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Speaking in Stellarton, Todd Leader says mental health services as designed aren’t working

Todd Leader spoke at the NSCC in Stellarton this week.
Todd Leader spoke at the NSCC in Stellarton this week. - Sueann Musick


A client-centred system.

Three simple words Todd Leader said can change the lives of thousands of people who struggle with their own mental health addictions and then are forced to manoeuvre through a system that isn’t consumer friendly.

This is not to be confused with client-centred care, which is currently taking place in the health care system, he told about 300 people at the NSCC Pictou County campus Wednesday.

“We have good people who provide good patient care,” he said, stressing that it’s the system that’s hindering the work of these people by having them lose sight of good customer service because they are bogged down in policies, paperwork and trying to meet the standardization guidelines.

Hiring new people to do the same job in the same system doesn’t make the difference, Leader said, because they are hired to manage a system that has been broken for many years.

“No one ever actually designed a mental health and addictions system,” he said. “It just evolved. No one sat down with a chalkboard or blank slate and said, if we were going to improve the mental health of our nation, how would we design it?”

“Now we look at it and see what we can improve with little tweaks year after year. The evolution of the system is what we blame but responsibility to fix it is with current management.”

Leader put his words to the test when he worked in health care on the South Shore. He said changes were small and simple, but they made a difference to help client access them.

For example, he said, they made sure that all mental health inquiries went through one phone line answered by a friendly person who was able to direct clients to exactly where they needed to be.

“If you are struggling with clarity of thinking, post-traumatic stress, anxiety then what are you feeling when you see multiple phone numbers (for mental health)? Do you know what to do? Those multiple numbers are a reflection of structure of the program that is system centred. Client centred is one number that will let staff figure out where the hell you should be.”

Leader said people need to be hired because they are the right people for the job rather than for their years of seniority or union status. Someone calling for mental health services does not want to speak to a person equipped in data entry but lacking social or communication skills.

“You can teach data entry but you can’t teach nice. You can teach technical skills but not niceness,” he said. “Hire people based on interpersonal skills. People that make you feel like you belong.”

One of the other changes Leader said he put in place was to erase wait times. This was done by changing the thought process of his team and making them think about how they would feel if their loved one was going through the system.

“The only thing that matters is getting rid of the barriers, hassles and nuisances for clients,” he said.

He questioned why people need to make appointments to schedule appointments. He told his staff that when people showed up on time for their appointments they were to be seen immediately, basically wiping out the need for a waiting room.

“When we make appointments, it’s a two-way contract. You stop whatever you are doing and attend to the client. It took a few days to adjust, but after a few days, we ended up with a hallway which used to be our waiting room,” he said.

Some the changes will be an inconvenience to staff or cost money to implement the changes because they are not system centred.

“If the client is at the centre than the client is number one,” he said. “You can’t say you are patient centred if you are making decisions that are system centred.”

Standardization is not the answer to fixing the system, he said. No two people have the same mental health or addiction issues so no two people can be treated the same.

Leader stressed to those in attendance that nothing will be changed unless people start speaking out. He said letters and emails need to be written to the board of directors of the Nova Scotia Health Authority because they have control of service and delivery in health care.

“If you haven’t used your voice to say what you want in mental health and addictions, use your voice,” Leader said. “Silence is agreement. That is a well-known rule in the public sector.

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