Sask. residents facing mental health barriers
Survey finds stigma, access among problems
The Psychological Association of Saskatchewan (PAS) recently completed a non-academic survey of their members on the topic of barriers to mental health access and treatment in Saskatchewan, finding some disturbing results. Most respondents were from urban areas, but together they covered countless areas of psychology from those who work with preschool-aged children all the way up to the elderly. 94 per cent of those psychologists stated through the survey that they have observed barriers to treatment throughout their time in the practice. The most significant barriers they identified were:
- financial barriers
- a lack of provincial funding
- a lack of specialized services (i.e. services for those with learning disabilities) and practitioners trained to offer them properly
- a lack of community resources
- a lack in the continuation of providing those community resources to the same degree once established
- a lack of visible minority practitioners
- long waitlists
- the excessive workloads put on the providers of mental health resources
- the unavailability and inaccessibility of resources in rural and remote areas
Kent Klippenstine, the Advocacy Chair for the PAS, used an analogy to explain how those barriers can make it difficult for people to get the help they need. “It’s like there’s a mountain, and we all get dropped at different spots on the mountain, and I get dropped where there’s a path up there… I’ll make it to the top, right? You get dropped on the other side and there’s snakes – you can still technically make it to the top, right, you’re just going to have to go through some stuff. I think we don’t really understand that, we don’t understand that not everybody walks the same path.” Which he elaborated on by saying: “The more individual responsibilities someone has in their life, the less they’re going to put a priority on their own mental health… In times of stress the first thing we trade off is ourselves.”
Some additional barriers mentioned by Klippenstine were adequate education on mental health, and the stigma around mental health disorders. Adequate education on mental health can involve knowledge of Saskatchewan’s mental health resources, how they can be accessed, who’s able to access them, and whether the cost is covered or needs to come out of the individual’s own pocket. Closely tied to this area is stigma, as people who aren’t educated in what mental health disorders look like can have difficulty recognizing when they’re experiencing one. Without education, people assume the diagnosis of mental health disorders functions like a cookie-cutter, with everyone who has a disorder displaying the same symptoms in the same ways.
In reality, there’s many symptoms an individual with a disorder can experience, and many different degrees of severity those symptoms can be experienced in. Klippenstine said as an example that some of his clients will tell him they aren’t depressed “but they’ll describe depression to a T” when talking with him about their mental and physical condition. The media’s portrayal of depression stereotypes the disorder by creating the impression it presents the same way in everyone who experiences it, so that even those with severe cases can be unaware that they’re experiencing an episode of depression because they don’t see themselves as “one of those people.”
63 per cent of respondents to the PAS survey said these barriers impact everyone living in Saskatchewan, with the top three most vulnerable groups being minors, First Nations people, and minorities. In the survey, “minorities” was not defined as any one specific group, meaning it could include anything from people of colour to the queer community to those living with physical disabilities, and more.
The PAS survey also asked if the psychologists responding knew of ways to raise concerns about the barriers that 94 per cent of them observed, and furthered that by asking what the outcome was if they’d raised concerns about barriers in the past. 40 per cent were aware of how concerns could be raised, 33 per cent didn’t know how, and 27 per cent said they didn’t know if there were ways for those concerns to be raised. This means three out of five respondents weren’t aware of ways to challenge the barriers impacting their clients, or the people who need mental health treatment and due to barriers are unable to access it. Of those who did raise concerns, only 3 per cent said there was an adequate resolution reached. A whopping 80 per cent said there was no meaningful resolution, and 17 per cent reported that the situation required a more complex solution than they could provide or achieve.
Those are disheartening statistics. With barriers that numerous, and so few resolutions when concerns were raised, it’s difficult to image things getting better, and even the most optimistic humanitarians get discouraged. Klippenstine made an insightful comment about the realistic direction he’d like to see taken that I’m going to leave you with:
“In the election here they’re talking about throwing a bunch of money into (the mental healthcare system). We all agree that there’s problems, we all agree that there’s barriers. Why are you going to throw more money into a broken system? That’s just going to cost more for the same poor outcomes. So realistically you can’t solve a problem until you start to define it. This was the motivation behind the barrier survey, was to say ‘Let’s just say that we at least agree that not everybody has the same ability to access.’ We also need to ask what I think the fundamental question is – what is healthcare? Psychology doesn’t work well by itself; it is part of a system, so you can’t fix mental health and neglect the other areas… You don’t fix mental health by fixing mental health, you fix mental health by fixing the societal structural needs. I could give you the best therapy ever, but if you’re getting evicted what’s that worth?”