Left Speechless

A presentation made by Tom Shand, Executive Director of CMHA Alberta, at the Giving Voice: Advocacy and Mental Health forum held in Edmonton on November 9, 2009.

Good morning,

My name is Tom Shand. It is my pleasure to present to you today as Executive Director of the Alberta Division of the Canadian Mental Health Association and as Chair of the Alberta Alliance on Mental Illness and Mental Health.

In a few moments, I will speak to the role that these two organizations currently have in representing the interests of those living with mental illness in Alberta and the apparent voids that exist in that regard for the majority of those individuals.

In so doing, I am the first to recognize that I am a mental health novice relative to others you will hear from today and probably most of you who have come to gain insight from their respective wisdom and viewpoints.

That being said, I don’t think it takes a lifetime in the system to recognize the systematic and societal shortfalls that now exist relating to the unheard voices of many thousands of Albertans when it comes to concerns relating to their mental illness or that of family or friends. And there is an equal if not even greater void when it comes to speaking out for better mental health for those who do not have a diagnosed mental illness.

The mere fact that we don’t even know how many people in Alberta have experienced a mental illness in a given year should be a telltale sign that our health care system does not have a very good handle on this largely forgotten, long-standing pandemic.

To give you some idea of the scale of this issue, let’s use the commonly held estimate that one in 10 Canadians have a mental illness at any given time. In Alberta, that works out to about 350,000 people.

Of these, about 9,000 – or 2.5 per cent – are patients under the Mental Health Act, with their rights legislatively protected by the Mental Health Patient Advocate. I will not speak to advocacy for those individuals, as they will be well addressed in other presentations.

My remarks, and concerns, relate to the other 340,000 Albertans living with mental illness, and who speaks for them.

Who speaks for the person who discloses that he is being treated from depression and finds himself no longer eligible for promotion – or a soldier or police officer now stuck doing paperwork instead of being out in the field?

Who speaks for the family whose daughter needs therapy and can’t wait for their spot on the waiting list, nor do they have the funds for her to be treated privately?

Who speaks for the person in Grande Prairie who has to come to Edmonton for treatment at times when there are no psychiatrists there to help?

Who speaks for the person who loses his apartment because his illness has caused him to miss work that month and is too late with his rent?

Who speaks for the person whose personal health information has leaked out of the AHS system without her permission and is now being used against her?

Even in my small office at CMHA, I hear these types of complaints almost daily and have no ability or resources to help. And I know I am not the only call these individuals and/or their families have made in an effort to seek help. With each day, their frustrations grow. And with no help, their ability to cope with their illness, or to recover, diminishes.

Some will be heard because they will end up becoming eligible for support from the Advocate’s office as a result of having become a danger to themselves or others. Or, as per recent changes in the Mental Health Act, it can be demonstrated that their health is seriously deteriorating – or perhaps they presented themselves that way in their desperation to seek help. The cost to society is huge as these people become less productive and sometimes a burden. And the cost to their health and welfare is often beyond measure.

So who can help? In a perfect scenario, Alberta Health Services would work cooperatively with NGOs and across the spectrum of other departments and social agencies to provide much broader and comprehensive service as, and when, needed by these individuals. But resources are clearly not currently there, and never have been there, to properly address the needs of many of those people living with mental illness. Efforts are most often concentrated heavily on those few most severely ill who could pose a threat to themselves or others. Recovery for those with less severe symptoms seems a secondary consideration, especially when resources are tight.

And cross-ministerial programs are few and far between, although now beginning to emerge, as evidenced by homelessness initiatives and mental health diversion, which works cooperatively with the justice system.

Community organizations like CMHA do their best, with very limited funding, to provide support services, but come nowhere near meeting the demands for services such as supportive housing.

And the Alberta Alliance on Mental Illness and Mental Health, while constituted well – with 10 professional associations and community organizations to represent people with mental illness as a whole in fighting systemic or legislative issues – has no mandate or resources to assist individuals.

It is difficult enough for any person to fight for their rights or for needed services, but it is that much more difficult for many people living with mental illness, who have an uphill fight with the stigma surrounding their illness, the lack of resources dedicated to mental illness, the crossovers of their needs from one department to another, and often a lack of income or capacity to carry on any type of extended action, particularly one involving litigation.

So who can help those who fall through the cracks or are being treated unfairly?

There is no simple answer but it is clear that the present system is not working and a large number of people need help.

Addressing the need is a huge subject unto itself, and time is too short to go there right now, but I do have a couple of suggestions to help address the advocacy needs when people living with mental illness need to voice their individual concerns.

I would suggest that at a high level, there needs to be governmental action to set in place an empowered body, such as a Mental Health Council, that has the ability to cross departmental lines and address the needs of those living with mental illness, whether they be through the health care system, education, justice, housing, employment, social services or elsewhere.

I would further suggest that either the Patient Advocate’s office have its mandate and staffing expanded to go beyond those committed under the Mental Health Act, or establish another staffed office to do so.

And finally, more funding is needed of those organizations of the mentally ill to assist them in better speaking for themselves. Often there is now a call for a so-called consumer voice to sit on various committees but an inability to find people who could be effective in that role.

The solution lies with us. We must be vocal in raising the profile of mental illness and the need for improved mental health to a higher level, and we must be ensure that the hundreds of thousands of people living with mental illness in our province get the help they need and are able to be heard when their needs are not being met. It is the right thing to be doing to support those individuals with their recovery and also a wise investment for our province and our society.

Thank you for your attention to my remarks today, and I hope they left you with some food for thought.

I would also like to thank the organizers of this forum for putting this together and for giving me the privilege of presenting to you. This is a significant step forward, and I hope the start of a movement to a brighter day and a stronger voice for those living with mental illness in our province.