By Andrew Macdonald
In Nova Scotia, if you see a provincially sanctioned psychiatrist, the sessions, which normally go for an hour, are paid for by the government.
I know this because I have seen a psychiatrist since 2005 who has treated my schizophrenic condition with two brands of anti-psychotics.
But, I also see a psychologist to deal with past drinking triggers and MSI does not cover visits to a psychologist in Nova Scotia.
Sometimes private health plans cover sessions with a psychologist, which usually last for an hour session. But, my private health plan only covers two such sessions a year, and then I pay out of pocket $210 per session.
So, I was intrigued to hear Premier Tim Houston’s government this week announce some mental health illnesses like mood and anxiety issues will be covered under MSI as soon as this coming spring.
It’s a promise Houston first promised in Opposition in 2018. His other promise to create a ministry of Addictions and Mental Health was delivered soon after he won the 2021 election.
When you consider, one in five in society has a mental disorder, whether mild or severe depression, bipolar, or more severe psychosis, or schizophrenia, the fact a politician is addressing this issue is in itself significant, given the stigma in society to mental illnesses.
In 2020, back when Houston used to speak to me — he no longer takes my news calls — I asked him If he became premier would his government include visits to a psychologist under MSI.
“Absolutely, that is the whole crux of it,” Houston replied.
So that means visits to a psychologist would be given universal coverage under administration?
“Universal coverage for Nova Scotians means that a Progressive Conservative government will introduce legislation to establish billing codes allowing approved mental health professionals to treat everyone, regardless of their socioeconomic circumstances,” stated Houston as Opposition leader five years ago.
So that means, not only covering psychology sessions but therapy sessions from social workers, too.
That is a significant political policy position, because there are far more psychologists in the province, than there are psychiatrists. You can argue there is a shortage of psychiatrists.
“The plan is based on one simple premise and that is to mobilize the resources of the province for the benefit of Nova Scotians,” says Houston.
“There are a lot of psychiatrists, psychologists and social workers, family counsellors and healthcare professions with mental health training that…have the skills that can support Nova Scotians. They don’t all work for the Nova Scotia Health Authority, and what our plan says, if you have the skills in this province to help a Nova Scotian, then we will let you do that,” said Houston.
“And, the province will pay for that.”
Because the Houston policy is so transformational, especially with his stance to make MSI universally cover sessions to psychologists and private practice psychiatrists, I wanted to be clear of my understanding with Houston.
So I asked him to be clear: Your plan means MSI would cover therapy sessions with psychologists and private practice psychiatrists?
Houston re-iterated his policy stance in 2020: “Yeah, we will open up the billing codes. We will have to make sure people are properly qualified, so psychologists would be for sure. If (professionals) are properly qualified to provide (therapy) services to Nova Scotians, then, yes, people will get a billing code from MSI, and you will be compensated.”
Existing ‘gold plated’ health benefit plans provide coverage, but thousands upon thousands of Nova Scotians can’t afford such plans.
“It’s the extreme of a two-tiered system. If you have money in your pocket, or you have a job that has health care insurance, you can get the care you need,” explained Houston. But for those who are not in that position,. such therapy sessions are out of reach, he agrees.
Houston said one family told him recently their daughter was going to have to wait for 30 months to see a therapist.
“So that family had to scramble and get some private support (by paying out of pocket). We can not have that happening in this province, not when there are (therapists) who are there, ready, willing and able to help. That is why we would open up the billing code so people can get access.”
While universal therapy care is the Houston plan, it would come at a huge government expense to make MSI cover therapy sessions.
“I am always concerned about the cost,” admits Houston.
He says in Canada, statistics he has read disclose that 500,000 Canadians miss work every year due to a mental health ailment.
“That is a huge cost to our economy. When you think of that impact on families and communities on organizations, we are already paying for (mental health issues). An occupational therapist I was talking to (the other day), said the cost of not treating mental health conditions in our society is in the range of four per cent of our GDP.
“The cost is already there. What we’re saying, let’s recognize it, and let’s address it because if we can support people along the way, and there are thousands and thousands of Nova Scotians that are suffering from a mental health condition, but if they get the support, it can be completely manageable. By not getting the support, it has an incredibly negative impact on their lives, the family and the community.
“Let’s treat the people, let’s not ignore it, let’s help them improve their quality of life, and improve our communities as a result,” said Houston.
While one in five Nova Scotians has a mental health issue, and while Houston’s predecessor, Jamie Baillie raised the mental health issue for seven years as Tory leader and made the issue a key election platform in 2017, I did suggest to Houston that mental health is not a huge sexy vote-getter, despite the fact it should be a top priority in modern society.
Question: How do you balance the fact that mental health is a significant issue in society, but not seen as a big vote-getter?
“I don’t necessarily accept the premise it is not having a wide impact on our society, so, therefore, I believe it is important to a lot of families, and I believe this is a policy that is attractive to a lot of families,” he said.
Houston announced this policy stance in 2018 and said to me in 2020 it generated even more public feedback than his announcement to begin building new nursing homes, something that has not happened in the former seven-year Liberal government.
“I was amazed at the feedback from people who have stopped me on the streets,” he said.
“The statistic (of a mental illness) is one in five people, but outside that one in five, there are family members, and co-workers…so it is actually four in five or five out five, to my mind, of people who are impacted and touched by it. So one in five actually have the ailment, but when you think about it, this is a significant issue for Nova Scotians. You can’t find a family that has not been touched by it in some way, shape or form,” Houston previously told The Notebook.
“It is really important to me that we recognize it is happening and we recognize the impact on our society and we address it.”
In 2020, Houston said: “When we form government we can (implement it). We don’t have to say we need to study it for years and think about it. We are doing that work right now, so we are ready for action when we form the government, and we can help to start improving the quality of life for Nova Scotians right away — that is what is driving me”.
