'There is such a gap for resources': Mental health advocates say system is broken

As the leaders of Ontario's four main political parties criss-cross the province, making pledges in an effort to appeal to voters, advocates are sounding the alarm over a lack of resources in the mental health system, which they say is stretched so thin it's putting patients at risk.

Maria Estrada knows first-hand about stretched resources for mental health. She first attempted suicide at age 12.

"I woke up the next day and remember just looking up at the ceiling and being just so upset that I was still alive," Estrada told CBC Toronto this week.

"And it was at that moment that I realized a 12 year old shouldn't feel this way and I needed help and I needed to advocate for myself because if I didn't, the next attempt was probably going to be successful."

When she sought help at a clinic, she was told the wait list for mental health services was between three and eight months.

"I was so shocked," she said. "I had just attempted to take my own life and now I have to wait to talk to somebody. And even then they said you could only have eight sessions. That was so frustrating."

Now 22, Estrada has been hospitalized five times and has been forced to ride a rollercoaster of referrals, wait lists for tests and treatments.

"If you're not diagnosed officially, then you can't get the right treatment," she said.

In the end, it was her own Google search for a community agency in Burlington that led her to a co-ordinated care program and the psychiatrist she currently sees.

"There is such a gap for resources, and the fact that I had to wait to get help — that just blows my mind," she said.

'Awareness is building'

Issues such as hydro bills, taxes and the high cost of home ownership have featured prominently in this campaign. But each party has also made pledges aimed at boosting Ontario's mental health system.

• The Liberals and NDP want to add mental health supports to every high school.
• The Progressive Conservatives are vowing to reduce wait times for youth mental health services.
• The Green Party is pledging to bring mental health services under OHIP to expand access to every Ontarian.

Asked Tuesday about the Liberals' commitment to improving access to mental health services, Leader Kathleen Wynne acknowledged the system needs "more investment."

"The support is building. The awareness is building," Wynne said. "I would be the first to admit that for more than 20 years, for decades, we've not had the supports in place across this country for mental health."

In March, psychiatrists at the London Health Sciences Centre wrote a letter to the hospital's CEO and board of directors, warning of deteriorating mental health services in the city.

"It is no secret that it has been a challenge for the hospital to manage the volume of patients seeking mental health care — and that the challenge is only becoming more intense," they wrote.

Youth system not well-coordinated

Dr. Peter Szatmari, chief of psychiatry at the Hospital for Sick Children and chief of child and youth psychiatry at the Centre for Addiction and Mental Health (CAMH), said one in five children in Ontario experiences some type of mental health challenge, and for one in 10 of them, the issue is chronic.

The problem, he said, is that funding is insufficient to support the required services for that population. On top of that, the mental health system for youth is fragmented between schools and various government ministries, "not all of which work together in a systematic fashion in order to ensure services are well-coordinated."

Stigma surrounding mental health issues is still a barrier to both funding and access, he said. There is also limited capacity to grow the system. There are currently only about 350 child and youth psychiatrists in the entire country, he said. Residency spaces are scarce and funding for research has been cut, he added.

While the system is "better than it used to be," according to Szatmari, youth are still walking into emergency rooms with symptoms of anxiety and depression, rather than finding help in the community. That's a sign, he said, that the system isn't working.

"One of the great things in our field is that there's been an explosion of new knowledge about effective evidence-based interventions, but getting those interventions out in the community, training practitioners, has been a real challenge," he said.

While he would not endorse any party's plan for addressing mental health, Szatmari said whatever changes do come after the election must be done in a "collaborative, systematic and evidence-based way."

For Maria Estrada, the fact that she had to take her care into her own hands as a child makes it clear that the system needs fixing.

Asked what changes she would like to see, Estrada echoes Szatmari that proper care begins in the community. When patients are discharged from hospital, a care plan with referrals to specialists should be in place so next steps are clear and easy to follow.

"I wouldn't be here right now if I didn't advocate for myself and if I didn't Google things. I would have taken my own life," she said.

"We shouldn't have to lose lives to realize that the system is broken."