Access to Mental Health Care in Crisis

It was a Sunday afternoon, and my friend ran out of his medication he uses for clinical depression. Although he has a full-time job, he was lacking the funds to purchase more, and too proud to tell anyone. Thus, he went about his business until Tuesday morning, when he felt a psychotic episode coming on. He headed to his doctor’s office, where after explaining his situation (with the hope that his doctor could give him some samples to tide him through), he was told he would have to return for an appointment in the afternoon.

With what was left of his good senses, my friend knew he did not have until the afternoon to wait, and went to the Emergency room of the nearest hospital. After explaining himself to yet another front desk person, he was informed it would be up to two hours before he would be able to see a doctor.

That was the final straw. A combination of frustration and deprivation of his meds led my friend to lay himself down on a grassy area outside of the hospital, and do some funky things to his wrists with a pocket knife. Ultimately, he was found by police, who, in essence, temporarily committed him by depositing him back inside the same emergency room — probably saving his life. He was treated for his wounds, physically and mentally, and later released. The knife was confiscated.

Welcome to the land of universal health care. Mental health is part of this, yet appears to be far less universal. I guess the people he dealt with did not understand that a mentally ill person without his meds is a ticking time bomb. He did the responsible thing by seeking help, but it was only when he became a clear danger to himself that anyone took him seriously.

If my friend had gone to emergency with a broken leg or in the process of a heart attack, he probably would have received swift and immediate attention. But because he was not in obviously physical pain, nor going to immediately expire in front of everyone, he would have to wait his turn, along with people who come to emergency with trivial matters that can be dealt with as well at a walk-in medial clinic.

Access to mental health services can be difficult, not only for the low-income person, but just about anyone in need of affordable services. Although covered by Alberta Health, it can take up to three months to see a psychiatrist, like just about any medical specialist these days, especially for an initial appointment. Psychologists are easier to access physically, but financially out of the budget for all but the wealthy – the standard rate for an individual is $145 per 50-minute session ($155 for couples), according to the Psychologist’s Association of Alberta. Even those who operate using a sliding scale do not slide far enough down for low-income clients, especially those who require services on an ongoing basis.

Then there are services like The Support Network that offer walk-in help, but only for short-term intervention. Crisis lines are excellent places for people to vent, as long as they are not put on hold, which can happen due to high numbers of callers and low numbers of volunteers. Have you ever heard the joke about the person who calls the suicide hotline and is put on hold? It’s really not funny, and it happens in real life.

Mental health consumers need to be taken seriously when they turn up at hospital emergency rooms, let alone in their own doctor’s offices. Often, they are breakdowns waiting to happen, and there is nowhere else for them to turn. My friend, despite the cuts on his wrist, was lucky. How many aren’t?

Paula E. Kirman is a writer, editor, photographer, website designer, guitarist, book lover, coffee shop hanger-outer, and occasionally a juggler. You can reach her at: