First off, this is being sent to every MHA and full disclosure— I'm going to be posting this online. I've written to all the parties before, and want each and every one of you to read this, but I also want the public to care about mental healthcare too. Sometimes it feels like I’m screaming into the void.
For the last 26 weeks I’ve been demonstrating in front of the Waterford Hospital each Saturday from 30-60 minutes which is the average length of a therapy session. When I started, I wasn't exactly sure what I was trying to accomplish, I was just tired of people dying by suicide and it being accepted as a part of life. But the thing is, suicide is preventable. Not by any one person, but by systemic change and access to mental healthcare.
In 2020 I watched an entire nation come together to save lives and marveled at NL's willingness to do whatever it took to fight Covid-19. Along came CERB, help for businesses, tax breaks, and even mental health programs like Wellness Together and Hope for Wellness. The government was willing to do whatever it needed to save lives and not overflow our hospitals. But by now Covid-19 has claimed the lives of six Newfoundlanders and Labradorians, and I think we all agree that that’s six lives too many.
But did you know that in 2020, 60 lives were lost due to death by suicide in NL? Well, that’s 60 too many. The number of suicides this decade is a 23% increase from the previous decade. And I truly believe the 2020 figure is an underestimate because overdoses and car accidents rarely are documented as death by suicide, due to the uncertainty and stigma. Even today, after all these years, suicide is an uncomfortable subject and hard to reconcile with.
And did you know the cost of a suicide is one million dollars per person?
And the thing is, the number of suicides tells very little of the story. The unemployment, hospitalizations, physical toll, and addictions that result from inaccessible mental healthcare is staggering.
But in December, when I heard of yet another death by suicide, I had reached my limit. Until Covid-19, we had been told over and over that things take time and it's not as easy as it looks to create change. But Covid-19 showed us something. It turns out that change happens if it's deemed important enough.
We hear over and over that our system is broken. (Sorry, I know this is a long letter and I apologize for that, but if I'm expected to read a Greene Report, budget, and Health Accord Report to provide feedback, I hope you can read this.) And it is. But not only do we say it— we accept it(!), thinking that it’s too hard to create change quickly.
But you know how I said access to long-term mental healthcare is systemic? I want to tell you about how my privilege has helped me at each step of my battle with mental health.
I have Bipolar Disorder. My life was a living hell until just a few weeks ago. I was sicker than I had realized and in March of this year I tried to kill myself. I was tired of the 20 years of fighting and convinced that even with all my privilege, I couldn’t do it anymore. I didn’t die after all, and thankfully I'm doing better. Lithium, it turns out, is a wonder drug for my illness. I’m still in the early stages of recovery, but I might have hope after all.
But even though I was so sick, I had it better than so many in this province. Here’s how:
First of all, I live in the most populated area of Newfoundland and Labrador. This immediately puts me at an advantage as I can access the Waterford Hospital or a walk-in clinic.
However, an experience at the Waterford Hospital several years ago was bad enough to make me never want to go back. When I tried to take my life, my boyfriend chose to watch me at home instead of taking me in because I was so scared of experiencing it again. PLEASE don't mistake this as my disliking all the staff; I’m so thankful for the people who work there who care and are trying to help within the current system. I owe my life to Dr. Rees who worked there back in 2016. She saved my life, but my bad experience left an impression and I avoided going at all costs during my breakdowns. I'm still fortunate enough to have the option of staying home because I have people to look out for me even though it’s not fair to them. People often do this for their loved ones. But what about those who don't have people looking out for them? What if they are afraid to go back to a place like the Waterford? Caring for a mentally unwell loved one sometimes isn't possible, whether that be due to a financial, mental, or physical toll. It's not their fault if they can't, but what happens to the mentally unwell person if there is no one there to fill the gaps in the system?
I have a job that pays me a living wage. Keeping my job as I fought through the roller coaster ups and downs was incredibly difficult. I'm not sure how I did it. Working from home was such a wonderful thing for me in this pandemic as I was able to battle my sickness privately. I also was fortunate enough to have a supportive manager . However, I earned a living wage which means I was able to afford proper housing, heat, and food, some things that many are not able to access. I believe having a home motivated me to fight as hard as I did to keep it. I wouldn't have been able to do it if I didn't have proper housing and food. A living wage is KNOWN to be suicide prevention.
