Manitoba 'falling further behind' in mental health care, advocates say

Working full time as a single mother to a five-year-old, Raven Deering has a lot on her plate. 

The 25-year-old Brandon woman says she has received mental health treatment since she was a teen. But her mental health went downhill during the pandemic, and when she tried to book an appointment with her psychiatrist last year, she was told they'd retired. 

Deering's family doctor gave her an urgent requisition for a psychiatrist so she could return to psychotherapy and get her medication adjusted. Even with that referral, she says she was told the wait would be about eight months.  

"That kind of broke my heart," Deering said.  

Advocates say the Brandonite is far from alone. Years of chronic underfunding have taken a toll, leading to staffing shortages, lengthy wait-lists and a system that's difficult to navigate, according to the Manitoba Psychological Society (MPS).

"The wait-lists that people have in private and public right now are really quite astounding," said Dr. Jo Ann Unger, president of MPS and a registered psychologist.

"If people don't get timely treatment for their mental health concerns, for the most part, people's symptoms get worse." 

Waits can be especially long for people outside of Winnipeg. "We talk about shortages and gaps in the mental health system — that is exacerbated if you live rurally," said Unger. 

Deering says she's grateful to have a strong support system of family and friends. But she worries for others who don't. 

"It's still scary that these resources are little to none and not available right away," she said. "Eight months, whether or not it's short or long, anything can happen in that time." 

Groups call for increased mental health spending 

Concerns about ease of access and effectiveness of mental health and addictions services were flagged to the province in a 2018 report. 

In its deep-dive, VIRGO Planning and Evaluation Consultants concluded Manitoba's mental health needs were significant, complex and largely unmet. The report made 125 recommendations to improve access to mental health and addictions services in the province.

More than four years later, the province says it has fully addressed seven and partially addressed 62 of those recommendations.

"We just really need the government to take a courageous act here," said Unger. "Really seriously fund mental health in a way that hasn't historically been done before."

The province has committed over $58 million to improving access to mental health and addictions services since 2019, says a spokesperson for Mental Health Minister Sarah Guillemard. Manitoba's total budget for mental health and addictions services in 2022 is $399 million.

But the national advocacy group for mental health says it's not enough. 

Before the pandemic, the Canadian Alliance on Mental Illness and Mental Health (CAMIMH) recommended provinces invest a minimum of nine per cent of public health spending in mental health services.

That recommendation has grown to 12 per cent to mitigate the worst of COVID-19's impacts on mental health, says the chair of CAMIMH's public affairs committee, Glenn Brimacombe.

In Manitoba, the provincial government projects its mental health spending for 2021-22 will go from 5.4 per cent of the health care budget to 5.6 per cent in 2022-23.

In other words, to meet national recommendations, Manitoba's spending would have to double.  

"There's room to grow," Brimacombe said of Manitoba's budget.

"There's a tremendous amount of unmet need when it comes to mental health and substance use health that is only continuing to grow — it's not like over time we're going to have less demand."

Shortage of psychologists 

Meeting the growing demand is proving difficult in Manitoba, says Unger, and changes to the system as a whole are overdue. 

Right now, Unger says there are multiple barriers in Manitoba that can prevent people from getting timely treatment.

People looking for assessment and treatment through the public health system have to get referred by a doctor and face long waits, resources can be difficult to navigate and paying out of pocket for private care can get expensive. As a result, access to treatment is often dependent on the ability to afford private therapy, an extended health insurance plan or a psychiatric crisis. 

The province also has the lowest number of psychologists in Canada per capita, making matters worse, says Unger. 

Psychologists and psychiatrists can assess, diagnose and treat mental illness similar to how a family doctor consults on physical health concerns. Both are experts in mental health, but psychiatrists are specialized medical doctors who can prescribe medications. Unger says she's hearing from people who don't know where to turn for help.

"To be perfectly honest, it's really hard as a professional to be able to tell them, I'm not sure what to tell them," she said. "We're falling further behind." 

Province says it's 'building capacity'

The province says it has a plan. In February, Mental Health Minister Sarah Guillemard rolled out the broad strokes of a five-year roadmap to address gaps in mental health treatment and care.  

"The Manitoba government's focus will be building capacity of publicly-funded services including our mental health and addictions workforce," said a spokesperson from Guillemard's office.

The spokesperson said the province has also identified actions to "promote the development of the clinical psychology and psychiatry workforces."

The province says 77 per cent of the plan's $17.1-million year-one budget will fund more services for Manitobans, and the majority of that will go toward hiring more mental health professionals, and doubling down on recruitment and retention efforts. 

Until those gaps can be addressed, Manitobans like Deering are left to wait. She says she's well-supported, taking the antidepressants her previous psychiatrist prescribed, and she has sought out counselling. 

"I've just kind of been doing things day by day, month by month, and just paying out of pocket for myself," she said. "When I need it I get it."  

But she says she wishes it were easier to get assessed and treated, and she misses the outside perspective and assessment her psychiatrist gave her. 

"But I have to do that all by myself now," Deering said. "It's a little overwhelming."

If you're experiencing suicidal thoughts or having a mental health crisis, there is help out there. Contact the Manitoba Suicide Prevention and Support Line toll-free at 1-877-435-7170 (1-877-HELP170) or at reasontolive.ca.

You can also text CONNECT to 686868 and get immediate support from a crisis responder through the Crisis Text Line, powered by Kids Help Phone.