Nova Scotia

Government lacks plan to deliver mental health services for all, says AG

Nova Scotia's auditor general says the province doesn't have a completed plan for how to deliver mental health services to all Nova Scotians and says wait times standards are not being met.

About 1 in 5 Canadians will have a mental health issue in any given year, said Michael Pickup

Mental health services can differ, depending on where you live in Nova Scotia. (David Donnelly/CBC)

Fran Morrison says she tried to get her son into treatment when he suffered a mental health crisis seven years ago but he was "kicked to the curb."

"When you have a mental illness, it's not an overnight thing," she said. "You know, you don't go in to see a doctor and the doctor says, 'Do you have a plan to kill yourself?' and you say, 'No,' that the crisis over? That's not the way it works."

Morrison's son never got the help he needed when he visited the Dartmouth General, where a doctor marked his chart as urgent. Instead, at the age of 21, he took his own life.

It came to her as no surprise then that Nova Scotia's auditor general has concluded the province lacks a plan for delivering mental health services to all Nova Scotians, and that standards for wait times aren't being met.

"They talk about centralizing and standardizing everything, but that's not giving people the help they need," said Morrison, who is from Donkin, and has since become an advocate of comprehensive mental health care.

"They need client-centred health care, mental health care, where you go in [the] crisis centre, you get the help you need. You don't get a pill and sent home, which is what's happening now."

Wait times longer in some areas

In a report released Wednesday, Auditor General Michael Pickup outlined three key findings about mental health services in the province:

  • The government does not have a provincewide plan for how it intends to deliver mental health services, even though Pickup says it has been working on one since 2015.
  • Pickup said some areas of the province have longer wait times than others, and assessment methods can differ.
  • There is a lack of provincewide policies for crisis services, Pickup said. For instance, the Dartmouth General Hospital has no crisis response staff or psychiatry staff on site.

Speaking to reporters Wednesday, Pickup said he highlighted the situation at the Dartmouth General because it shows the variation in services, in particular at the fourth-largest hospital in the province.

"What we're saying is, in looking at the focus, looking at the service, the government should re-evaluate if that is actually the way they want to deliver service," he said. "The Dartmouth General staff themselves indicate a concern that the system of mental health at the hospital is not patient-focused."

In his report, Pickup also said the 2012 mental health plan unveiled by the then-governing NDP was "poorly managed."

1 in 5 affected by mental illness

About one in five Canadians will have a mental health issue in any given year, said Pickup. In Nova Scotia, the government spends about $225 million a year on mental health services.

"We did this audit so that Nova Scotians would know whether the government is delivering these services as it intends to do," said Pickup in a video posted on the AG's website.

Auditor General Michael Pickup says the province doesn't have a completed plan for how to deliver mental health services. (CBC)

Following the 2015 merger of nine health authorities, the Department of Health told the newly created Nova Scotia Health Authority to begin a planning project to solve problems in the health system, including mental health and addiction treatment.

The project was supposed to be completed March 16, 2016, but the health authority said that wasn't a realistic goal. The province told the AG that once the project is complete, it will address many of the concerns outlined in Wednesday's report.

The report also pointed out that the province is communicating mental health service information on the nine old health authorities' websites, two years after the merger. 

"The quality, layout and consistency of these websites varies significantly," said the report, pointing out that during the audit three websites were under construction and had few details other than where to access emergency help.

Pickup said his office has made nine recommendations, including that the province complete and implement a plan outlining how the government intends to provide mental health services to all Nova Scotians.

Pickup's report also said the government needs to clarify and report wait times standards for those waiting for treatment.

Pickup said the government has accepted and is "committed to take action" on all his recommendations.

Speaking to reporters in Cape Breton during a break in meetings, Dr. Linda Courey, the health authority's director of mental health and addiction services, said they are committed to equitable access regardless of where people live, but realistically it will take up to two years to reach that goal.

"There are inconsistencies in practices, in standards around many aspects around the provisions of mental health and addictions services. It is our commitment to ensure that we develop standards that are provincewide."

If you are in distress or considering suicide, there are places to turn for support, including your doctor or Nova Scotia's Mental Health Mobile Crisis Team at (902) 429-8167. The Canadian Association for Suicide Prevention also has information about where to find help.

With files from Michael Gorman and Peggy Macdonald