Waitlisted: The unacceptable standard of mental health care in Canada

While aimlessly scrolling through my Twitter newsfeed at 3:15 in the morning, I saw a story which triggered my "ranting phase", so this will be an "opinion" piece, which I seem to do many of actually.  

The article, entitled "Teen waiting over 18 months for psychiatry appointment", published by CBC Saskatchewan, this in-depth article immediately struck a chord with me. Mainly because I have found myself to be in a similar position two years ago. As I continued to scroll through the article, I found myself becoming more enraged, simply at the fact that the health care system was clearly neglecting the needs of a 15-year old girl, who is in need of mental health counselling. Just like the same was done to me at the time.

An infographic outlining the inefficiency of the Canadian [mental]health care system. To me, these statistics appear to be grossly inflated.

This is an unacceptable standard of mental health care. I can feel this young girl's pain, as I was her. When I was 17, I was admitted to CHEO for suicidal ideations and extreme depression. While I was there they diagnosed me with Major Depressive Disorder (MDD), Social/Generalized Anxiety Disorder, Panic Disorder and OCD (which I had suffered from since I was about 11 years old). 

I spent approximately 2 months and once I was finally released they put me on a waiting list for a team of mental heath professionals at the Royal Ottawa (because I was almost 18, which seemed to be quite a big issue with them in terms of treatment options).

I started school again and continued to wait, and wait. 

Graduation came along, and so did more waiting. 

September, university, a huge transition in one's young life then crept up on me, and yet I still eagerly waited for that phone call. 

Then around November/December, my depression got worse and I slowly felt myself falling back down the rabbit hole again. The isolation, the overwhelming sadness, the thoughts of dying. Everything was crumbing around me and I had no one to help me (except for my parents who were over 4 hours away). During that time I went through a lot, my anxiety spiked due to the new changes and people, a relationship (which didn't go over so well; lying, abuse, staking, ect...), grades dropping like bombs in the sky. I informed the doctor I was seeing at the time about my depression and suicidal/self harm ideations, and they referred me to their psychiatrist. This didn't prove to be any better. All they did was put me on new medications, which made me feel even worse (without even consulting with my family physician about my medical history) and later told me that they had a five visit policy, meaning that you could only receive five hours of counselling throughout the school year. I ended up seeking the help of the crisis counsellor at the university, however all they did was tell me to call the crisis hotline. Now, for someone with severe anxiety issues, talking on the phone is a huge trigger (at least for myself, I cannot speak for others.) It makes the feelings even worse, so at that point it's better off suffering in silence.

In March I had to move back home (and drop out of university) due to health issues and because my family and friends became extremely worried about me due to the fact that I cut off communication and had not been heard from in months (to the point where they were making public pleas for me to come home). At that moment, we all realized that something needed to be done (for good). 

During that time, I was seeing a psychologist with the clinic I went to. However, they abruptly informed me seconds after walking out of a session that I was no longer eligible to receive treatment, due to the fact that my family doctor transferred clinics. At that point my doctor took the initiative to make the call to inform them that I was in crisis again. 

16 months it took to finally receive that phone call. Too long in my opinion. No one should have to wait that long for mental health care. Megan and myself are only a fraction of people suffering through the same ordeal. The rise in suicide rates across Canada just confirms this. 

Mental health is an extremely important issue, just as important as one's own physical health. More important than the millions of dollars the government spends on tearing up and rebuilding (nearly) perfectly functional streets, cutting thousands of public sector jobs and building environmentally harmful pipelines (big priorities indeed.)

Now I don't consider myself a political person, in fact I don't even follow politics, but when it comes to issues like these, it even ruffles my feathers. Even an average citizen like myself can see how wrong this is. 18 months, how long this young girl has suffered with mental health issues. You wouldn't make a patient suffering from a stroke wait that long, or a heart transplant patient wait for a functioning organ essential to sustain their's and human life (oh wait, yes we would...) There's the Canadian health care system for you ladies and gentlemen! It's free, but only if you live long enough to see a doctor...

