A7

Peter T. Smith

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We're going to sell NB Power, or not, and the lights will still come on when you hit the light switch. We're going to elect Shawn Graham next fall, or David Alward, and policy will be made and pundits will chirp. People will commit notable acts of cruelty and kindness, and we'll read about them in this paper. Life, irrespective these important decisions, goes on.

But things really don't go on so well if you are seriously mentally ill and can't get to see a psychiatrist.

Last week, the Fraser Institute, a right-wing think tank in British Columbia, released a report with the self-explanatory title "National Psychiatry Waiting List Survey 2009," which indicated that New Brunswickers have the longest waits to see a psychiatrist. The median wait time for a New Brunswicker referred to a psychiatrist is 30 weeks. This represents the overall time from referral to seeing the specialist to beginning treatment. If you have a serious psychiatric illness, you can't wait more than six months to begin treatment by a specialist and a good health outcome.

Psychiatrists are medical doctors who have specialized in psychiatry, which is the branch of medicine that deals with mental illness. Like their colleagues who are oncologists or pediatricians or orthopedic surgeons, they completed a medical degree, then undertook further training in a medical specialty. They are not psychologists, which is certainly a related profession which can have some degree of overlap. Psychologists are important (and we do need more of them, too!) but they aren't psychiatrists, and psychiatrists are in short supply.

The Fraser Institute has a history of being criticized for its research methodology, and this study is not an exception to that history. In addition, rankings such as this are philosophically intended to promote competition (or more radical free market outcomes) between those ranked. However, the neo-liberal principles underlying the ranking is immaterial to the data generated.

Any problems with the methodology can be minimized; we all know wait times are daunting in this province, and with at least one psychiatrist reporting a seven-and-a-half month waiting list, the Fraser report just quantifies what we already know is a problem. In addition, psychiatrists who responded to the Fraser study also provided clinically appropriate wait times. The actual wait times were 150 per cent longer than those times.

If, at a later date, a more comprehensive study shows a larger margin of error or somewhat different figures from the Fraser report, it's just academic - sick New Brunswickers are waiting too long to see these specialists and we know it. The president of the New Brunswick Psychiatric Association estimates a 25-per-cent increase in psychiatrists is necessary to give people good access to these medical specialists.

Meanwhile, the McKee report waits to see reality. Judge Michael McKee studied the state of mental health services, including ramifications in the legal system, and released 80 recommendations in February. The president of the College of Psychologists has expressed disappointment with Health Minister Mary Schryer's response to the report in September.

There are good parts to the government's response, but there is no question it is inadequate. Schryer promises a new mental health strategy in the spring. It would be wise to give her a chance to deliver on this promise; although it was Kelly Lamrock providing the sound bites for the Department of Social Development, it was Mary Schryer who was the minister who got the ball rolling for this month's $5-million to $8-million anti-poverty initiative. She may yet deliver on mental health.

In Nova Scotia, an inquiry is playing out into another death of a mentally ill person in custody. Howard Hyde suffered from paranoid schizophrenia - a life-altering illness that can be disabling to those afflicted with it. Hyde was tasered as many as five times by Halifax police, sent to court, then to a correctional facility in Dartmouth. Three correctional officers restrained Hyde, one admitting to putting his body weight on the prone man, when he refused to go down a hallway because of the "demons" lurking there.

The story has all the nightmare elements of the legal system mishandling a person with a serious mental illness: questions of stun-gun use, lack of a mental health court, guards with insufficient training in dealing with the mentally ill, and a death which could have been avoided. It's like we as a society learned nothing from the Ashley Smith tragedy.

When we know the scope of the problem as well as its solution, this "worst case" mishandling of mental illness should never be repeated.

Peter T. Smith is a teacher and writer. His column appears Tuesday.