Report on reforming mental health services is a start, says HEU

But input from front-line workers is of utmost importance

In response to a major review of mental health services being carried out in Vancouver, the Hospital Employees' Union has outlined a series of recommendations in areas like housing, training, education and employment opportunities which it says are critical to the provision of mental health services for British Columbians. The Vancouver Richmond health region is carrying out the review because the delivery of mental health services in the region is fragmented. On the ground this means that consumers of the services often fall through the cracks. They are left floundering, not knowing which way to turn for help. A working group was formed to address these problems by providing an overall perspective and making concrete proposals on how to fix them. HEU recognized the importance of the proposals contained in the discussion document and focused on five areas in its response, drawing on the expertise of its 800 members who work in community health services. The shortage of housing is critical. There needs to be not only more housing, but a range of options in the types of place to live, with varying levels of support available. People in a fragile life situation need both stable housing and the flexibility to move from one level of independence to another. Standards, eligibility and discharge procedures need to be defined, according to HEU. The involvement of front-line staff in decision making is crucial. They possess important information and have day-to-day relationships with the people involved. They represent continuity to the consumer of mental health services. Criticizing the report, secretary-business manager Chris Allnutt said, "In our view, the report focuses too narrowly on administrative solutions and linkages, paying too little attention to the key role played by front-line staff, and mental health workers in particular, in implementing best practices." Although their role is important in exercising these methods, too often front-line staff have no formal training in best practices. And this should be addressed, says HEU's response. Precisely because front-line workers gain much of their knowledge on the job, HEU is pressing for training as well as formal recognition of skills learned on the job. To that end it would like to see a training program set up in colleges using the social/rehabilitation model, the use of experienced workers as mentors for new workers and students and the establishment of in-service training programs which are linked to credentialed training. The social/rehabilitation model recognizes that some consumers of mental health services never make a complete recovery and advocates the use of harm reduction. This model is helpful in that it helps individuals to stabilize, work towards their potential and yet still retain some choice about how they will live. HEU recommends that all mental health service providers - community mental health workers, registered psychiatric nurses and physicians - be educated in the social/rehabilitation model. Last, but not least, HEU advocates for the rights of consumers of these services, along with their families, to participate more fully in the mental health delivery system. A Charter of Residentsí Rights for housing and a human resource policy that supports employment opportunities for consumers of the system in the system are two recommendations made by the union. The union reiterated its interest in being full participants in redesigning mental health services in the Vancouver Richmond region. "Our members are very dedicated to their work and to advocating on behalf of the consumers of mental health services," says Allnutt. "Our recommendations reflect this commitment. Their addition to the final document Redesigning Vancouver Mental Health Services will only strengthen the report."