One of my inspirations for wanting to become a psychologist is because of this very issue. I have lived it and have been a member of this corrupted system. I want to do something to fix this unacceptable standard of health care, especially relating to mental health. By adding one more registered psychologist to a team, it can help dozens of patients in need. Think about that for a minute. Now, if only the federal (and provincial) governments would have this same realization and think about making changes to the system. 

Now, this article focuses specifically on Saskatchewan's issue with wait listing, however I see the same problem in Ontario. In fact, this problem is most likely occurring across the nation. In fact, I know it is. 

People become so desperate or so ill that they get to the point where they lose control. They represent it in many ways, but the most common seems to be suicide (a solemn and pointless act, when putting it into perspective, considering our claim of having "one of the best health care systems in the world") 

Others take it out externally, on the public. Now I make it extremely clear, I am not one of those people who believe that mentally ill individuals are responsible for crimes. The Greyhound bus decapitation and most recently, the Moncton shootings were cases in which the accused called upon "the defence of mental disorder", therefore deeming them "not criminally responsible (NCR)" for their crimes. Now, these are clearly a fraction of these criminal cases, and are not reflective of the link between mental illness and crime as a whole. However upon reflection, perhaps if these individuals were given proper treatment, those crimes could have been avoided. 


When one steps back and looks at the whole picture, it makes you think about the relative simplicity of the potential solution of this issue. What is it? Well, it's a collection of simplistic ideas combined into a prospectively successful aggregation/collective:

- Address the issue, don't deny it
- Increase the number and encourage the enrolment of mental health workers in Canada
- Decrease wait times (resulting from the above point)
- Provide immediate crisis counselling for patients waiting for a permanent psychologist/psychiatrist
- Remove the "10-session policy", because this results in a never-ending circle of crisis
- Enforce stricter procedures regarding crisis intervention and patient care (referring to the recent suicide at the Civic hospital in Ottawa)


These are just some of the ideas I came up with within the span of 30 seconds, so I'm sure the individuals in charge of these issues can come up with even more, and enforce them (if the motivation and attention is brought to the issue) 

News media is just the start, but in a world of technological innovation and impassioned individuals, I am hopeful that we, as a collective society, can do something to solve this issue and draw the government's attention to these matters. Matters which are important to the smooth functioning of a cogent nation as well as to the well-being of its citizens.



You can find the original story here.

The Strategic Mandate Agreement: A Misrepresentation of Trent’s True Identity?

January 7, 2014

This year’s Strategic Mandate Agreement (SMA) left a lot to be desired when it was initially released on November 15 in the form of a Green Paper on the MyTrent portal. With a limited timeline of a few weeks, Trent was put under an enormous amount of pressure when ordered to develop a clear and professional SMA that detailed its objectives and reasoning so as to convince the government to keep funding its various programs and initiatives.

However, things didn’t really go as planned and now Trent is under pressure from numerous students, faculty, alumni, and community members after the release of the revised SMA, which failed to mention many of the defining features and key aspects of Trent’s unique identity, the very things which distinguishes it from other universities in Canada.

quoteone

For those who are just as ‘politically challenged’ as I am, the SMA is the university’s response to a policy from the province designed to address three desired outcomes for Ontario universities:

1) To increase the differentiation between post-secondary institutions by highlighting strengths and identifying objectives,

2) To discuss how Ontario’s education system can continue to deliver a quality education to more students within various financial constraints, and

3) To produce the best reflections from institutions about innovations that would produce a higher quality of learning and transform Ontario’s public post-secondary system. 

With these goals, the Ministry of Training, Colleges and Universities (MTCU) launched a process to establish strategic mandate agreements with each of Ontario’s 44 colleges and universities “that will strongly inform future decisions, including allocation decisions and program approvals.”

I know this sounds like a lot to process, but, to sum it up, the SMA basically determines whether or not Trent continues to receive funding. Ultimately, it could result in the cessation of several aspects of Trent including programs, future initiatives, and research funding.

This single document could determine the future of Trent and impact the education of current and future students to come.

