Systemic Change Needed in the Provision Of healthcare to support vulnerable populations
The stigma surrounding mental illnesses and addiction exists in all settings including places where people go to receive care. Misconceptions and discrimination can and do occur. Negative attitudes of healthcare workers can contribute significantly to adverse health outcomes and can create barriers for people with mental illness and/or substance use disorders in seeking treatment.
We hear often from clients that they feel devalued, dismissed, dehumanized, and rejected by the very services that should be helping them. Such responses from healthcare workers compounds clients’ feelings of hopelessness and low self-esteem. Healthcare practitioners are constrained by a lack of training and support. They may feel their hands are tied when the services they want to refer patients to have long waiting lists. Some give patients the impression that people with mental illnesses and substance use disorders are difficult, manipulative, and less deserving of care. Some providers see the illness rather than the person and have pessimistic views about the likelihood of recovery. Healthcare worker burnout and compassion fatigue also contribute to the treatment people with mental illnesses and addictions receive.
Mental Health Stigma
This culture of mental health stigma is deeply ingrained in our healthcare system and there is no quick cure. Systemic change is needed in how our healthcare structure perceives and prioritizes people with mental illness and addictions. We need to change how services are developed and delivered, as well as shift attitudes and values of healthcare workers on the frontlines.
Studies show that people with a history of mental illness receive poorer care for their physical health problems. Clients commonly report that healthcare workers do not take their symptoms seriously when seeking care for non-mental health reasons. We find clients receive better treatment when staff accompany them to appointments and act as advocates. Our frontline workers know the clients and have a better understanding of what treatment will work best for them. Funding for more staff, particularly more Indigenous workers, to act as advocates is needed.
We need to integrate clinical care with supportive housing sites to better meet the needs of clients. Having onsite nurses makes a significant difference in dealing with healthcare concerns. The current healthcare system creates situations where clients forget offsite appointments or are challenged when managing multiple appointments at different sites. Clients can also be reluctant to attend unfamiliar sites or places where they have been previously mistreated.
People with mental illness and addictions need treatment plans that are tailored to them and that take into account the chaos in which some of them live. More urgent primary care clinics are needed and we need government to invest in healthcare outreach teams. Community transition care teams, such as the one operating at the Pennsylvania Hotel in Vancouver’s Downtown Eastside neighbourhood, have been successful in providing acute care in residential settings. We need more such teams so clients can be treated where they are at and with dignity.
British Columbia is recognized for making progressive changes in the treatment of people with mental illness and addictions. But much more work is needed to overhaul the healthcare system. We urge the government to conduct a study to determine the cost-effectiveness of funding the programs we suggest. Investing in these programs is both the compassionate and the fiscally responsible thing to do.
With your support, we can do more. Say #yesinmybackyard and help #fundmentalhealth.
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