Finding your way to and through services in BC
Reprinted from the "System Navigation" issue of Visions Journal, 2014, 10 (1), pp. 8-11
Phone and email support
There are several different free phone and online support organizations. Many of these organizations offer crisis support as well as general advice around identifying local resources. See Navigating the Navigators: British Columbia’s phone-based support and information lines on page 28 to learn more about these phone-based services in BC.
For email support to navigate mental health and addiction services anywhere in BC, please contact us at HeretoHelp at [email protected]
When you’re seeking mental health services and providers, you may feel confused or even overwhelmed. You may be wondering which path is the right path for you. Or wondering, is there a right path? You might even wonder if there is a path at all...
The reality is that everyone has a path, and it isn’t always clear. And everyone experiences unexpected setbacks or challenges at some point along the way. However, as long as you’re moving, with the intention of improving your health and well-being in a way that supports your goals, you are likely already on the right path—the right path for you.
Actually, your path is defined by your situation, your wishes, and your choices. For some people, it may include only medical health services like doctors and psychiatrists. Other people look outside of medical health systems for help and support. Whether it’s intentional or not, many people use supports from different systems. After all, seeing a psychiatrist doesn’t exclude someone from exploring the benefits of yoga or meditation.
In BC, a reality is that geography does impact the services that are available. Some communities will offer most or all of the services in this article, while rural or remote communities may not offer all of these options. While travel may be an option for some people, it may be not an option for everyone.
This article focuses only on medical health services, included those covered by the BC Medical Services Plan (MSP).* The major players in BC’s medical health services are the health authorities, which are government agencies that administer health services in a particular geographic area. There are five health regions for adults in BC (Northern, Interior, Island, Fraser, Vancouver Coastal. There are also two BC-wide health authorities: the Provincial Health Services Authority (BC Women’s and Children’s is part of this) and the new First Nations Health Authority. Children and youth also receive health services through the Ministry of Children and Family Development. These systems aren’t the only way, but they are systems that most people encounter at some point.
Before you start...
Before you begin your journey, it’s helpful to think about the challenges you’re experiencing and what you want to do about it. How would you describe the problem? How is it affecting your life? What do you expect to get out of treatment? Are you interested in a particular approach, or is there a treatment that you aren’t willing to try?
Remember to think about the practical aspects of seeking services too. Does your schedule restrict the times you could go to appointments? Do you anticipate any barriers, such as transportation or child care? Do you have family or friends who can help you? Can any community providers help reduce these barriers? For example, some community organizations can coordinate transportation to appointments.
When you talk with service providers, it’s important to be clear about your experiences and expectations so that everyone is on the same page. Some people find it helpful to bring a list of questions or points they want to talk about at their appointments.
You can learn more about how to work with health professionals at www.heretohelp.bc.ca/factsheet/managing-a-mental-illness. But first you need to find the right one.
Common service providers
There are many different kinds of services providers in the health care system. The type of professional you see will depend on your specific mental health challenges, the diagnostic and treatment strategies you feel most comfortable trying and your own goals for achieving wellness. It may also depend on where the service providers are located or your ability to travel, or not, to these providers.
A family doctor (also called “general practitioner” or “family physician”) is a medical doctor. They can diagnose mental illnesses and prescribe medications, and their services are covered by MSP. Most people initially seek help through a family doctor. A family doctor is a good first step for most people because they can refer you to more specialized psychiatric services, which usually require a doctor’s referral. A referral means that the doctor requests an appointment with the specialized service provider on your behalf. Your family doctor may also have good recommendations for counsellors or psychologists, local mental health resources, and other key support people in your community.
If you don’t have a family doctor you see regularly, you can also go to a walk-in clinic to see a doctor. You can find a regular family doctor through the College of Physicians and Surgeons of BC.
Psychiatrists are medical doctors with specialized training in mental health. They can diagnose mental illnesses and prescribe medication. Many psychiatrists also offer talk therapies, such as cognitive-behavioural therapy. A different medical doctor, like a family doctor, must refer you to a psychiatrist. A psychiatrist’s fees are covered by MSP.
Psychologists and registered or certified counsellors (such as a Registered Professional Counsellor or Registered Clinical Counsellor) assess mental health care needs and provide different therapy or counselling services. This often includes teaching skills that support recovery and improve well-being. Some psychologists or counsellors specialize in a particular therapy approach, mental health concern or population group. Psychologists and counsellors cannot prescribe medication. Provinces have laws that regulate the standard of care that pyschologists offer. Cousellors may choose to join a professional organization with its own standards of care, though these groups are not regulated by laws in all provinces.
You can access a psychologist or counsellor on your own, but their fees are not always covered by MSP. If you have a private insurance plan, such as your employee benefits, the insurance provider may also cover some costs.
