The Best We Have to Offer: Review of Youth Suicide Prevention and Mental Health Services in New Brunswick
New Brunswick Child & Youth Advocate
The Child, Youth and Senior Advocate has completed a Review of Youth Suicide Prevention and Mental Health Services in the Province of New Brunswick following the death of Lexi Daken at the Dr. Everett Chalmers Hospital in Fredericton on February 24th, 2021. The Advocate gave public notice of this review at a press conference on March 5th, 2021. With funding from the Department of Health, a large staff team was assigned internally from the Advocate’s Office and augmented with external consultants and research program staff. A consultation document and website for the review were launched in early May and an Interim report with 10 recommendations filed with government on June 15th.
The final report and recommendations are informed by review of the extensive documentary disclosure by government, augmented by internal literature review and research, as well as extensive public consultation via over 4000 online survey responses, over 10 community online consultations, key informant interviews, expert dialogue sessions, individual citizen feedback and formal submissions. The Advocate’s findings are summarized in two parts of the report relating firstly to the individual case study of the facts surrounding Lexi Daken’s death and secondly from the findings in relation to the broader review questions framed in the Advocate’s Consultation document.
The final report finds that acute care youth mental health settings lack appropriate mental health training and adequately resourced specialized services, both in terms of physical infrastructure and human resources. They also lack standardized suicide risk assessment tools and practices to adequately triage mental health cases that present at emergency rooms. The Review found that youth mental health and suicide prevention services in the Province were suffering from a chronic shortage of psychologists and psychiatrists, as well as from alack of coordination between formal systems of care and community-based programs such as Integrated Service Delivery (ISD).
In relation to the broader systemic issues raised by the review, the Advocate found that New Brunswick youth mental health services remain far too reliant upon crisis care, with rates of youth hospitalization for mental health that are 40% higher than the national average. More effective services (assessment and intervention) could be possible if the Province invested earlier and more significantly in community-based care in preventative and early care settings. The report inventories a number of promising community-based services and informal system supports that deserve more sustained investment and assistance.
The Review also found that many shortfalls in the current system could have been addressed if better governance and accountability mechanisms had been in place to track and implement earlier recommendations. The report also puts forward an Accountability Framework for health proposed by the UN Committee on the Rights of the Child, in application of Article 24 of the Convention on the Rights of the Child which proclaims the child’s right to enjoy the highest attainable standard of health and which insists upon mechanisms to hold government accountable for the delivery of Available, Accessible, Acceptable and Quality health services (AAAQ).