Unclear if mental health needs are being met in Yukon communities: report

While the Yukon government has taken strides to improve mental health services in communities, there is much more work that needs to be done, according to a report released by the Office of the Auditor General of Canada. 

In 2018, mental health hubs were established in Dawson City, Carmacks, Haines Junction and Watson Lake. In turn, mental health and addiction services are more accessible in and around these communities, the report states.

But that's on the face of it. Drill down a little further and there are problems with how the Department of Health and Social Services manages those hubs, and perhaps the services they provide.

"[B]ecause the department did not measure and report on its efforts, it did not know if the services being provided through these hubs were meeting the needs of Yukoners," the report states. 

The report includes four recommendations for the Yukon government to make good on. Those include creating a recruitment and retention strategy, improving cultural safety for First Nations, ramping up consultation efforts and ongoing evaluation of mental health services.

The department agrees with all four suggestions, said Glenn Wheeler, principal auditor.

"Ongoing engagement with stakeholders will be critical for the department to identify adjustments and improvements to provide mental health services that are most needed and culturally safe," he said.

Health and Social Services Minister Tracy-Anne McPhee said the department has already identified the shortcomings that are raised in the report.

"We'll be setting up a work plan to address those issues," she said.

Are services actually working?

Whether mental health services are effective in communities is unknown, making it difficult to determine whether Yukoners' needs are being met, according to the report. 

The issue boils down to limited data, the report states.

"[The department] did not adequately monitor the performance of these services and had not identified the performance indicators it would use to monitor and measure services on an ongoing basis," it states. "As a result, the department could not know whether the mental health services were meeting Yukoners' needs."

Staff retention

The Yukon government grappled with retaining staff in rural areas, and compounding the problem is a lack of housing in those places, according to the report.

Originally, the department planned to have 33 staff members in the communities. In August of last year, though, there were 26, according to the report.

"This finding matters because vacancies in human resources put pressure on existing staff and have a negative impact on the level of service the hubs are able to provide," the report states. "Such vacancies also negatively affect continuity of care, which is an important factor in establishing trust between clients and mental health service providers."

Consultation

While consultation did happen, some of it occurred after the mental health hubs were set up, according to the report. 

"Also, the department could not demonstrate how it integrated feedback into the model's development," it states. 

"For the department to provide the services that rural Yukoners need, it is important to understand their needs. Needs can include services or support for substance use, child and youth trauma, depression, domestic violence, and mental illness."

Cultural safety 

The report recommends the Yukon government devise a plan, in concert with First Nations, to increase cultural safety.

While the Yukon government has made some inroads — putting First Nations people on a hiring panel, for instance — there's more work to do. 

The department failed to develop a plan regarding ways to improve culturally responsive services, the report states. 

It also notes that roughly 60 per cent of service providers took mandatory coursework to develop their understanding of Yukon First Nations history.

"We heard from some Yukon First Nations members that they did not feel the services reflected and respected their culture," the report states. "They would like to see more outreach activities so that providers can better understand the culture of their communities."