HEALTH DISTRICT CLIENT REPRESENTATIVE

HOW DO YOU GET MENTAL HEALTH SERVICES?

• There are a number of ways to get mental health services in Saskatchewan.
• Most people concerned about their mental health will go to see a doctor of their choice.
• Your family doctor may be able to provide the health care you need, or may refer you to a psychiatrist in a mental health clinic or in private practice. A psychiatrist is a medical doctor who specializes in treating mental health problems.
• You may also contact a mental health clinic yourself to make an appointment to see a psychiatrist.
• Unfortunately some people do not go for help themselves when they have mental health problems. They become too mentally confused to realize they need treatment, or may be too fearful and mistrusting to accept help. When the illness is severe, assessment and treatment may have to be provided, even if the person does not give consent.
• The Mental Health Services Act regulates the way treatment may be provided to persons with mental disorders in Saskatchewan when they do not willingly accept health care. This Act attempts to balance the rights of the person to refuse health care with the protection of the public and with the importance for the person’s well being that treatment be obtained even when that person is too mentally disturbed to be able to give consent for such treatment.

WHEN DO YOU NEED MENTAL HEALTH SERVICES?

Some of the early warning signs of a mental disorder are:

• preoccupation with own thoughts, most of the time and regardless of the situation;
• unusual, troubling thoughts, “weird” ideas;
• losing interest in usual activities;
• withdrawing from other people;
• becoming suspicious of others;
• feeling frightened, confused, anxious;
• unable to concentrate in school or in the workplace;
• having trouble remembering things;
• rapidly changing mood swings e.g. from anger to bewilderment, to sadness, to fearfulness, or sudden unusual happiness;
• neglecting personal hygiene and daily activities such as sleeping and eating;
• seeing, hearing or smelling things that other people do not see, hear or smell;
• experiencing unusual skin sensations or sensitivity to be touched;
• having strange ideas or strongly held beliefs that other people do not think are real;
• unable to express emotions, such as joy or sadness;
• unable to cry or excessive crying;
• misinterpreting information from the TV, radio, newspaper, or what other people are saying;
• decline in academic, athletic or employment activities, unable to keep up with classes or usual work;
• inappropriate laughter;
• excessive fatigue and sleepiness or unable to sleep;
• unable to cope with minor problems;
• extreme preoccupation with religion or the occult;
• sudden unexpected anger;
• hyperactivity or inactivity or alternating between the two.

Most of us have some of these feelings or ideas at times. It is a matter of degree.

If you have several of these symptoms and they are severe and you are not getting any treatment…You Need Help!

If someone you care about seems to be experiencing many of these symptoms, and is not seeing a psychiatrist or getting any treatment … That Person Needs Help!

Remember that:

• mental illness is a physical disease of the brain that can be treated;
• medications to treat mental illnesses are improving all the time;
• it is not hopeless, it is a treatable illness;
• if nothing is done, the symptoms will likely just get worse;
• the longer you wait before getting treatment, the harder it will be to overcome the symptoms, and like other illnesses, the longer it is left untreated, the more permanent damage there will likely be.

WHEN MENTAL HEALTH SERVICES MAY BE NEEDED, WHAT CAN YOU DO?

For Yourself

• If you have had problems like this in the past, contact the doctor or mental health clinic that provided treatment before.
• If this is a new experience, you should see a doctor as soon as possible.
• In Saskatchewan to get treatment for a mental disorder, you have the choice of going to a family doctor, a psychiatrist in private practice or to a mental health clinic.
• The first step is usually to see a family doctor who knows your background; try to find a doctor you feel comfortable with, a doctor you can talk to, and who will listen to you and take your concerns seriously.
• The doctor may want to refer you to a psychiatrist. A psychiatrist is a doctor who specializes in treating mental disorders. You may know of a psychiatrist you would like to see. If not, your doctor may help you choose one. You may decide to go to a psychiatrist in private practice or in a mental health clinic. In some parts of Saskatchewan there are few private psychiatrists so it could take awhile to get an appointment with one of them.
• You may contact a mental health clinic yourself to get an appointment. In addition to psychiatrists, mental health clinics include other mental health workers such as psychologists, nurses and social workers. The psychiatrist will treat the psychiatric problem while other mental health workers help you or your family members to deal with social or personal problems, or everyday living difficulties that often result from having a mental disorder. In some mental health clinics there will be an intake worker to help sort out who you should see. There are mental health clinics available to residents in every health district in the province. (See Appendix V to find out where your nearest Mental Health Clinic is located.)

For Someone Else You Care About

• Be supportive.
• Listen to the person, try to understand what the person is going through.
• Don’t judge or condemn the person or expect him or her to “smarten up” or “snap out of it”.
• Let the person know you really care about him or her, and can tell something is wrong.
• Try to get the person to confide in you about what he or she is experiencing – remember, the person will likely be frightened and confused.
• Don’t dismiss strange or confused ideas as “just silliness”.
• Let the person know that you think the symptoms could be caused by an illness such as a brain disease that can be treated with medications, that the sooner the treatment the better, that a brain disease is nothing to be ashamed of any more than diabetes, cancer, arthritis, or any other disease. It does need treatment and it will not just go away.
• Remember that some other illness or condition may cause the mental disturbances or confusion, e.g. blood circulatory problems, diabetes, brain tumors, toxins which may come from infections, insecticides or other sprays, but it is very important to find out what is causing the problems as soon as possible.
• Try to convince your loved one to see your family doctor or a psychiatrist.
• Offer to make an appointment and to accompany him or her to the doctor’s office or mental health clinic.
• Offer to discuss the problems you see with the doctor, either before or at the time of the visit, because it may be very hard for your loved one to describe the symptoms to the doctor.
• If your doctor refers your loved one to a psychiatrist, be supportive; remember, a psychiatrist is just another medical specialist, and a mental disorder is just another illness that needs to be properly diagnosed and treated.

