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OPINION | Not-for-profits shouldn't be counted on to provide essential services

Lori Fox says the ongoing troubles at Many Rivers counselling shows that Yukon's model for delivering mental health care — an essential service — is broken.

Lori Fox says the ongoing troubles at Many Rivers counselling shows Yukon's model is broken

Many Rivers Counselling and Support Services provided mental health and counselling services in Yukon for 50 years, until its staff went on strike in November 2018. The strike is over, but the future of the not-for-profit is still uncertain. (Paul Tukker/CBC)

There are Yukoners who need mental health services and aren't getting them.

These people are not strangers, but neighbours you see every day; they stand in line behind you at the grocery store or drink coffee next to you at the café. Many haven't had access to free community mental health care in months.

This represents the failure of a model that sees government rely on not-for-profits as primary providers for essential services — such as those once provided by Many Rivers Counselling and Support Services.

Many Rivers provided mental health and counselling services to the territory for 50 years, until its staff went on strike in November 2018. A deal was reached in late January, but workers were handed pink slips only days after returning to work, as the organization was found non-compliant with the Societies Act and had its government funding pulled. It's still not clear when Many Rivers might resume services.  

It's still not clear when Many Rivers might resume services.   (Jane Sponagle/CBC)

When asked how many mental health care and counseling spaces were currently available to Yukoners, Clarissa Wall, a spokesperson for Yukon's Department of Health and Social Services, told CBC that the government doesn't "have a defined number of spaces available for mental wellness supports" and adjusts "programming as needed."

The Yukon division of the Canadian Mental Health Association has been contracted to provide counselling services and the government's Mental Wellness and Substance Abuse Services has increased its drop-in counselling availability while Many Rivers sorts itself out, Wall said.

However, given that the government apparently doesn't have solid numbers on what the demand is — and also that wait times for regular counselling at Many Rivers were, according to its website, three to four weeks when the organization was running normally – it seems unlikely these stop-gap measures are meeting the need for what is a very personal, private form of care.

Many Rivers has been publicly funded to the tune of $2 million a year. According to Wall, the last quarterly government payment was made to Many Rivers just before the strike began last fall.

So what happened to that money? Many Rivers has not filed a financial report since 2017 and that information is not public at this time; even if it was, the details would be general, and specifics are not accessible under the Access to Information and Privacy Protection Act (ATIPP).

What is certain is that taxpayers weren't getting the services they paid for in late 2018.

Minister of Community Services John Streicker said in the Yukon Legislature last month that it would be inappropriate for the government to have interfered in either the strike or the investigation into Many Rivers' compliance with the Societies Act. It is not the government's "role" to "provide certainty" for Many Rivers or any other not-for-profit, he said.

Yukon's Minister of Community Services John Streicker said it would be inappropriate for the government to have interfered in either the strike or the investigation into Many Rivers' compliance with the Societies Act. (CBC)

This is true, but it was the government that entrusted Many Rivers with these duties. Regardless of whose "role" it is, some Yukoners who need care are not getting care, and that falls squarely in the government's wheelhouse.

This is not about how not-for-profits should be handled. The issue is that an essential service was entrusted to an organization dependent on public cash but without the same standards of oversight or transparency as a government entity, where financial details would be a matter of public record and accessible through ATIPP.

Moreover, the fact that Many Rivers provided these vital community services while remaining outside the realm of government interference was part of the problem in the first place.

The way we look at mental health care further compounds these issues.

A 2017 study by the Mental Health Commission of Canada found that although "counselling, psychotherapy and psychological services are effective, and better access to them would help improve the lives of hundreds of thousands of people," but there is "significant unmet need" for this kind of care.

Moreover, Many Rivers provided free services, and that's important. A 2015 Australian study found that the best mental health-care professionals were accessed three times as often in wealthy areas than they were in poor areas, despite the fact that research shows higher rates of mental illness among the impoverished.

A five-month interruption in physical health care services would be met with a different response. Our hospitals are government-funded but subject to much tighter scrutiny and standards than Many Rivers; both are supposed to deliver health services on which people's lives may depend.

Many Rivers has been around for 50 years, and the way we think about mental health has changed dramatically in that time — homosexuality was still considered a mental illness in the DSM when Many Rivers was founded.

Maybe it's time to update the model for — and the importance we place on — mental health-care services in the community, which is something the government is definitely responsible for.  

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

About the Author

Lori Fox is a writer and journalist whose work has also appeared in Yukon News, Vice, and The Guardian. When they aren't writing, they can usually be found fishing, gathering wild mushrooms, or chilling with a book and their pitbull, Herman.

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