Support for mental illness: British Columbia and Alberta
- Cynthia Yuen
- Nov 30, 2022
- 6 min read
Stacey (RRT from B.C.)and I (RRT from Alberta) compared the support for mental illness between British Columbia and Alberta.
Rasali et al. (2020) examined the prevalence rates of common chronic diseases occurring in Canada: cardiovascular disease, respiratory disease, mental illness, hypertension, and diabetes. Interestingly, in the years 2011-2012 up to 26.5% of Canadians suffered from two or more of these chronic diseases concurrently – multimorbidity. This discussion looks at mental illness and compares the similarities and differences in surveillance, management and funding across two provinces in Canada: British Columbia (B.C.) and Alberta. One in three Canadians will have a mental illness in their lifetime; mental illness has a significant disease burden.
Surveillance (British Columbia)
In comparison to the national average of comorbidities, B.C. had a 24.8% prevalence rate of comorbidities in the years 2011-2012. As noted by Rasali et al. (2020), there is no standardized surveillance methodology that exists for the chronic diseases commonly seen across Canada.
The B.C. Alliance for Monitoring Mental Health Equity (2022) is an organization focused on research which uses evidence-based findings to form recommendations to policymakers. Their work includes a monitoring tool which reflects proposed research, and current findings/recommendations.
The BC Centre for Disease Control (2022) monitors chronic diseases across jurisdictions within B.C. Figure 1 reveals incidence rates for six different chronic diseases in the Vancouver Coastal Health region. Although there is a trend downwards for mental health (defined in this cohort as depression or anxiety diagnosis) between the years 2001-2015 the incidence has remained relatively stable, and high, throughout the years. Figure 2 captures how in one year, 2015, depression and anxiety was the chronic disease with the highest rate of new diagnoses.
Figure 1 (BC Centre for Disease Control, 2022).
Figure 2 (BC Centre for Disease Control, 2022).
Surveillance (Alberta):
Surveillance of chronic diseases, which involves the systematic collection, analysis, interpretation, and dissemination of data, is essential for strategic planning, program development and healthcare system monitoring (Lix et al., 2017).
The prevalence of treated psychiatric disorders was similar in British Columbia and Alberta at about 15% (Kisely et al., 2009).
Findings from the provinces showed remarkable consistency across age and sex, despite variations in data coding. Women tended to show a higher prevalence overall of treated mental disorders than men. Prevalence increased steadily to middle age, declining in the 50s and 60s, then increasing again after age 70 (Kisely et al., 2009).
Management (British Columbia):
· Several organizations within B.C. are dedicated to empowering society by providing information and education, such as Cultural Humility, Creating a Climate for Change and the BC Centre for Elder Advocacy and Support (Government of British Columbia, n.d.).
· 24/7 suicide hotline, including one specifically for children. A non-urgent mental health hotline is also available to discuss concerns. Online chat and services/resources, in-person resources and email services are available for many different forms of mental illness (e.g., substance use, psychosis, eating disorders, etc.). (Government of BC, n.d., b).
· BC Mental Health and Substance Use Services (2022) provides mental health services through their 620+ residential treatment and transitional housing beds along with 6 outpatient clinics.
Management (Alberta):
Organizations such as Mental Health Foundation Alberta, Wellness Together and Togetherall empower people to seek and provide mental health support (AHS, n.d.c).
Alberta Health Services operate an Alberta-wide mental health helpline, a 24/7, confidential service that provides support, information and referrals to Albertans experiencing mental health concerns (AHS, n.d.a).
Various mental health services are available to manage different stages of mental illness, such as urgent care, regional psychological assessment service, community addiction and mental health clinics, short-stay unit follow-up clinics, adult day hospital, active rehabilitation programs and mood disorder programs (InformAlberta, n.d.a). There are also services to support children and adolescents, such as youth outpatient counselling, adolescent day treatment program, child adolescent addiction mental health and psychiatry program community clinics, and child and adolescent inpatient mental health services (informAlberta, n.d.b).
For patients involuntarily detained under the circumstances stated in the Mental Health Act, a community treatment order (CTO) under the Mental Health Act is a tool to assist patients with mental illness to comply with the treatment and care while living in the community. The treatment and care plan is tailor-made to meet each individual’s needs and may include taking medications and attending appointments (Government of Alberta, n.d.).
Mental Health Regional Housing provides transitional living options for adults with serious and ongoing mental health problems (AHS, n.d.b).
Funding (British Columbia):
Issues: inequalities are rampant in care for mental illness, with organizations like the BC Alliance for Monitoring Mental Health Equity (2022) stating that funding is necessary to address unequal access to care. The pandemic increased accessibility to care and exacerbated the prevalence of mental illnesses across Canada, including within B.C.
The BC provincial budget outlined 2 billion for new resources over four years for mental health, which was recommended by the Canadian Mental Health Association, BC Division (Canadian Mental Health Association, 2022). This is a significant increase – $375 million per year – when compared to the 2017 BC provincial budget. There are some specific allocations, such as $164 million for complex care housing and $633 for the prevention/management of homelessness.
Funding (Alberta):
For the budget in 2022, Alberta’s government has planned to allocate $1 billion annually for addiction and mental health care. Also, there will be additional funding of $60 million over three years to build a recovery-oriented system of care (Government of Alberta, 2022).