To find a psychologist or counsellor, contact the BC Psychological Association or the BC Association of Clinical Counsellors. You can also ask a family doctor or other medical service provider for recommendations.
Social workers and nurses may be involved in mental health care. They can help coordinate your care, teach skills and support recovery goals. Occupational therapists support skills around activities like self-care, daily tasks or obligations, community involvement, paid work, volunteer work, and social or recreation activities. You can learn more about these professionals through a health care provider and through community mental health organizations. Some fees for these services may not be covered by MSP, so it’s a good idea to ask about this when you make your first appointment.
Support is an important part of recovery and well-being. Peer supporters, or peer support workers, are people who have experienced a mental illness or who support a family member with mental health issues. Peer supporters use their experience to provide support and understanding as well as practical help to navigate health systems and find community services. Support groups are a formal or informal place to gather and share experiences, learn from others and connect with people who understand what you’re going through and are navigating medical health systems too. Support groups may be led by a service provider or by peers. They often work within and alongside medical health services. Ask your health care providers for more information about peer supporters, peer support workers, and support groups.
Where else can I find help?
Health authorities deliver (or fund other non-profits to deliver) many of the services described above. They can provide a lot of information around inpatient services (where you stay at a hospital or other facility) and outpatient services (where you stay at home but attend services at a hospital or other facility). They may also provide other services in the community, like mental health teams for people who need more support than a family doctor. Be aware that many of these programs have some sort of eligibility requirement—for example, you may need a doctor’s referral or you may need to live in a certain area to access services. Health authorities may offer assistance around navigating the local health system or assistance with advocacy. To find contact information for your local health authority, visit www.health.gov.bc.ca/socsec. To learn more about services for children and youth, visit the Ministry of Children and Family Development at www.mcf.gov.bc.ca/mental_health.
Some workplaces can provide a lot of guidance and support around accessing mental health services. In addition to employee health benefits, you may be able to access counselling sessions or other supports directly through an Employee and Family Assistance Program (EFAP). Your EFAP can also recommend service providers in your area.
Schools are another great resource. Some schools offer counselling or therapy services to students, and some offer other tools like support groups, advocacy, information sessions or guidance for parents. Remember that mental illnesses are considered disabilities, so a school disabilities assistance provider or advocate at the school can also help with mental health resources. Teachers can play an important role, too. Teachers can connect you to other resources in the school or community, or suggest places to seek extra help. If younger people need to talk to someone, teachers and school counsellors are a good option.
Health services for Aboriginal community members are administered through the First Nations Health Authority in an agreement between BC First Nations, the government of BC, and the government of Canada. Learn more at www.fnha.ca. In Nisga’a communities, health services are provided by the Nisga’a Valley Health Authority. Learn more at www.nisgaahealth.bc.ca.
Many Aboriginal people living off reserve find health and mental health services through their local Friendship Centre. Learn more from the BC Association of Aboriginal Friendship Centres at www.bcaafc.com
All health authorities in BC have Aboriginal patient liaisons, navigators or nurses. For more information, visit HealthLink BC.
Community mental health organizations can connect you with service providers and provide a great deal of guidance around local resources. Many organizations offer education, support and recovery programs. If you can’t find an organization in your community, provincial organizations like the partners behind HeretoHelp have diverse networks and can still help identify helpful options near you. Visit www.heretohelp.bc.ca/about about for a list of some major provincial mental health organizations.
There are other types of health services, generally considered to be “alternative” or “complementary,” which some people find to be useful. Some of these services may be offered by physicians while others may be offered alongside mainstream medical systems. A few options include acupuncture, massage therapy, and naturopathic treatments. Be aware that some treatments should not be used alongside others (for example, using certain medications at the same time as certain herbs), so it’s important to talk with all care providers about all of the approaches that you’re using. Some of these services may be covered by private health insurance.
Finding the right service provider for you
When you start connecting with service providers, it’s easy to feel like you have to accept the first available option, especially when options feel limited. However, some people just aren’t the best fit. This isn’t anyone’s fault—it’s just the nature of human relationships. You could have different values or perspectives, or you may simply not match in terms of experiences and expertise. If you feel like you aren’t connecting well with a service provider, it’s okay to explore other options. Take advantage of any introductory consultations to see how you work with the service provider, and don’t be afraid to speak up if it isn’t working for you.
*BC Medical Services Plan is the public insurance provider that covers necessary medical appointments and tests, along with some complementary services. To learn more about MSP, visit www.health.gov.bc.ca/msp/.
About the author
Stephanie is Editorial Coordinator for Visions and the Canadian Mental Health Association’s BC Division