City Council and Mental Health

running-in-circles

Sometimes I fail. And sometimes really good leaders fail. Sometimes. Last night I felt that way when London City Council endorsed the misinformed and misguided mental health strategy for our city. Many will say that mental health services are a very complex with many parts and many factors.  But frankly in that’s balderdash.

Let me share with you some thoughts on why I feel this way this is an issue. Some background first.

In Ontario the Provincial Government is responsible for all health care including mental health. But Adult Mental Health is fatally underfunded and Child and Youth Mental Health is so bad that 80% of children/Youth with a mental health issue never get service. The Child and Youth system is so underfunded that recently 5 local Mental Health Agencies sent an open letter to the Liberal Government saying they were afraid they would no longer be able to meet service demand unless funding increased. Unlike every other medical illness, those with a mental illness wait 6 months to 3 years for service, and is often sporadic with no continuity of care to follow people throughout their illness. In other words those with a mental illness, which in london is up 130%, are discriminated against when it comes to primary health care. The Provincial Legislature’s Select Committee on Addictions and Mental Health has said this, The Ontario Ombudsman has said this, and the Auditor general has pointed out the inequities. The last three provincial governments have fundamentally failed in their duty of care. Why? It’s not about stigma it’s that there isn’t a single ministry in charge of mental health. It is divided amongst 5 ministries with often contradictory directions. The result is that suicide is the leading non accidental cause of death in Ontario and thousands suffer with a fractured and underfunded system. The Select Committee on Addictions and Mental Health’s first, and strongest recommendation, was that mental health for all in Ontario should be focused in one ministry.

In the last 20 years I have been through so many attempts to solve the issues in mental health including system including mapping exercises, collaboration tables, system integration efforts, that I have lost count. All of these efforts have failed because at the heart of the matter that there is no one ministry responsible and mental health care is fatally underfunded. Yet our City Council has decided to go down the well-worn path of previous local and provincial efforts hoping they can recreate the wheel despite all the times this has been tried before with the same failed result.

What is equally as troubling is that Council decided to follow this tired strategy despite the absolutely failed process they used , at the cost of $80,000 for a consult, in order to arrive at their strategy. I attended one of the meetings that was open to “those with lived experience” where 7 people were in attendance. At an earlier meeting there were 12. Yet at the meeting for service providers there were 40 people attended. Why the difference? Well the City of London staff, and their consultant, sent the invitation out with 2 days notice and hosted the meetings at times that was difficultly for those with families and jobs to attend. Add to this that the advisory Committee council appointed to advise them has no one with lived experience on it. Yet Council used this minimal input, by those who have to live and survive with this broken system, in order to make an “informed” decision about what their strategy should be?

The City of London does not fund mental health nor do they have any jurisdiction when it comes mental health yet Council deals with the consequences of the mental illness epidemic in London. But rather than publicly call on the Provincial Government to create one ministry for mental health or demand that this medical illness be equitably funded they chose to create tables of conversations. The same tables that I have sat at again and again for 20 years.

I have a great deal of respect for many members of Council and agree with their work on transit, city planning, supervised injection sets, poverty , and infrastructure. This Council works hard and tires to do the right thing and is filled with good people. But in this case, despite my many meetings with The Mayor and members of Council, and my two letters to all members of Council, they chose the leaset effective path forward and dd not call for a serious correction by the provincial government to address the inequity of mental health care. No Council has ever done this. Instead we’ll have the tired formula of tables and talk with no end in sight.

I want to thank Councillors Salih, Squire, and especially Ridley ( who completely understands the mental health issues) for taking the time to understand and voting in the way they did.

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