Monday, 12 October 2015

Huge savings to be found in health and the justice systems

A recent letter to the editor in the Advocate has suggested it's a bad idea to spend public money on a provincial wellness initiative, when there are so many non-profits able to handle that portfolio for the province, at a much cheaper cost.

Since the new Alberta government is about to release its first provincial budget, I thought I might point out a local community wellness project to remind us that community wellness has a pretty high return on investment. And that if we want to maximize profits from these investments, it makes sense to “go big” and have them cover the entire province.

I recently attended the annual general meeting for the Red Deer Canadian Mental Health Association. When you volunteer, you're a member (my wife also works for CMHA).

One of the duties performed at an AGM is to recognize exemplary work within the organization and hand out awards. The first award given this year was to Red Deer's Police and Crisis Team (PACT).

Actually, Red Deer has two such teams, and there is a push on to both create a third Red Deer team, and also to demonstrate the need for a regional team outside the city. That's if the organizers can find the money (which in this case means investment from Alberta Health Services).

A PACT team consists of two members: a full-time RCMP member and a registered nurse with mental health training. They are called to cases where mental health issues are involved, or where people under significant stress may harm themselves or others.

The police staff are paid out of the general policing budget. It's a full-time placement — they have no outside policing duties. Red Deer's Primary Care Network has found budget for the nursing side. So, as far as spending for mental health services goes, it's a pretty cheap deal.

The problem is that the PACT teams are so successful, a third team needs to be added. Red Deer RCMP have already said they would find staff budget internally for a third officer, but PCN cannot expand the program with their current funding.

More, the success of the program has extended beyond city's RCMP jurisdiction. Red Deer police cannot fund a regional program, but depression, anxiety, suicide and other mental illnesses do not respect city boundaries.

We were told that last year, the Red Deer PACT teams attended to 805 cases. Where previously they would generally have ended in arrest or a forced visit to the hospital emergency ward, in 740 cases — 92 per cent — people were instead put in touch with local support services instead.

The savings to taxpayers in both our health and the justice systems are huge.

Without PACT, when a situation comes to the point where police are called, arrest or a trip to emergency ward are pretty well the only two possible outcomes. Police are not trained to make mental health assessments and are not trained to bring people to other services.

I was able to find that a visit to an Alberta emergency ward costs taxpayers on average between $150 and $225 per visit. When police take people to the emergency ward, they must stay with their charges until medical staff can take over responsibility for them. The wait can last hours, adding to the cost to taxpayers, and taking police away from other duties.

Anyone with a calculator can make a rough calculation of the cost of 700 or so emergency ward visits, and only guess at the staff costs for the hours spent by police sitting, waiting.

I was also able to find that in 2004/05 there were 40,000 emergency visits for mental health reasons in Alberta. Another provincial site posted that 12-15 per cent of all health disorders are for mental health.

Yet, in much of the province, a mental health crisis is dealt with by police alone, and people who are sick end up in the criminal justice system. That's what police are trained to do with someone who's at risk of harm to themselves or others.

The tax cost of this is nearly impossible to calculate, not just the cost to taxpayers of this misuse of the justice system, but of the lost opportunities for well-being of people who shouldn't have gone into the justice system in the first place.

The current practice criminalizes mental illness, delays treatment and raises needless fears in the community that people who are mentally ill are dangerous. We've seen these fears played up even in the current federal election campaign.

The cost of all this can easily be prevented, if we invest in a cross-provincial PACT program. Locally, we could at least free up more emergency ward time for local patients, and clear court time for other cases, if we expanded this wellness program here.

But it's not the job of non-profits to do this on their own. They must be funded. With tax dollars. And if we want to save hundreds of millions we now spend in Alberta's emergency wards, on jails, courts and police time, a few million spent on a provincial wellness program isn't such a bad idea at all.

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