The recovery-oriented system of care includes support services specifically for youth’s mental health, the establishment of the Alberta Recovery Council, and 8,000 addiction treatment spaces (Government of Alberta, 2022).
In 2020, Alberta’s government spent more than $53 million to enhance online, phone and in-person mental health and addiction recovery support during and after the COVID-19 pandemic (Government of Alberta, 2022).
Similarities between Alberta and B.C.:
Surveillance:
Canadian Chronic Disease Surveillance System (CCDSS) infrastructure was used as the basis for creating electronic chronic disease registries in the Alberta and British Columbia provinces.
The prevalence of treated psychiatric disorders was similar in British Columbia and Alberta at about 15% (Kisely et al., 2009).
Findings from the provinces showed remarkable consistency across age and sex, despite variations in data coding. Women tended to show a higher prevalence overall of treated mental disorders than men. Prevalence increased steadily to middle age, declining in the 50s and 60s, then increasing again after age 70 (Kisely et al., 2009).
Management:
Both provinces have organizations that are either directly operated or funded by the provincial government to advocate mental health. Helplines are available to provide 24/7 mental health support, mental health services for adolescents and transitional housing are also available in both BC and AB.
Research and analysts examined data across 5 provinces (2 of which were Alberta and B.C.), highlighting important mental health findings (Butler et al., 2017). Figure 3 shows relatively similar findings in B.C. and Alberta for those afflicted with mental illness having access to the same physician. Both provinces trend upwards and above 80% for ages greater than 35 years. Alberta is slightly below B.C. (< 80%) for ages <35 years of age.
Figure 4: Physician follow-up 30 days post emergency department visit for mental illness (Butler et al., 2017)
Figure 4 reveals Alberta performing slightly better for follow-up by physicians 30 days after post-emergency department visits for mental illness. The largest difference was found with ages > 85 years.
Figure 5: Rates of suicide per 1000 (Butler et al., 2017)
Figure 5 reveals very similar rates of suicide per 1000 individuals between Alberta and B.C., with the most notable difference in 10-14 years of age, with Alberta having slightly higher rates.
Funding:
British Columbia and Alberta have increased the mental health budget. Both provinces allocated additional budgets in response to the increased mental health support related to the COVID-19 pandemic.
References
Alberta Health Services (AHS). (n.d.a). Mental Health Help Line.
Alberta Health Services (AHS). (n.d.b). Mental Health Regional Housing.
Alberta Health Services (AHS). (n.d.c.). Help in Tough Times.
BC Alliance for Mental Health Equity. (2022). BC alliance for mental health equity. https://www.bcammhe.ca/
BC Centre for Disease Control (2022). BC Community Health Data.
BC Mental Health and Substance Use Services. (2022). Caring for people with complex mental health and substance use challenges.
Butler, A., Adair, C.E., Jones, W., Kurdyak, P., Vigod, S., Smith, M., Lesage, A., Bolton, J., Madi, N., Sareen, J., Enns, M., Rochette, L., Rittenbach, K., Bakal, J., Youngson, E., Clellandm S., Bercov, M., Santana, M., Goldner, E. M. (2017, July). Toward quality mental health services in Canada: A comparison of performance indicators across 5 provinces.
Canadian Mental Health Association. (2022, February 22). BC budget 2022: New mental health and addiction spending.
https://cmha.bc.ca/news/bc-budget-2022-new-mental-health-and-addiction-spending/#:~:text=The%20overall%20allocation%20of%20%24633,on%20adults%20and%20older%20adults.
Government of Alberta. (2022). Toward an Alberta model of wellness.
Government of Alberta. (n.d.). Mental health patient right.
Government of British Columbia. (n.d.a). Education and awareness.
Government of British Columbia. (n.d.b). Psychosis and thought disorders.
Government of Canada. (2015). Report from the Canadian Chronic Disease Surveillance System: Mental illness in Canada 2015.
InformAlberta. (n.d.a). Adult Addiction and Mental Health Services - Calgary Zone.
InformAlberta. (n.d.b.). Child and Adolescent Addiction and Mental Health Services - Calgary Zone.
Kisely, S., Lin, E., Lesage, A., Gilbert, C., Smith, M., Campbell, L. A., & Vasiliadis, M. (2009). Use of Administrative Data for the Surveillance of Mental Disorders in 5 Provinces. The Canadian Journal of Psychiatry.
Lix, L. M., Ayles, J., Bartholomew, S., Cooke, C. A., Ellison, J., Emond, V., Hamm, N. C., Hannah, H., Jean, S., LeBlanc, S., Paterson, J. M., Pelletier, C., Phillips, A. M., Puchtinger, R., Reimer, K., Robitaille, C., Smith, M., Svenson, L. W., Tu, K., . . . Pelletier, L. (2017). The Canadian Chronic Disease Surveillance System: A model for collaborative surveillance. International Journal of Population Data Science, 3(3).
Rasali, D., FACE, Li, C., & Rose, C. (2020). Measuring multimorbidity to support chronic disease management and prevention. BC Medical Journal, 62(4), 135.
Togetherall. (n.d.). Get support: Take control: Feel better.
Commenti