Response to mental health must address poverty and housing -- symposium

Building on five priorities for change, OPSEU’s second mental health symposium Nov. 12-13 aimed to provide wind under the wings of a diverse group of organizations and individuals committed to changing the way mental health services are delivered in Ontario.

Patty Rout, OPSEU’s 1st Vice-President, presented the priorities to the gathering of activists, health care professionals, policy makers, consumer-survivors and academics.   “As long as services are fragmented, not grounded in the social determinants of health, and do not retain a highly-skilled and experienced workforce, then reform initiatives will not succeed,” she said.

Rout was critical of the government’s direction to hospitals to freely cut any mental health programs that were funded outside a protected ministry envelope of services.

“No other health services are openly put on the chopping block in the same way as mental health,” she said.

OPSEU’s five priorities include

• putting a stop to front-of-the-line cuts to mental health;

• addressing wage inequities between hospital and community mental health workers;

• accessing more forensic beds and court diversion programs;

• making housing a right; and

• establishing income security for people who are mentally ill.

 “It is a moral failure on our part when we permit governments to get away with disability support payments that don’t come close to providing a living wage,” said Rout.

On the threshold of a movement

“We are on the threshold of the kind of movement we’ve seen in cancer or HIV/AIDS,” said Glenn Thompson, Interim President of the Canadian Mental Health Commission. 

As keynote speaker, Thompson said the labour movement can play a role in placing mental health higher on the provincial/territorial agenda.

Internationally, there is already a growing movement to address what is often called the “orphan of the health care sector,” from a recent announcement in the UK that they were to invest £2 billion on mental health services to a commitment by New Zealand to spend 10 per cent of health care funding on mental health.

In Canada,  Thompson’s Commission emerged from the recommendations of Senator Michael Kirby’s 2004 report, Out of the Shadows At Last. Thompson sees the role of the commission as building a cross-Canada movement and directly fighting the stigma – or discrimination – that is associated with mental illness.

Given a 10-year mandate, the Commission intends to solicit input, debate solutions, and propose a plan of action . Canada will be the last of the G-8 nations to craft a national mental health strategy.

Thompson said a national strategy should be pragmatic and must identify where the dollars will come from.

“That includes making a more efficient system than the one we have,” he said. “Hundreds of community agencies are not the most efficient.”

When the Commission was set up, there was debate over the role of consumer-survivors. Thompson said Senator Kirby felt it important that consumer-survivors be present on every committee, not relegated to one specific committee.

Consumer-survivors play key role

Consumer-survivors played a central role in the symposium, serving as moderators on the various panels, asking questions and facilitating comments from the floor. Moderators Dan Carter, Craig Hurst and Robin Harvey are all recipients of the “Courage to Come Back"  Award from the Centre for Addiction and Mental Health.

Approaching government

“This isn’t just about government,” said Ann Bowlby, manager of the ministry’s mental health and addictions unit, “It’s also about you. What are you going to do?”

As advocates, she said labour can “do things we can’t do.” That includes bringing together the various ministries to try and solve the problem together.

Bowlby said there are fabulous initiatives and good collaborations going on. She says the government was to play a different role now that the local health integration networks are here.

“Our roles are different than  before April 1st. Government can encourage, facilitate, but we are not here to fund directly.”

Hy Eliasoph, CEO of the Central LHIN, said mental health advocates are competing with many other needs for government funding, and instead should strategically seek to build capacity within mental health and then advocate for resources.

With the Central LHIN, all 28 mental health providers – employers and labour -- sit at the same table to speak as one mental health and addictions network, he says.

“You build and implement the plan, tell us the resources you need to get the job done. Identify projects and activities. The empowerment is over to you guys.”

Aboriginal mental health

Deborah Pegahmagabow, Director of Bisanibemasdwin Mental Health Services, and Nancy Stevens, Regional Aboriginal Mental Health Programs Coordinator for Northeast Mental Health Centre, brought a focus to the unique requirements for improving aboriginal mental health.

Stevens said the response has to start with a multi-faceted approach. “There is no such thing as just a mental health issue. It is all inter-related, it’s about the equalization of power.”

“How do you have good mental health if you live in a mouldy house, or live in poverty?” asked Stevens.

Stevens was critical of the current mental health assessment tools, pointing out that everyone is aware that there are both gender and culturally biases built into these tools. “Then why are we using it?”

Pegahmogabow said there was a duty to consult aboriginal governing body when planning for mental health services.

“You have to recognize that the First Nations experience is grounded in colonization.”

 Housing is a right

OPSEU Board member Nancy Pridham spoke about the need for housing and poverty reduction.

“Access to housing is a right,” she said. “Without this basic need, people do not succeed in achieving stability in other areas.”

Pridham said government has not lived up to its promises and obligations under various international declarations, covenants and conventions.

She said government cannot talk about poverty elimination and quality mental health programs without introducing stronger rent control legislation, creating mixed income housing neighborhoods that include rental units, cooperatives, subsidized housing, supportive housing and provincially-regulated boarding homes.

Pridham called on the province to raise the rates for the Ontario Disability Support Program (ODSP) and Ontario Works, as well as increase the minimum wage to $10 an hour immediately.

The three lies

Michael Shapcott of the Wellesley Institute said politicians give three reasons for their inaction on mental health: its too complex, there are not enough dollars, and that it is not a priority for Canadians.

“All three are lies,” he says. With the 9th largest economy in the world, the federal government has chosen to implement tax cuts rather than invest in the priorities of Canadians. Polls show Canadians overwhelming in favour of investment in supportive house.

Dr. Cheryl Forchuk of the Lawson Research Insitute at the University of Western Ontario, said we need to get past our silos to address what is a “man-made disaster.”

Forchuk says we should blame the system, not the individual. “Future generations will question what were we thinking.”

Participants at the symposium attended workshops on how to influence public policy for change and screened the Susan Smiley film, Out of the Shadow, which illustrates the painful complexities of severe mental illness and the inadequate public health system set up to deal with it.