For those who have followed the controversy regarding thetransfer of some services from Alberta Hospital Edmonton, it is clear that Albertans care about mental health issues. It is also clear that mental health issues are not political ones. We need good plans first and implementation second – not a process of implementation followed by planning – ready, fire, aim. I wrote a Letter to the Editor of the Edmonton Journal on this subject.
Mental health care needs solid, sound plan
Edmonton Journal, January 21, 2010
Re: “Tories back down on Alberta Hospital bed closings; Only geriatric patients will be relocated, top health official says,” The Journal, Jan. 19.
Thank you, Health Minister Gene Zwozdesky. It is time to close this chapter. Ready-fire-aim was not the best way to plan health services. Neither politics, nor special interests, nor focusing only on current budgets make for good mental health policy.
Both the decision to close Alberta Hospital Edmonton and the earlier decision to simply rebuild the facility were not driven by comprehensive plans. Even the AHE review process was not driven by a plan.
The decision to defer the future of AHE to the development of a provincial mental health plan is good. A comprehensive provincial mental health plan was developed and adopted within the last decade; it has yet to be implemented.
The order seems simple — plan first, then invest, finally restructure. Planning is good, but not enough. Committing to implementing plans over the long term is even better.
It is clear to mental health professionals, patients and family members, that programs must be improved. Mental health and addictions are areas where significant employer and privately funded services fill gaps in public services. Many individuals with serious and chronic conditions fall through these gaps and their unmet mental needs become issues of homelessness, policing and poverty.
Mental health and addictions services are still not fully integrated with health and social services, as though mind and body are not two parts of the same person. There are still considerable stigma and many people do not seek services for treatable conditions such as depression, which still tops the World Health Organization list of causes of disability worldwide. We can do much better as a society. That challenges us to both commit sufficient resources and do the right thing for people experiencing psychological disorders.
AHE is not closing, but as we look at what services people need, the role of AHE must be re-examined. It would be surprising to believe that the future of this or any hospital can simply be to continue to do what they have done in the past. The free-standing psychiatric hospital is a product of an earlier model of care. There are newer models of in-patient and outpatient care. Shifting to better models of care must be done responsibly. The earlier deinstitutionalization of patients from hospitals across North America, done without first creating adequate community treatment resources and social supports, was a terrible tragedy. We need to build the comprehensive system of care patients and families need first. What that means for the future of AHE remains to be determined. The goal is not saving a hospital. It is bigger. The goal is developing a better system of mental health care that does right by Albertans. The new health minister’s decision is the right next step.
George Lucki, psychologist and former chair, Alberta Alliance on Mental Illness and Mental Health, Sherwood Park
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