The extensive 21-page document outlines Trent’s main objectives as Canada’s “most-research driven, primarily undergraduate university.” In the SMA, Trent states that over the next five years, its goal is “to prepare students to make significant contributions to society by providing them with a distinct liberal arts, science or professional education.”

The document also highlights Trent’s founding commitments, and promotes Trent’s various priorities: interdisciplinary academics; research-driven teaching, small class sizes, community engagement; and finally, providing academic excellence in sustainable programs. These priorities correspond to various aspects of Trent as a whole.

A release from Provost and Vice-President Academic of Trent Gary Boire on December 11, requested feedback on ways that the SMA could be improved by emphasizing Trent’s strengths that might have been overlooked.

However, he stated certain points which undermined the whole notion of Trent’s identity and failed to note two of Trent’s key identifying features: the college system, which distinguishes Trent from other Canadian universities and are the focus of Trent’s foundation; and the school-centered model which Trent is looking to move toward.

Boire feels that the topic of Trent’s schools is “not especially germane to this specific exercise” and that the matter of the colleges is “inappropriate for our SMA submitted to MTCU.”

Putting all of the “pedagogical” jargon aside, there lie significant errors in the SMA’s formatting, politics, and judgment. In my honest opinion, it does not reflect Trent’s true identity.

It is comprised of political conformity and financial coercion. Yes, this is the case with most things in life, but the question I beg myself to ask throughout reading this document is regarding this sort of “metric system,” and why, if Trent is considered a smaller university, is this system being used?

The metrics clearly favour larger institutions that focus on offering more PhD programs, rather than smaller arts-based universities that offer more specialized programs.

First off, the “metrics” used to classify and judge universities are accused of “favouring larger, more comprehensive, medical/doctoral institutions.” Universities that are centered around one or more of the following: engineering, medicine, nursing, education, and/or law, will score higher than institutions that are smaller and more arts-based, like Trent.

Unless Trent declares itself as being more predominantly science-based, the prospect of receiving additional funding seems unlikely. Despite the “Sunshine List” wages of 229 Trent faculty members, including that $305,000.04 of our own President Steven Franklin, Trent still remains one of the most underfunded universities in Ontario, falling just behind Algoma, Nipissing, and OCAD.

Since Trent falls in between the categories of a small and large university, it is hard to gauge the sufficient amount of funding needed for Trent to continue supporting community projects. With over double the number of full-time students, Trent receives nearly the same amount of funding as other small Ontario universities, despite awarding more PhDs and contributing more to research initiatives.

Nevertheless, Trent is still being compared to much larger universities such as the University of Toronto. Trent also receives less funding than universities of similar size, such as Laurentian and Lakehead.

Comparing universities of drastically different characters, based on factors such as size, enrolment rate, and number of graduate programs, is highly biased against smaller universities like Trent. This publication is highly subjective towards PhD-distributing institutions such as U of T, Queen’s, and Waterloo, all of which make up a large portion of the funding distribution.

In response to the MTCU’s supposed bias towards larger universities in relation to “research productivity” and funding for graduate programs, Trent states, “It is with all due respect that we challenge this inexplicable decision,” echoing, perhaps, one aspect of its true identity: rebellion from the norm.

The SMA also describes partnerships with other institutions and how they have provided Ontario students with mobility and a “seamless transfer” between the two. Some of the programs listed include the Trent-Fleming School of Nursing, Trent-Fleming Transfer program, Trent-Loyalist Journalism, Trent-Queen’s Education (which is being cut in 2015), Trent-Carleton Canadian Studies PhD (which has also been cut), and Trent-Humber Public Texts/Creative Book Publishing.

If these partnerships are supposedly so seamless, why is it that I can’t even find a direct bus route from Trent to Loyalist College, located just an hour and a half away in Belleville?

quotetwo

Second, please excuse my “grammar nazi”-like disposition, but formatting inconsistencies do not reflect well on Trent as a whole, especially when it is being evaluated in terms of how academically established it is. In all honesty, the SMA appeared to be rushed and unprofessional, almost as if it was written by someone who didn’t even know Trent.