• Remember that refusal to admit there is anything wrong as well as suspicion or even hostility about you trying to get help for him or her may be a symptom of a mental disorder.
• Remember that a mental disorder may affect a person’s judgment, so that he or she may be unable to make arrangements to get treatment for him or herself.
• Try not to react with anger to difficult, destructive, or hostile behaviour from your loved one, and remember that this behaviour is a symptom of the illness.

1. Contact your doctor

If your family doctor or any qualified medical doctor has seen your loved one within the last 7 days, and thinks a psychiatric assessment is needed, but the person won’t go to a psychiatrist, the doctor can issue a medical certificate. The certificate gives authority to a police officer or anyone else named in the certificate (such as a mental health worker, mobile crisis worker, emergency measures technician, or a friend or relative), to take the person to a psychiatrist for an assessment.

Once the doctor has issued a medical certificate, you may be able to persuade your loved one to go to see the psychiatrist voluntarily, rather than having to be taken forcefully.

2. Contact the Mental Health Clinic

If someone you care about will not see a doctor, and you cannot get a doctor to make a home visit, contact your local mental health clinic, to tell them about your concerns. If the person is known at the clinic, the case manager or psychiatrist may be able to take some action.

Even if your loved one is not known at the clinic, you may be given some useful advice or even assistance in getting help for the person. A mental health or crisis worker may be able to make a home visit. The worker may be able to persuade your loved one to go to the clinic for an assessment. If not, and it seems to be urgent, the worker may be able to get a judge’s warrant or help you get a warrant to have the person taken to a psychiatrist to be assessed.

3. Contact Mobile Crisis

If it is an emergency and your local mental health office is not open or able to assist, try calling Mobile Crisis. This service may not be available in your area, but if it is, someone may make a home visit and help you take appropriate action.

4. Get a Judge’s Warrant

When all else fails, you can go to a provincial court and ask a Judge for assistance. You will be given a form to complete. The form will have questions about why you think the person you are concerned about is mentally ill and in need of treatment. A Judge will talk to you about the information you have provided on the form. That is called “laying information”. If your reasons are convincing, the Judge may arrange for a psychiatrist to make an assessment. The Judge will then write out a warrant which will allow the police or anyone else named in the warrant, to take the person to the psychiatrist to be assessed. (See Appendix VII for Provincial Court Locations.)

It is usually helpful to discuss your concerns with a psychiatrist before going to a Court. The advance information you provide to the psychiatrist may assist in making the psychiatric assessment. It will also be helpful to the Judge to know there is a psychiatrist who has been informed about the situation and agrees that an assessment would be appropriate.

5. Emergency Police Powers

If someone is creating a public disturbance and seems to be mentally ill, the police can take the person to a psychiatrist for an examination without a warrant.

6. Assessment on Return to Saskatchewan

If a person from Saskatchewan is being held outside of the province for involuntary psychiatric treatment, arrangements may be made by the Director of Mental Health services in Saskatchewan to have the person returned to Saskatchewan for an out-patient assessment. This psychiatric assessment will determine whether or not the person is admitted to a hospital in Saskatchewan.

7. Mental Health Assessment for Someone Charged with an Offence

A person who is charged with an offence may ask for a mental health assessment, or a judge may decide that someone charged with an offence should have a mental health assessment.

In either case, the judge may order that the person be taken to a psychiatrist for an examination.

The psychiatrist has to give the judge a written report. If treatment is recommended and the person agrees, the judge arranges for the treatment to be provided.

If the person doesn’t agree to accept treatment, two doctors (including a psychiatrist) must assess the person to decide whether involuntary hospital treatment is needed.

Return to

CONFIDENTIALITY

All records concerning persons being seen by Mental Health Services belong to the mental health unit which is providing the service.

A person has the right to see his or her own health care records on request, unless the doctor believes it would be harmful to the person or to a third party. If the doctor refuses to let someone see his or her own medical records, the person can take the matter to Court. The Court may order the doctor to let the person see his/her records, unless the doctor can convince the Court that it would not be in the person’s best interests.

Any information concerning a patient is confidential. Staff members may only share information about a patient under very strict conditions.

Information must be disclosed:

• if required by law;
• if the minister orders it.

Information may be disclosed:

• if it is needed to carry out duties resulting from the Act or Regulations; or
• if it is needed by another agency or person to assist in providing services for the patient, and
• if the patient concerned gives permission to share the information; or
• if it is needed by a care provider to be able to provide care, assistance or support, as long as the patient is informed, and if possible is present when the information is shared.