Both the PC’s and the Liberals rejected the idea of a living wage and I ask you to PLEASE rethink where you stand. If you are an MHA who believes in it, please make your voice heard even if your party thinks it’s not worth mandating.
The budget outlines that there will be $17 million dollars put into housing-- However, from what I understand due to the bilateral agreement signed with the federal government in 2019, there is federal housing money left on the table because of that. $17 million looks good, but it was less than expected to be in the budget for housing given that federal agreement.
I have a healthcare plan that pays for my medication. Finding a medication that works has been a huge battle. After almost six years, I finally have a medication that is truly effective. But unlike many, I don't worry about paying for it.
I found a doctor who listened to me. This is a huge struggle for so many people. I know those who have been denied referrals to a psychiatrist and or put on the two-year waiting list. I know that wait times have improved if you fall in the urgent care category, but if you're not seen as sick enough, then you are waiting for a really long time. Like the Embracing Experiences Report from the CMHA-NL pointed out, people feel they aren't crazy enough to access care or sometimes they feel they are too crazy to access other services they need. (Page 22 of the report). Are we supposed to lose our jobs, threaten to end our lives, and act crazy enough to access care?
I have a psychiatrist-- I had to wait, but I also waited less than many people. My psychiatrist is knowledgeable and a good human, but I am acutely aware that I need to be in and out of my sessions as fast as possible. They’re extremely busy. I feel equal parts guilty and lucky, as those in the Embracing Experiences Report also mentioned. I feel bad for having ANY complaints because having a psychiatrist at all is a miracle.
I have transportation. When I started lithium, I had to drive to the hospital and also repeatedly now need to get bloodwork done. This requires me to have transportation and take time out of my day. What of those who can't rely on the bus or aren't within walking distance? How do they access medications that require follow up? What if they just give up because it’s too hard to sort through the maze of accessing medication and care?
I had the credit to access therapy in 2020. This saved my life that year. I understand we have Doorways, Same Day Walk-In, and perhaps the most accessible— Wellness Together. However, all these are short term and not permanent options. Trauma and chronic mental illness can't be fixed in one, two, or even six sessions-- treatment needs to be regular and continuous. Preventative and continuous care needs to be an option. I felt privileged to access therapy via increasing my debt.
I chose counseling which was the cheaper option, but it's not even considered medical care and can't be claimed on my tax return. I hear changing this might be in the works-- what is holding this legislation up? We have a refund available for those who access physical health programs-- there should be one for this mental health program too.
As you can tell, my privilege has been apparent every single step of the way, yet I still felt despair, frustration, and got sicker and sicker. Even with my privileged access, I felt the system was too hard to navigate. Fighting to keep my job and home was overwhelming and I knew there would be no safety net to catch me. I was depressed, hypo-manic, paranoid, and living a brain I can only describe as hell— but I still knew how privileged I am.
I keep asking myself how others manage to do keep going without support. Can you imagine?
Imagine not having any safety net in the first place. Imagine not being able to function enough to keep track of appointments. Imagine not having a place that was a safe refuge. Imagine worrying about paying for medications that can make you sick or send you spiraling if you don't take them. Imagine being told you're not sick or suicidal enough to access better care. Imagine not knowing where your next meal is coming from as you fight to live.
I understand you think we are trying to make it better, but emergency and short term care isn't remotely enough; it’s short-sighted. Our thoughts around what mental healthcare is need to change. In your budget I was happy to see you were budgeting more for telemedicine. The $716 000 you have allocated for mental health services through 811 looks good on paper, but what mental healthcare service will it be? More short-term options? Continuity of care is so important and having one-time options is not enough. Nurses refilling prescriptions that need to have already been prescribed?
What are you doing to provide mental health services to those in rural parts of Labrador? I saw that $4.8 million is allocated for a mental health unit in Happy Valley- Goose Bay, but what about in the meantime? I'm thankful this unit will be built, but are six beds enough, and are they for emergency care only? We know suicide rates in Labrador are higher than the rest of the island. Six beds will not solve that.