The comparison, when reading through Carleton University’s SMA, left me mystified to say the least. The incorporation of diagrams, tables, and tasteful graphics grabbed my attention and helped their objectives come across clearly.

Lastly, the SMA draws attention to the strengths and weaknesses of Trent as a whole. As stated in the SMA via the AAPP, strengths include: interdisciplinary environmental science, interdisciplinary humanities, community health, culture and society, nursing, social justice and global development, education, indigenous knowledge, sustainability studies and Canadian studies.

The areas for “future development” are specifically targeted towards the formation of new [under]graduate programs including: synergies (planned with UOIT in 2020), social work, water science, health studies, arts administration, conservation biology, instrumental analysis, and archaeology. Future development also includes the discontinuation of low enrolment courses such as Canadian studies and Concurrent Education.

The key issue surrounding this, which was discussed in the SMA, was program prioritization. In other words, determining which programs will be cut from Trent’s academic programming based on enrolment rates. In this case appears to primarily be affecting the Humanities department.

Trent’s Canadian studies and concurrent education programs will reportedly be phased out from provincial funding. Who knows how many other programs will be cut?

However, if they are basing enrolment rates on the 2012-2013 Full Credit Enrolment (FCE) Count table included in the SMA, things don’t look good for many of the Language and Cultural studies programs either, including indigenous studies (which Trent specifically draws attention to as one of its defining features in relation to the student population), cultural studies, Greek, and history.

The main concern here lies with a “decline in humanities programmes.”

As a student of both an interchangeably arts- or science-oriented program (Psychology) as well as a newly introduced, lower enrolment program (Journalism), my opinion is not swayed by preference towards the arts, science, or humanities based programs. Valuing every type of degree program is something Trent fails to do without bias or external influences.

Trent seems to be biased against the Humanities and fails to attempt to revitalize the decline in enrolment, which has been seen across the board with other universities as well (mainly due to the scientific bias of today’s society).

In the SMA, it states that, while “strong academic programs will receive increased resources to foster growth, weaker programs will, in the first instance, be offered incentives to consolidate their programs. By 2016 remaining weak programs as per the criteria established in the AAPP will be eliminated.”

In other words, there will be no real attempt to consolidate the low enrolment programs such as cultural and language studies.

Despite the MTCU’s conceptions of smaller class sizes and program enrolment, programs with lower enrolment are just as qualified as higher enrolment programs. In fact, it often means that these are specialized programs that no other university offers, which may make them even more valued in the workplace due to their specialized nature.

One thing is for certain: the student voice has definitely been silenced by the ‘Big Guys of Trent.’

The TCSA has failed to do its job in ensuring that students have their say in issues regarding Trent’s future, or in those that affect Trent’s current or future students.

However, one Trent Student has made it her mission to ensure that the student voice is heard. When questioned about the SMA, TCSA’s Anti-Racism Commissioner Zara Syed stated:

“There is no student voice here. These decisions are being made at a middle management level, but we as clients of the business we pay for are virtually unheard. We do have college heads as reps on the Senate but other than that I can’t see how our voices are factored in the decision making.”

As a result, Syed, along with a few other students, mobilized a student group called SMA Discussion, which is designed to critique and alter Trent’s SMA as well as to strengthen the student voice within Trent. She also developed a petition called “We Deserve a Conversation” to request that the administration allow a discussion regarding Trent’s proposed direction.

quotethree

The overall implications this could have on Trent’s future are immense.

Trent’s current operating budget is approximately $104,181,000, the fourth lowest operating budget overall among Ontario Universities.

With an economic impact of $390,000,000 on Peterborough to date, Trent makes up a great portion of economic revenue in the Peterborough area as well.

Without sufficient funding, Trent will no longer be able to provide services for the community, hosting local events to help stimulate local culture. Also, the lack of input from students, faculty, alumni, and community members has caused Trent to gain significant negative feedback in relation to free discussion.

The decisions regarding the SMA have ultimately ignored the opinions of the Trent community, and were instead formulated by corrupt, white-collar fat cats of Trent, without any regard given to our university’s true identity.