The
Province of Nova Scotia spends about 3.8 percent of its health care budget on
mental health services. Well below the minimum recommended by the World Health
Organization. A small proportion of this goes to child and youth mental health.
As the week long series in the Chronicle Herald (March 8 to March 12) pointed
out – the entire provincial mental health system is very broken. In my opinion,
we have to tear it down and start again. If we had a blank slate there is no
way that we would build a mental health system in the way we currently have it.
So, where do we start. Tearing and building
will take a bit of creative thought and a bit of time, not to mention some very
difficult slogging to move out of current rigidities and the control of vested
interests.
What should we do now?
Most mental disorders begin before age 25
years. Most of these are life-long. Most of these respond quite well to the
evidence based treatments that we have. Early intervention with effective care
has the potential to decrease short term morbidity and improve long term
outcomes. The most effective way to decrease suicide rates is to identify and
treat mental disorders. And the list goes on and on.
Yet we persist in back end investment. Lets
stop this foolishness now. Of course we need to provide better care and
services for post-youth and vulnerable populations (such as refugees, first
nations, the economically and socially disadvantaged, etc), but we need to
really ramp up our investment at the front end. So while we work on
transforming the entire system we should immediately increase our investment in
providing the best evidence based care with the best human resources we can
allocate to children, youth and their families. And we should do it now!
--Stan
