New Brunswick’s child and youth advocate says, although the province has increased funding and training for mental health services in the past year, its long-term plan is “still too vague.”
Kelly Lamrock’s finding was included in his office’s first update on the New Brunswick government’s implementation of recommendations from the Youth Suicide Prevention and Mental Health Services Review.
Under the Child, Youth and Seniors’ Advocate Act, Lamrock had asked the Department of Health to provide a progress response on recommendations from recent reports. According to a news release from the province Monday, this was part of a new recommendation monitoring process, which Lamrock intends to use to hold executive brand of government accountable.
“Often reports get released, discussed, and forgotten,” said Lamrock. “It is our intention to make sure that we advise the legislative assembly and the public what government is and is not doing to follow up on reports from the advocate’s office.”
The first focus was set on tracking recommendations from The Best We Have to Offer, No Child Left Behind and A Matter of Life and Death — three reports covering youth mental health services to provide guidance for suicide prevention, detection, treatment, and compassionate urgent response.
“We know that the system failed young Lexi Daken,” said Lamrock. “We approached this update with one key question in mind – would the outcome be different today? We want to see signs that people with power have acted with urgency and learned from the past.”
Lexi Daken was suicidal when she went to the emergency room at Fredericton’s Dr. Everett Chalmers Hospital on Feb. 18, 2021. The 16-year-old waited in hospital for eight hours to see a psychiatrist but instead left the hospital with a referral. She died by suicide six days later.
Lamrock identified three themes to categorize recommendations in the reports from the Youth Suicide Prevention and Mental Health Services Review. Those are:
timely access to care
community support for timely prevention and detection
governance that advances child rights, not government silos
In reviewing those areas, the advocate found progress was made in increasing the funding and human resources in the mental health sector, providing better training and knowledge transfer processes for urgent care, and providing preliminary funding in needed areas, such as social pediatrics, FASD research, and walk-in mental health services.
However, Lamrock found serious deficiencies concerning planning and long-term strategies in several key areas, such as human resource recruitment, community partnerships, First Nations services, and primary care in mental health.
“As one young person said, there needs to be something between sitting at home and going to the emergency room. To get there requires not only more funding and goodwill. It takes a long-term plan with long-term funding and clear objectives,” Lamrock said. “A pilot project without a plan is just a placebo. Services in one First Nation are only an adequate response if there is a plan for all 15 First Nations. Blaming staff shortages is only acceptable if you have clear numbers and a plan to train those people. Funding a community program is only effective if they have a long-term role and secure funding.”
Lamrock adds there has been some ideas put forward, but says now it’s time to see sustained interest and leadership that turns an idea into a system. He says he will expect to see that in his next interim report.
Lamrock said he will issue a second progress report in 2023 and set out the following expectations of government:
Have a credible recruitment plan to attract mental health professionals.
Provide training to consider youth mental health issues in emergency response with a more child-friendly and culturally sensitive approach.
Establish clear practice standards with identified and documented best practices.
Expand treatment options outside urgent response with a clear plan.
Invest in peer networks and schools or community programs as part of a global plan for youth mental health and suicide prevention in the government’s Mental Health reform.
Appoint a point person and a department responsible for First Nations mental health and have a credible plan for all 15 First Nations.
Plan for youth engagement and peer training.
Identify community partners with defined roles with clear funding included in the government’s budget.
Review the complex case protocol and expanded use of integrated teams.
Simplify integrated planning for children with acute mental health needs by identifying barriers and setting a plan to eradicate them.
Implement clear responsibility and accountability measures at the cabinet and bureaucratic levels.
Lamrock said signs of improvement to Integrated Service Delivery (ISD) showed commitment from the government through the amendment of the Child and Youth Well-Being Act. He urged the government to adopt the practice of assessing, opening a file and completing an ISD plan for every child or youth treated for emergency mental health services or who has shown signs of suicide ideation.
He says he has opened an investigation into training and recruitment of mental health professionals and funding for programs through the Department of Post-Secondary Education, Training and Labour. He further urged the government to ensure that the surplus addresses the current issues in emergency services.
Lamrock also cited the need for the federal government to act quickly in providing funds to provinces to address the emergency room crisis.
“Accountability is fine, but the federal government does not need a study to know that the system is straining,” said Lamrock. “Bob Dylan famously said that you don’t need to be a meteorologist to know which way the wind is blowing. Similarly, we do not need studies to know that our emergency rooms are in crisis.”
Lamrock says he plans to report back to the legislative assembly in about eight months.