Coping with mental illness is one thing. Navigating the health-care system is another.
Keith Bundock suffers from chronic depression and sought help after a suicide attempt left him in the hospital. By Lauren PelleyStaff Reporter
Sun., Dec. 11, 2016
Keith Bundock isnt sure when his life started falling apart.
He mightve been 35, or maybe 40. During that time, his marriage was breaking down and his church was closing up. His support network was suddenly gone, and he was having odd, unsettling feelings of fogginess and confusion.
Even stranger, though, was that Bundock often didnt feel much at all.
It wasnt until a suicide attempt left him in a psychiatric ward that the east-end resident learned what was really going on: He was coping with severe chronic depression.
Looking back, I can see little flashes of it throughout life I didnt understand it, Bundock, now 53, recalls. I didnt associate what I was feeling with a mental illness.
Once Bundock was diagnosed, he faced a new challenge: To get the treatment he needed, he had to navigate Ontarios complex mental health care system.
With long wait times and an array of services available from different types of care providers, figuring out where to turn and where to start can be tricky when it comes to mental health care, experts say. Theres also a cost element, and determining how to pay for care is often another challenge for people coping with mental health issues, says the Canadian Mental Health Association.
Indeed, people often dont know how to navigate Ontarios bewildering mental health care system, says psychiatrist Dr. David S. Goldbloom, senior medical adviser at the Centre for Addiction and Mental Health. And its probably a misnomer to call it a system, because that would suggest an organization of networks, and thats not the case.
Entry into the system can be, at best, a bit of a shock, he says recalling his experience. Its not smooth and its not clear we dont know what our own needs are when we enter.
Keith Bundock works as a cook at a Toronto group home.
For Bundock, being put into contact with a social worker at CMHA was a huge help.
She was able to walk with me and explore things and was one of those people that would bring things to me that I didnt know were out there, he said.
The social worker helped Bundock access disability support as he underwent treatment with a physician.
It took several years before I could get by without medication, he says. I learned the signs of what was leading me to depression.
That support from his social worker was integral as Bundock began to rebuild his life. He moved into a rooming house and eventually took out a student loan to obtain a culinary degree from George Brown College.
Hes now working full-time running a food program, and volunteers at CMHA his way of giving back to the organization that helped him stay afloat during one of the darkest times of his life.
I volunteer to help people who are in the same place I was, he says.
HOW TO GET HELP
A majority of people connect with mental health services through their family doctor but there are other ways to get mental health care.
Family physicians are a common door 60 per cent of the time for people appearing with mental health issues, says Steve Lurie, executive director with the Toronto branch of the Canadian Mental Health Association.
OHIP covers any care provided by a family physician. If the family doctor is part of a family health team, working alongside psychiatrists, social workers or other professionals, any services provided by professionals on the team would also be covered, Lurie adds.
Family health teams and community health centres are based on rostering patients in a given area, so once you qualify to be served by that family health team … you shouldnt face waits, Lurie says.
If your family doctor isnt on a health team, or you need specialized mental health care beyond what they can provide, you might need your doctor to refer you to a psychiatrist. Or, if you can afford it, you can go through a private clinician like a psychologist or therapist.
Psychiatrists are medical doctors who can prescribe medication, and their services are covered by OHIP. A referral is required from your family physician, and Lurie says there may be significant wait times.
Psychologists arent physicians and cant prescribe medication, so they arent covered by OHIP. But they are registered health professionals, and private health insurance often covers at least a portion of their services.
There are also counsellors and therapists, who may have a background in social work. Again, they cant provide medication, and people pay for their services out-of-pocket.
When it comes to services that arent covered by OHIP, Goldbloom says there is a huge spectrum of costs, since clinicians may have a sliding scale.
Some people may get charged $10 an hour for counselling, because thats all they can afford, while other people may be paying $300 an hour, says Goldbloom. For many people, costs of $100 an hour or more are simply unaffordable.
Going through a hospital is another way to access care, if you cant get it through a family doctor and dont have benefits to pay for private treatment, Goldbloom says.
Every hospital has a psychiatry department, and its not exclusively for hospitalized patients; outpatient services are also typically covered by the umbrella funding of hospitals.
Lurie says you can call an ambulance to take you to the hospital if youre having a severe mental health crisis, but he recommends contacting a specialized mental health crisis centre, like Torontos Gerstein Crisis Centre, instead.
There are also free community resources available to help people navigate the mental health system and find affordable care.
These are complex systems, and so having somebody to navigate and to advocate is always a help, says Goldbloom.
Connex Ontario operates three help lines that provide health services information for people experiencing problems with drugs or alcohol, mental illness, or gambling.
There are also mental health organizations such as the Canadian Mental Health Association, Mood Disorders Association of Ontario, and Schizophrenia Society of Ontario that direct people to the right path for treatment.
How to access affordable mental health care in Ontario
- Talk to your doctor about what youre experiencing and they can either treat you directly or get you a referral to a psychiatrist, both of which are covered by OHIP.
- Go through your workplace employee assistance program if you have one. Check what types of counselling or other services are covered by your benefits plan. This could get faster access to services.
- There is a community organization for just about any mental health issue in Ontario. These are all resources for finding affordable care. More broadly, there is a mental health helpline available through Connex Ontario (1-866-531-2600), and various services are provided by the Toronto branch of the Canadian Mental Health Association.
- If youre having an urgent mental health crisis, dont wait. Call Torontos 408 Help Line at 416-408-HELP (4357) or the Gerstein Crisis Centre at 416-929-5200 24 hours a day.