Burin Peninsula drop-in mental health services a success, but concerns linger

November2017 was a dark time for Sarah Furlong.

The 32-year-old St. John's resident was dealing with symptoms of PTSD, postpartum depressionand a recent bipolar disorder diagnosis. That fall,her mental health fizzled to a crisis point.

If she hadn't seen a counselor right away, she fears what might have transpired.

Furlong used themental health serviceDoorWays, which allows clients to drop in, without an appointment, to access single-session therapy. Within minutes of her walking through the door, a peer worker also diagnosed bipolar offered a listening ear in a private room.

"If I didn't have that peer counsellor as I was screeching my eyes out," Furlong recalled, "I wouldn't be here today."

DoorWays, which opened a handful of locations in February 2017, is similar to a new model for mental health care implemented on the Burin Peninsula in response to a spate of suicides in the Grand Bank area.

We knew we had to do something.- Evelyn Tilley, Eastern Health

Over the course of 16 months in 2016 and 2017, there were 14 suicides in the region, which prompted an emergency call from the Grand Bank mayor to the province to reduce wait lists for mental health services.

The mayor "asked for help because they were losing too many people to suicide," saidEvelyn Tilley, a mental health manager with Eastern Health.

"We knew we had to do something."

A new model

Eastern Health did do something: the health authorityramped up its mental health offerings, openingdrop-in services in Grand Bank,Marystown, St. Lawrence andPlacentiaWest.

Clients are able to get the same one-time counseling session, the authority said, but can keep seeing that same therapist, or receive additional referrals to long-term treatment and access to workshops and support groups.

All emergency room nurses and eight doctors in the area were also trained in suicide intervention, according to Eastern Health, and walk-in sessions are offered every two weeks atJohn Burke Senior High School in Grand Bank.

In 2017, Tilley said more than100 people were stuck on a list for counseling in Grand Bank. Some were waiting for up to eight months.

Eastern Health workers contacted each of those people, notifyingthem the wait list had been eliminated. Suddenly, they could see someone any time,Tilley said."We said to them, come in. And they did."

About 2,000 people have used the program since. Eastern Health says one suicide hasbeen recorded since the new model was implemented.

No extra workers or facilities were neededfor the new model, Tilley explained. Instead, the authority shuffled itspriorities and changed how it operated.

"We didn't have new resources. We redirected the ones we had ... we were actually able to free up time to see all of these people."

That response to suicides is now reaping national recognition.

The model is one of two under the spotlight at the National Health Leadership Conference this June in Toronto, which is applauding Eastern Health for "tremendous leadership and exemplary patient engagement in the redesign of care and service."

• No more wait lists for mental health services in Happy Valley-Goose Bay

It appeared to work so well, Labrador-Grenfell Health followed suit, redesigning its services to mimic Eastern Health's approach last year.

'We have to engage communities'

For all its apparent success, some concerns about the program remain.

Dan Goodyear, CEO of the Newfoundland and Labrador chapter of the Canadian Mental Health Association, said community mental health services need to have a focus on the people actually using them.

"We've gone in and said, 'Move over, we can do this for you.' That doesn't work. That's been proven time and time again," Goodyear said. "We have to engage communities ...they know the needs, they know their strengths."

Tilley said Eastern Health did exactly that, when they consulted with patients, community leaders, and front-line workersabout the program's design in 2017.

"What's so unique about this is the patient-centeredness," Tilleysaid.

"The people who are actually using the services built the services, and they continue to support them and guide the practice."

But Lisa Moores, president of the Association of Psychology in the province,said some psychologists have expressed concern about feedback mechanisms since the program was introduced in late 2017.

Mooressaid clinicians in the area have told her there's room for improvement when it comes to the health authority including them on how to tweak the model and plan next steps.

She also worries that rearranging resources might leave gaps elsewhere, with patients potentially waiting longer for long-term therapy.

"We need to look for places it may be creating tension in other parts of the system," Moores said.

Saving lives

Moores compared the ideal mental health system to the physical care model already in place a walk-in clinic for immediate needs, a family doctor or psychologist for ongoing care, and specialists to address more intensive illness.

And while she too commends the authority for its swift responsein the region, she cautions there's no way to establish that the new model has directly caused the apparent drop in suicides.

Tilleysays Eastern Health knows simply removing the barrier for care won't solve all cases.

Sarah Furlong, now a mental health advocate, agrees.But she emphasizes that having immediate access to care from people who understood her diagnosissaved her life.

"I was having some very dark thoughts," she said. "Just having that peer counselor you never know who's going to walk through your door."

If you are in a crisis, call 1-833-456-4566, available 24/7, or visitCrisis Services Canadafor text or chat options.

Read more from CBC Newfoundland and Labrador