British Columbia's minister for child welfare says her government has not done enough to improve mental health services for children and youth but promised to unveil a plan shortly to alleviate what a new report describes as a "wildly inconsistent and chronically underfunded" network of care.
Stephanie Cadieux, Minister for Children and Family Development, was responding to a report Thursday about a 16-year-old boy who killed himself in 2013 when he could not access the support he needed from a provincially funded aboriginal mental health care system.
The youth, identified by the pseudonym Chester in the report by the province's child and youth watchdog Mary Ellen Turpel-Lafond, was not even in the two-year-long queue for mental health services despite requests from counsellors who were concerned about his hallucinations and threats of suicide.
"Chronic understaffing and administrative confusion at [aboriginal child and youth mental health] meant that two calls made by service providers on behalf of Chester did not result in a referral and there were delays in even having discussions about the possibility of service for him," wrote Ms. Turpel-Lafond, the Representative for Children and Youth.
Ms. Cadieux said her ministry has improved services since Chester's death, but agreed with the report's conclusion that more needs to be done.
"Clearly the system as it was failed and that's tragic," she told reporters. "We've made a lot of improvements and we are continuing to do more [but] it's not enough and we know that and we are going to be doing more." She said a cabinet committee is working on a new plan and it is due to report back soon.
The report describes Chester as a "sweet" boy from a close-knit family, but teachers, counsellors and medical professionals did not get a complete picture of his deteriorating mental health.
The failures of the fragmented support network were exacerbated because the delegated aboriginal agency responsible for his file – which is not named in the report to protect the youth's identity – allowed support services to slide while staff frantically prepared for a government audit of its chronically subpar performance record.
"Seriously misplaced priorities by the entities responsible to help Chester also had an effect," the report says. The Ministry of Children and Family Development (MCFD) launched a routine audit of the agency in late 2012, while it was supposed to be delivering services to Chester and his family. The audit "caused a panic" and the agency "focused almost all its efforts on getting its files in order in advance of ministry scrutiny, rather than prioritizing the children and youth it served."
But Ms. Turpel-Lafond reserved her harshest criticism for the provincial government, saying it has starved the system of needed resources.
"This is a known cohort of children and youth who require support and seek a therapeutic system that understands and supports them, yet instead, they get a brick wall." This spring, three years after Chester's death, the waiting time for mental health services for aboriginal children and youth in his region was 270 days.
Ms. Turpel-Lafond also singled out MCFD, the ministry that is fully responsible for overseeing delegated aboriginal agencies. Despite a long-running record of failed audits at the agency that had Chester's file, the ministry continued to hand over funding without a clear plan to improve services. Months before his death in May, 2013, the agency was only 40 per cent compliant with ministry standards.
"The audits were not the only warning bells ringing and MCFD did not have the inclination to step back and assess or respond to a crisis over a decade. That speaks to a level of indifference that is troubling," she wrote.
Ms. Cadieux said the government has changed the intake process so that children and youth can get a clinical assessment faster, but the average waiting list for services is still 84 days. However, the report notes that the challenges are not limited to any one agency, region or population. Fewer than one-third of the children and youth in B.C. with mental health disorders are receiving the specialized services they need.
Melanie Mark, the NDP critic for MCFD, said the government doesn't need to wait for a new plan – years of reports have identified the gaps and recommended action.
"We don't have a system of care, we don't have a system that cares," she said in an interview.