Michelle Danda and Trish Dribnenki: Systemic problems exist in mental health services, too

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If the system shifts away from police as first responders, and towards mental health professionals intervening in someone’s mental health crisis, the public needs to be aware that systemic neglect is also deeply embedded in the mental health system.

For example, in mental health emergency departments and/or community mental health teams, people are turned away because they do not meet admission criteria or when admission is determined to be “unhelpful” to the individual. In practice, the system condones labels to describe patients such as frequent flyers, drug seeking, substance intoxicated, malingering or treatment resistant.

Individuals are discharged or referred elsewhere for “not fitting the mandate” or “being non-compliant” with treatment. Individuals are turned away for being “too behavioural,” “too violent,” “too needy,” “too bizarre” or even “too suicidal” for hospital admission.

When this happens, we must ask broader system-focused questions, including: If individuals are “too much” or “not enough” for hospital admission, then who is responsible for providing support? Unfortunately, this is where our mental health and health care systems have by default left police to “support” those for whom the system does not create space or time.

Vancouver news reports identified a woman who died alone in her apartment despite recent assessment by her mental health team. In this case, the health authority issued a formal apology. An apology for someone who died as a result of holes in the system is grossly inadequate. It’s unacceptable. The system must change to ensure those who are experiencing a diverse range of life challenges from all socioeconomic statuses, lifestyles, cultures and ethnicities get the care and support they request and deserve.

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