Mental Health: Anti-stigma campaigns produce unintended consequences

There is no question that stigma is an obstacle to those seeking help for mental illness.

The question is, once mental illness is accepted in the same way as any other medical malady, will there be sufficient resources in place to deal with those who do come forward?

Alan Stevenson of the Canadian Mental Health Association recently told the Sarnia Observer that his agency is seeing yearly jumps in the number of people coming forward with anxiety and depression largely due to the success of anti-stigma campaigns.

The question is, what funding resources is he using to deal with these surges in demand?

The spring budget was again oddly silent about mental health. Ontario is in the final year of its three-year plan to improve funding for mental health addressing children and youth. That’s $93 million in new funding this year – the last of a $257 million investment over three years.

You may recall that two years ago we were surprised to learn that the 10-year general mental health strategy had turned into a three-year plan for children and youth.

Children’s Mental Health Ontario, despite receiving the only real increases in mental health funding, noted in this year’s pre-budget submission that the gap between demand for child and youth mental health services and the capacity to meet needs is as large as ever.

While they are treating more children, demand is continuing to outstrip supply.

Their rationale is similar to that the CMHA: “Efforts in the past decade to reduce stigma associated with mental health and addictions in schools and amongst parents and communities have created a new demand for service from a population that was not previously being reached.”

They note that waiting lists initially came down, but are once again growing. Some agencies have been forced to deal with deficit issues that have resulted in actual cuts to services.

If that’s what it looks like for the one sector getting funding, what does it look like for the rest?

It’s hard to tell. The psychiatric hospitals are part of the freeze on base funding general hospitals are experiencing. That includes no new money to support or expand assertive community teams (ACT) that are coordinated from these hospitals.

That is traditionally about 60 per cent of mental health funding. The rest is spread out in a number of multi-faceted community agencies that spill over into other sectors, such as home and community care. That was supposed to be 60 per cent of funding but never got there.

Theoretically community is where the money is going, but it is far less than what is needed to address new demand created through anti-stigma campaigns and the uptake of existing demand from the red circling of public hospital budgets.

It’s relatively easy for the public to see how Ontario is doing with regards to wait times for hips and knees, cancer care, and cataracts. It is far more difficult to assess what is happening with mental health. That could very well be deliberate given the government’s overall obsession with data reporting appears absent in just this one sector.

If it is government’s attention to start planning for an expansion of mental health services directed towards adults for 2014-15, then we need to start a conversation about capacity building that will not only reflect existing demand, but reflect those who will be yet coaxed forward out of the shadows.

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