Darkness falls over N.S. mental health services

When it comes to provincial health budget, $5 million can get lost in the couch cushions

What’s $5 million in the Nova Scotia health budget? It’s a million bucks more than the department spends on something called “investment decision support,” but twoand-a-half million less than on “system strategy and performance.” It’s about a third of the department’s IT budget, but only one-tenth of the administration costs at the Nova Scotia Health Authority.

Let’s face it, in Nova Scotia’s $4,244,000,000 health budget, $5 million isn’t much more than a rounding error. Between September’s provincial budget and December’s fiscal update, health spending increased by $30 million, and the government only bothered to account for $6.7 million of that bump. In the health department, $5 million can get lost in the couch cushions.

It’s also the amount the government added this year, with some fanfare and not a hint of embarrassment, to an impoverished mental health system.

But money is only where the problems begin in mental health and addictions treatment, as advocate Laurel Walker articulated in a recent open letter to the all-but-invisible Nova Scotia Health Authority Board and CEO Janet Knox, who is more frequently sighted but only slightly more revealing.

Walker illuminated a mental health system where patients are afraid to speak out, less for the stigma attached to mental illness, than of retribution by losing their place in a very long line for services. Nova Scotians who work in mental health, or anywhere in the health system, speak on condition of anonymity because they fear the NSHA or the province will punish them for airing dirty laundry publicly.

But the story Walker relates of the mother who lost her daughter to suicide can’t be ignored or minimized, because it reflects a system that, at its pinnacle is so paralysed by political cowardice it is unable to summon common human decency.

Shattered by the death of a 37-year-old daughter who fell through the cracks that distinguish mental health services in Nova Scotia, the mother sought answers but was “stone-walled at every attempt,” Walker wrote.

Rather than respond with humanity when a mother tried to understand why her daughter took her own life, the NSHA sent a communications officer to screen the mom and make sure she wasn’t working for the news media.

The easy thing to do in this case is to shrug it off as an isolated incident or an embellished story from a distraught mother. The NSHA does that like this:

“We expect anyone who calls us with questions, concerns or complaints to be treated with respect. We are sorry if that did not happen in this specific instance. It is also important to note that we are bound by law to protect personal health information and have policies in place that we must follow to release patient information.”

“Operating in a make-believe, alt-reality is easy and without consequence,” a senior member of Nova Scotia’s legion of dangerously distressed doctors wrote in a recent email to help explain why the health bureaucracy generally, and the NSHA specifically, does the things it does.

One can assume that members of the NSHA board of directors, if they read Walkers’ letter at all, will dismiss it with whatever reassurance the CEO or other executives provide. One must assume what the board will do with the letter, because only a precious few are permitted a glimpse into the mysterious workings of the NSHA board.

The Nova Scotians whose taxes pay for the health system are not permitted to know what’s on the board’s agenda, and if there are minutes from board meetings they are locked away in a vault purchased with Nova Scotians’ tax dollars.

Average health service consumers, who for the most part get good treatment if they have a doctor to call their own, wonder what the fuss is about, if they wonder at all.

That disinterested acquiesce is what Stephen McNeil’s government and the NSHA are counting on. Nova Scotians are still getting decent health services despite dysfunctional, unaccountable management.

And Laurel Walker, whose passion in advocating for better mental health and addiction services is stoked by her own recovery and the knowledge that there is light and life after the dark, joins in the chorus of voices in the wilderness.

Executive administration of Nova Scotia’s health system is a dark place, and those who participate in the tacit conspiracy that makes it so are not contributing to Nova Scotia. They are making a withdrawal.

“The mother sought answers but was “stonewalled at every attempt.”