N.B. child and youth advocate says province lacks long-term vision for mental health care

New Brunswick is missing a long-term vision for its mental health-care system, according to child and youth advocate Kelly Lamrock.

Lamrock released an update report looking at the government’s progress on three past youth mental health and suicide prevention reports from his office.

The report comes a year after the office’s report on the circumstances surrounding the suicide of 16-year-old Lexi Daken, days after failing to receive psychiatric care from the Dr. Edward Chalmers Hospital in Fredericton.

Lamrock says there have been positive developments over the last year, including an increase in mental health funding, but says the government is failing to craft a long-term vision for what mental health care should look like.

“There seems to be a culture in New Brunswick government that we never set a clear goal because then we might have to explain why we didn’t do it,” Lamrock told reporters.

“But without goals, we get more and more used to muddling through and saying, ‘Well, you know, everyone is muddling through so I guess it’s OK that somebody waited 30 hours for treatment,’ or, ‘I guess it’s OK that they went home and it took four weeks for mental health to call them because everyone’s doing their best.’

“Well, what would it look like if we weren’t in crisis? If we just keep blaming the crisis for the fact that things aren’t changing then we’re going to be in crisis 20 years from now.”

The update report notes that the province boosted mental health funding by $7 million in 2021. That increase was just $1.9 million this year, but Lamrock says it’s hard to know how much money is needed to improve the system until the government defines what sort of system it’s aiming for.

“Money plays a part in it,” he said.

“The bigger issue here is I don’t know what it would take to spend because I don’t know what kind of system we’re talking about having.”

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That should include a system where mental health is treated on par with physical health, Lamrock says. While moves are being made to shore up crisis care with additional training for emergency room staff and mental health-care support and advice are becoming increasingly common, access to basic-level mental health care is an issue.

Lamrock said the “primary care” level of mental health-care treatment for those with mental health needs is severely lacking.

“What do you got between sitting on your couch looking for someone to talk to and going to the ER saying ‘I’m in crisis’?” he said. “I think if you’d ask a lot of people and say ‘Where do you go?,’ they’d say ‘I don’t know.'”

“You could call it a navigation crisis except in a lot of communities you could navigate really well, there’s just nothing to navigate to.”

Liberal Leader Susan Holt says now is the time to put together a more holistic vision of mental health care in the province as it looks to reform the health system as a whole.

“Health service delivery needs to look different and that includes mental health service delivery, so who is thinking about that when we’re talking about recruiting nurses, paramedics, family doctors and other things,” she said.

“There isn’t long-term thinking applied here right now, at least that we can see as everyday New Brunswickers.”

Read more: Lexi Daken’s family 1 year later and how the N.B. teen’s legacy is now helping others

In order to see fundamental change, Green Party health critic Megan Mitton says mental health care needs to be treated like physical health care, rather than an afterthought.

“It’s so important, it’s part of our lives, it’s part of our health, but if it’s thought of as an afterthought, not given the budget, not given the importance it deserves, then we see the consequences,” she said.

Lamrock said his office intends to continue providing regular updates on the implementation of past reports and will issue another update in eight months. Until then, he is urging action along the following priority areas:

• a human resource plan with benchmarks and recruiting targets for mental health professionals along with standards for patient service and response times
• plans with measurables to transition pilot projects to province-wide programs
• statements of training requirements for emergency staff
• a provincial plan for service agreements for community partnerships and grants with all three social departments
• the definition of the community services to be used in the Icelandic model and plans to ensure those services are available equitably
• a focus on continued integrated service delivery

The report also says the provincial government is failing to respond to the mental health crisis among First Nations youth. Lamrock says the province must put forward a plan to roll out a mental health pilot program in Elsipogtog to the other 14 First Nations in the province and appoint a minister to lead the creation and implementation of a specific First Nations mental health plan.

“We are hearing from leaders in First Nations communities that several departments are each claiming the lead lies elsewhere. This needs to stop and the process needs to be clarified and activated,” the report reads.

“One year without even a clear plan to have a plan is unacceptable to us.”

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