Nova Scotia lacks a province-wide plan for “how and where” mental health services are delivered across the province, according to a new report from the auditor general.
“There are currently no plans,” Michael Pickup said, in his report released on Wednesday.
The report notes that the health authority, health department and IWK Health Centre missed a March 2016 deadline to create a province-wide plan. Health authority management told Pickup the deadline was “not realistic” and work is ongoing.
He also says the 2012 mental health strategy was “poorly managed” and there are no plans to evaluate whether mental health care improved between 2012 and 2017.
Meantime, he says the IWK does have a mental health services plan, which is annually reviewed and updated.
Pickup’s report also notes that wait times and wait time standards vary across the province, as does the availability of crisis support.
The report says whether you get crisis support depends on the time of day, where you live and the policies in place in that region.
“In many locations, crisis response services only operate during daytime hours from Monday to Friday,” the report said.
Asked if those hours for crisis support made sense, Health Minister Randy Delorey maintained “there’s crisis support and emergency support for Nova Scotians that is available throughout the province.”
For example, he said Nova Scotians can call emergency 911 services when they need help.
“We recognize that there’s work to be done,” he added. “We’ve taken steps to move forward.”
Pickup also noted that Dartmouth General is the only regional hospital without a crisis response service and no psychiatry support for the emergency department even though last year, its ER dealt with 1,400 mental health-related complaints.
“Dartmouth General staff expressed concern that the current system is not patient-focused,” the report said.
Pickup adds that some hospital sites have “comprehensive and well-defined” crisis response policies. But at least one — the Aberdeen Hospital in New Glasgow — doesn’t have any formal policies.
And he says there are patient and staff safety concerns because of lacking or “weak” policies and practices.
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Pickup suggests the province, health authority and the IWK deliver the plans and ensure they are implemented on schedule, use evidence-based policies and ensure that the policies are evaluated.
In response, the Nova Scotia Health Authority says it is already working on improving the system.
“We know Nova Scotians are eager to see change and improvement in this and other areas and so are we,” the authority said in a statement.
“Much of the foundational work is done—we’ve gathered the evidence, worked on required policy and information supports, met with staff and physicians for their input and feedback and will soon go out to meet with partners and the public to finalize actions for implementation. We will see a more effective and sustainable system come from this work.”