Speaking notes for OPSEU presentation to pre-budget consultation in Windsor

Good morning. My name is Philip Shearer. I am an Executive Board Member with the Ontario Public Service Employees Union – OPSEU – for southwestern Ontario where we represent almost 14,000 members working in youth mental health services, community colleges, the Ontario Public Service, the LCBO, hospitals, long-term care facilities, Children’s Aid, correctional services and in many other occupational groups.

I am here today not just in my capacity as an officer with OPSEU, but as a behavioural consultant for intensive services and complex special needs for children with mental health issues. I work for the Ontario Public Service with the Ministry of Children and Youth Services (MCYS). I have been employed in this field for close to a quarter century now and I take enormous pride in the work that I do.

In July 2015, the Ontario government commissioned the Residential Services Review Panel.  It was funded by MCYS. The review examined foster and group care, children and youth mental health residential treatment, and youth justice facilities. The ministry released the report to the public in July of this year and invited feedback from stakeholders.

The authors of the report got it right. They exposed a broken and fragmented system and made 33 recommendations, most of which OPSEU strongly supports. But this wasn’t the first time an external group painted a damning portrait of our systemic failure to address chronic shortcomings in the care and treatment of children and youth coping with behavioural and mental health issues.

Back in 2006, the Boston Consulting Group concluded the system intended to provide support and services to these vulnerable young people was, and I paraphrase:

confusing, complex, underfunded, and staffed by underpaid professionals who often lacked the proper training. The licensing mechanism failed to focus on quality care and varied from region to region in Ontario. Access to residential services failed to meet guidelines and waiting lists were too long.

Sound familiar? It should. That’s because 10 years later, in 2016, conditions have deteriorated even more, according to the Residential Services Review Panel that I mentioned a moment ago.

Sadly, the issues identified 10 years ago persist today – with one important difference: bed capacity in the system has dramatically declined. Unbelievably, there are 35 per cent fewer beds today than in 2006. Back then, there were 24,800 licensed residential beds. Today that number stands at about 16,100 beds. That’s an elimination of more than 8,700 children’s residential beds.

How on Earth are we supposed to properly treat the growing number of young people with behavioural and mental health issues, when we have slashed residential capacity by more than a third? If someone in this room has a solution, I invite them to step forward.

A moment ago, I mentioned that OPSEU supports many of the recommendations contained in this year’s Review Panel. But we remain deeply troubled that the report fails to put a spotlight on the chronic underfunding that underpins shortcomings in program delivery by failing to provide an adequate level of bed capacity in the system.

We’re not the only ones to hold this view. Even the employer group – Children’s Mental Health Ontario (CMHO) – has said that the funding crisis in residential services has failed to keep pace with demand. In its own report this year, the CMHO concluded: “Service providers can no longer afford to keep up with increasing demand and many are being forced to reduce their treatment beds and/or close their residential programs altogether.”

This is what Kim Moran, chief executive officer of the CMHO, has to say about the shameful conditions faced by young people with severe behavioural and mental health issues:

Ontario has turned its back on children and youth in desperate need of mental health services. Unacceptable wait times and insufficient access to mental health professionals have created a crisis. Many families are struggling tremendously because of this lack of access to care.

In the face of this crisis, where do vulnerable young people and their parents or guardians turn to? They turn to hospital emergency rooms and in-patient hospital admissions. Is this how we are supposed to treat some of the most vulnerable children and young people in Ontario? By warehousing them in hospital wards, without the necessary professional services available? I think not, and most care providers in my field would strongly agree.

Since 2006, there has been a 54 per cent increase in emergency department visits and a 60 per cent increase in hospitalizations for children seeking treatment for mental health issues, according to the Canadian Institute for Health Information.

The institute calculates that a strategic investment of $65 million in community-based children’s mental health centres will reduce wait times and ensure that kids receive timely access to treatment. In doing so, the province will actually save as much as $145 million in hospital costs.

No part of the province is immune to the crisis that has created wait times of up to 1.5 years for treatment in some regions. The CMHO estimates there are nearly 9,000 kids waiting for long-term psychotherapy such as cognitive behavioural therapy or intensive treatment for those with severe mental illness and who are in dire need of support.

In the western region of Ontario, which includes Windsor and London, some centres are reporting wait times of up to seven months.

It’s actually worse in other parts of the province, the CMHO says.

In eastern Ontario waits can last as long as two years.

In northern Ontario, wait times typically exceed one year.

It’s the same in the fast-growing suburbs of the Greater Toronto Area, where it’s not uncommon for wait times to hit one year.

This is unacceptable. As a society which claims to care for all – and which, in the view of many economists, has the financial resources to provide  care for all – we should be ashamed of this profound neglect.

There is no simple solution to the crisis. But let me start with a few suggestions that I know are shared by frontline workers, organized labour, employers, families and guardians. Room in next year’s budget must be found to provide for remedies before a dire state of affairs collapses into chaos.

We urge the government to adopt the recommendations contained in the Report of the Residential Services Review Panel. Support for these recommendations is widespread and shared by all stakeholders.

In particular, the government must take immediate steps to address the funding crisis as set out in the report of the Review Panel.

But we don’t want to be told, “We can’t meet your funding expectations because the kitty is empty.” It’s not. Per capita Gross Domestic Product in Ontario is at an all-time high.  There is more money in this province than ever before – which means all the great things Ontario did in the past were accomplished when we were poorer than we are today.

Looking for money? Let’s not look any further than the Auditor General’s report which – once again this year – said the government is burning through cash on public-private partnerships (P3s) like there’s no tomorrow.

And yet this government is still somehow proud of the fact that Ontario has the lowest per capita program spending of any province in Canada!

How can any of us be proud of that when we look at the crisis in children’s mental health? If we have any hope of reversing the downward spiral in this health care sector, we have no choice but to accept the advice of every expert in the field who says underfunding is at the heart of the problem.

Let’s stop saying there is no increased funding available for vulnerable children and young people. They are our most precious asset, and if we can’t treat them today, we are only putting off spending until tomorrow when worsening conditions will put even greater pressure on the public treasury.

Thank you. I would be pleased to take your questions. 

Publication Date: 

Thursday, December 15, 2016 - 2:15pm