. Her 18-year-old daughter presented as suicidal and was sent to Royal Jubilee Hospital. Several hours later, an apologetic locum psychiatrist explained that due to her age and the “relatively” minor nature of the symptoms she was presenting with, they could not refer her to a psychiatrist. They prescribed some new medication as the current medications were clearly not working and then discharged her back into the care of her family and family doctor.
Her family doctor refuses to refer her to a psychiatrist, telling her she doesn’t need a psychiatrist, she’s just being a “teenage girl.” In a society that was functioning the way it should, this family would shop for another doctor that would meet their needs. We all know that in British Columbia, particularly in Victoria, that’s not a reality.
Depression kills. According to the government’s own roadmap, B.C. has the country’s highest rate of hospitalization due to mental illness and substance use. Suicide has become the ninth leading cause of death in Canada. Do we entrust our family doctors to treat cancer? No. The doctor refers the patient to a medical professional who specializes in the disease. So why on earth would a family doctor be reluctant to refer a patient to a psychiatrist?
One reason that doctors won’t refer patients to a psychiatrist is because of a lack of psychiatrists. My friend was told the Victoria Mental Health Centre is not accepting new referrals unless they present with serious, multiple disorders because they don’t have the resources to meet demand.
Another reason she can’t get a referral to the amazing folks at the Victoria Mental Health Centre is because she is 18. There is a gap in coverage for people 17 and 18. They can’t be referred to youth psychiatric services because they are too old and Victoria Mental Health Centre only accepts referrals for patients over 19. She was told today that Foundry (a province-wide network) which accepts patients 12 to 24 will only accept referrals for people with serious mental disorders combined with substance abuse. So essentially, our health-care professionals are being told to perform triage, and major depressive disorder combined with wanting to die just doesn’t make the grade in British Columbia.
Patients with mental illness require access to specialized supports such as psychiatrists who manage medications, case managers who quarterback treatment, recovery coaches who facilitate a gradual return to society, counselors who help patients deal with trauma and other specialists who facilitate group therapies. How can we possibly expect individuals or parents to successfully manage serious mental illness without these critical supports?
We’re asking the impossible of families and we’re hamstringing family doctors. We need to stand up and demand better care for our loved ones and those who are alone in their struggles. Every death by suicide is preventable.