Regardless of the location, I'm thrilled that the Waterford will be replaced back in St. John’s. However, I worry that the system itself won't change just because there is a new building. All the problems won't go away— they will only be lessened if there are systematic changes from within. It's going to be completed three years from now at the very earliest, so what will you do in the meantime? Three years of people having to be in a terrible building, three years of people avoiding it due to the stigma, and three years of the same approach to care? All I could see was $716 000 for 811 is allocated. That’s all I could find in the budget.
It has become more and more clear that mental health is not seen the same as physical health. And to be fair— it's not the same, but it ought to be equal. This year more cabinet ministers were appointed. Why isn’t there a minister of mental health, Premier? During the many months of press briefings regarding Covid-19, there was very little attention given to mental health. Wellness Together by the Federal Government was NOT promoted in any way until recently. It wasn't even on the Bridge the Gapp website. Dr. Haggie, I’m a fan of yours— but this lack of attention for mental health is not okay. During the campaign I asked over and over what was being done for long-term mental healthcare. Not a single party pointed out Wellness Together. It might not be long term, but it’s more than Doorways and Bridge the Gapp offers.
As much as i like Wellness Together, short term therapy isn’t enough. What of psychiatrists? What are you specifically doing to attract and keep them in this province? Canada has a country-wide shortage of them. What are you doing to make sure they want to work here? The demand is all over the country. I hear a lot of talk about attracting family doctors, but never psychiatrists.
As you can tell, I could go on for a while. I'm not an economist, doctor, or academic. However, I have lived experience and listened to the stories of so many who need help and struggle to access it. I lost a beloved friend whose life ended due to not being able to access the help they needed.
I know we are broke. I know we all have to tighten our belts. Though I live paycheck to paycheck, I would happily pay more taxes if I trusted all of you to fight for long-term mental healthcare.
“What do you want done?” is a question I get a lot when I speak about this. And the truth is that solutions aren’t my job to dream up, even though I still dream. I know you can't pull something from nothing-- but I truly believe that it is possible for you to provide better long-term mental health care within your spending power. i have my list and I’m happy to talk— but we voted for you because we were told you had answers.
I've written each party, I've talked to some of you, but it still feels like no one is listening. Not really. What are some things I think you can do? This isn’t all of it by far, but…
Ask the federal government to offer long term therapy on Wellness Together so people don’t have to do intake again. Therapy with them shouldn’t be focused on ending as soon as possible, but healing at any pace needed.
Appoint a Minister of Mental Health who can be entirely focused on mental health.
Legislate that counseling count as a medical expense in Newfoundland and Labrador.
Increase the budget for housing and income support.
Pressure for the federal government to provide coverage for medication. This was a liberal promise at one point and it was voted down. Again, you have a voice to represent the people in your district.
Work to recruit psychiatrists here or offer incentives to provide services to NL even if they live away. (Have you seen Maple? They do it!)
Change it so people can be on a waiting list for a psychiatrist even if they don’t seem ‘crazy’ enough. Access should be a choice even if it’s a long wait.
Mandate a living wage
Prioritize consistent virtual care to Labrador while searching for people to physically work there. 811 and Medicuro is great, but people need to see the same doctor to establish a history. When it comes to mental health, sharing your story over and over again is traumatizing.
Hire a woman to work with Barry Hewitt. He is a treasure and there needs to be more like him and especially need a woman in a similar role. Please also advertise his services.
The list could go on. I’m not an expert and I know things cost money— but investing in mental health decreases the visits we make to the hospital for our physical health. It also prevents us from needing the most expensive emergency services.
60 people losing their lives last year costs $60 million dollars to Newfoundland and Labrador. Roughly $650 million over the last decade. That cost is from deaths by suicide alone.
I'm not going away. I'm going to keep reminding you that we need long-term mental healthcare. I don't care which party you represent, please know every single one of you represents a person who needs long-term care. It's not a rare need. Please forget about Bell Let's Talk or Awareness Days and prove with action that you care about the crisis that so many people like to forget exists.
I’ll end this for now because I don’t want to lose your attention— but LONG-TERM mental healthcare is desperately needed. You all were voted into power because someone believed in you. Please, please, each of you do your part to make it possible. Change doesn’t have to be so slow. Covid-19 proved that it’s really all about what we think is priority.
See you at Confederation Building tomorrow as long as my vaccine doesn't give me too many side effects, Kristi A
