When people are asked if mental health services for mental illness should be accessible to everyone they almost always answer “yes.” This then begs the question: Why isn’t this the case? Because in theory it is great; practice, however, is another can of worms. These services are expensive, invisible and subtle. It is easy to pay lip service to the importance of these services … not as easy to actually pay for them to exist.
Mental health is costly! It is expensive to provide or support these services financially to ensure greater accessibility for the public. In health care systems that are large and ineffective the layer of middle management that encourages bureaucracy to protect their very existence takes away money from front line services. This results in fewer qualified people in fewer positions where the mental health needs of the public can be served. When cuts are made they are not made “upwards;” managers look below themselves to determine what services are cut. This is the very opposite of increasing accessibility (which governments and health care systems say they want!). When governments cut funding to programs that support mental health these programs have to rely on public assistance, which is not always forth coming, then these programs are gone as well! Again… the opposite of increasing accessibility.
Governments, businesses and organizations like to promote what they have done and how the money they have spent has proven they are “accountable.” This is tricky with mental health issues as it is difficult to measure objectively the improvement in a public forum. If a person has surgery on a broken hip the outcome is measureable; it is black and white. Not so when it comes to mental health; the results must protect confidentiality. This invisibility reduces the desire/interest of people to put money into these services, which is another barrier to accessibility!
At Shift the biggest obstacle to a client completing their therapy is cost. We attempt to increase accessibility to services by providing services from counsellors, provisional psychologists, as well as registered psychologists; additionally we offer a sliding scale. This, however, is not enough for clients that require access to residential treatment or who have psychiatric concerns or who just cannot afford to access therapy in a private practice either because they have limited benefits or no benefits. There needs to be more! More walk-in clinics, more front line workers in our health care system, more funding for programs like the YWCA and Support Network, and more financial support for people to participate in therapy. The costs of NOT increasing accessibility are too high! We have all read about the tragedies where mental health was hidden or not treated; we need to insist on change at a fundamental level – how services are delivered needs to be altered to actually make services accessible.