British Columbians want mental health services paid for by the province’s health care system, but the challenge is figuring out how to pay for it, says Premier John Horgan.
Horgan told CHEK News he’s “open to” the idea raised by B.C. Green leader Sonia Furstenau and the B.C. Psychological Association to embed psychologists inside doctors’ offices and cover their sessions under the MSP fee-for-service system so that people don’t pay out-of-pocket for mental health treatment.
He linked mental health to his long-standing desire to see dental care covered under medicare, which Horgan first raised in 2018 but then put on the back burner due to estimated costs of more than $1 billion.
“Dentistry and mental health – the two of them together most families would go, boy it sure would be nice to know that is covered,” said Horgan.
“I think society is there. The challenge is can we get a budget in place that would address those issues, [and] make sure we’re not adding additional costs to get health care for mental illness or dental care.
“These are discussions people want to have. The challenge now as we come out of a pandemic is where do we find the resources, how do we build up these systems? And I’m very much open to that. And I know [Mental Health Minister] Sheila Malcolmson will be bringing that forward over the course of the budget process going into the spring and into next year as well.”
Mental health would undoubtedly add hundreds of millions of dollars, if not billions, to an already large annual health budget. The province currently spends more than $23 billion on health care annually, which is almost 40 per cent of the entire provincial budget.
Furstenau has been championing the idea of a 12-month pilot project for publicly-paid psychologists, warning a “mental health shadow pandemic looms” as people struggle through the COVID-19 crisis and restrictions. She said such a plan was in the works before Horgan called a snap election in September, and then was cancelled by his government after he won a majority in October. Horgan disputed that.
“There was no plan for a pilot,” he said. “I know the association has been advocating for that. And Sheila Malcolmson, the minister and now MLA for Nanaimo, will be looking at all those initiatives.”
Psychologists have warned the pandemic has caused a spike in mental health concerns, with the number one prescription being asked for by patients related to anxiety. Anti-depressants are close behind. A government survey early in the pandemic showed at least half the respondents identified their mental health as having worsened during the health crisis.
One current barrier to mental health service is cost. A private session with a psychologist averages $190 an hour. Rates can vary for private counsellors with varying levels of education. And psychiatrists are even more expensive.
A second barrier is long wait times clogging up the system for the few publicly-paid mental health treatment services available by health authorities. The average wait time for a first treatment session on the Island is 54.5 days, according to the Ministry of Mental Health. That’s lower than 69.3 days in 2016, but it doesn’t reflect the true wait in the system because the types of services, referrals and treatments can vary.
On Vancouver Island, the issue of youth mental health treatment has been in particular focus since 16-year-old Andre Courtemanche, of Langford, took his own life earlier this month at the Goldstream trestle.
His family issued a public plea for better youth mental health treatment, saying Andre had been waiting a year to see a publicly-paid psychiatrist through the health authority. His family received a call to set up his psychiatrist’s visit two days after he went missing.
“My heart goes out to Andre’s family,” said Horgan, who as Langford-Juan de Fuca MLA has the Courtemanche family as constituents. “I have reached out to them. My office is reaching out to the team of officials, from the Island Corridor, to the City of Langford the Vancouver Island Health Authority, everyone who is coming together to try and find a way to give some meaning to Andre’s death.”
Horgan said he supports calls for barriers at the Goldstream trestle site, where several other people in crisis have taken their own lives in the past few years.
“Whatever we can do as a society to protect vulnerable people who are struggling, we need to do,” said Horgan.
“This is now symbolic for Andre’s family and many others that we can put in safety provisions to protect people.”
But on the larger issue of youth mental health, Horgan said his government is making progress.
He cited 16 years of underfunding by the previous Liberal government and said he’s moving to better integrate mental health into the new urgent primary care clinics his government has opened across the province.
The premier is also moving to boost youth counsellors in schools and accelerate the Foundry BC youth mental health and addictions program.
If you or someone you know is struggling and need someone to talk to you can reach out to the Vancouver Island Crisis Line 24/7 at 1‑888‑494‑3888 or by clicking this link.