More mental health services needed in B.C., says auditor general
Carol Bellringer says lack of coordinated effort puts pressures on other parts of the medical system
British Columbia's auditor general says adults with mental illnesses who have a long history of hospitalization and substance abuse issues need more access to services.
Carol Bellringer said there's a lack of information about wait lists and whether programs meet the needs of the most vulnerable patients.
Mental health and substance abuse services that were once available at Riverview Hospital have been transferred to health authorities but there are gaps in programs, she said in a report released Tuesday.
Bellringer said some people who suffer from serious mental health and substance abuse issues plus brain injury, developmental disabilities and extreme violence may not be well served.
Impact on emergency rooms
She called on the Health Ministry to take leadership in setting a direction for service delivery and enhancing collaboration among health authorities for more consistent access across the province.
Gaps in services are compounded by a lack of housing when patients are discharged and that puts pressures on other parts of the medical system, such as emergency rooms, Bellringer said.
The Health Ministry and the health authorities had begun to develop a province-wide framework with standards and expectations for managing access to patients' complex needs but stopped short of deciding how the standards would be implemented, enforced, or monitored, the report said.
"The absence of a framework has resulted in different definitions of adult tertiary care services and inconsistent practices, measures and targets across the health authorities."
Lack of public reporting
Bellringer said her audit revealed that while some health authorities moved patients through the system as quickly as possible, others allowed them to remain for an extended period because services were not available upon discharge.
That meant beds continued to be occupied and patients waiting for services didn't get them, she said.
Neither the Health Ministry nor the health authorities publicly report on adults who had been admitted for mental health issues, the audit found.
"Without public reporting, legislators, stakeholders and the public may not know about the adult tertiary care services available or any access and flow challenges. This may lead to misinformation and unrealistic expectations in the public realm."
Bellringer made 10 recommendations, including more collaboration between the Health Ministry and health authorities in determining the needs of the mentally ill population and tracking wait lists.