Friday, 27 December 2013

Penny Wise and Pound Foolish

Mayor Gregor Robertson and the Vancouver Police Department have appealed to the Provincial Government for help to deal with a mental health crisis overwhelming the city’s resources.  Robertson wants 300 new hospital beds to accommodate the growing street population of mentally ill individuals who are also addicted to drugs and/or alcohol.

Health Minister Terry Lake recently announced that his Ministry would be adding a nine-to-12 bed psychiatric assessment and stabilization unit at St. Paul's, plus two more Assertive Community Treatment teams (ACT teams), which include social workers, psychiatrists, nurses, addiction counsellors, police and outreach workers to help people discharged from emergency.

Everyone concerned who is attempting to deal with the crisis is missing one critical piece; The best time to avert a crisis is before it becomes a crisis.

The problem is that in North American, what is commonly called a “health care system” is in practice a disease management system.  With one in three Canadians experiencing a mental health disorder at some point in their lives and 21% of youth between the ages of one and 15 currently having a mental health disorder, the current mental health crisis is only going to get worse unless we change how we think about mental health care delivery in our nation.

We can start by including all qualified mental health practitioners in our medical services plans so people can access counselling and therapy before it leads to greater problems like self-medicating through drug or alcohol abuse, criminality, or suicide.  Too costly you say?  Here are some real numbers;

Statistics from the World Health Organization and the Canadian Institute for Health information tell the same story; Canada spends $50 billion annually managing mental health problems.  That amounts to almost 25% of the $207 billion we spend on health care across Canada.

Hospital stays for a mental health crisis do not come cheap; A person admitted to hospital for depression costs on average $17,081 per day; an eating disorder averages $16,831 per day; and obsessive compulsive disorder comes in at $8,384 per day.

Treatment for these disorders cost far less and allows the patient to remain in their community and often at work.

Let’s take one disorder that I am very familiar with and help people overcome it on a daily basis; Obsessive Compulsive Disorder (OCD);

According to 12 different studies conducted by the American Psychological Association, 83% of clients undergoing therapy for OCD were improved after an average of 15 sessions with a counsellor.  At $85 per session, that comes to $1,275.  Yet left untreated, our health care system shells out an average of $8,384 for each OCD hospital stay.  So even if treatment for OCD only reduced emergency hospital visits by one per person affected, that still reduces our health care costs for OCD by 84%.

By “opening the books” and allowing mental health appointement coverage through our medical plans, we can vastly reduce that $50 billion we spend each year on crisis management.  To ensure there is no abuse of  the system, we can stipulate that a patient is required to have a referral from their physician to be covered under their health plan.

Keep in mind that the cost savings wouldn’t be limited to the health care budget alone.  According to B.C. Deputy Justice Minister, Brent Merchant, people suffering from a mental health disorder account for 56% of the Canadian prison population.  Therefore, more than half of the $30+ billion spent in Canada for police, courts, and prisons is spent as a direct result of untreated mental health problems.

As a tax payer, if you truly want value for your tax dollar and want to free up resources that may impact you directly, get involved;
Doubting that the voices of a few people can bring about change?  Let me leave you with this;

"Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." ~ Margaret Mead

Aaron D. McClelland, RPC –