I recently read in my local newspaper that there are 183 agencies in my town, London, Ontario, that look after mental health issues. Frankly, having 183 people looking after such an issue sounds like a lot to me, but 183 agencies, presumably each with its own management structure sounds seriously misguided.

Wasteful duplication of services aside, having so many agencies suggests that they each have their own niche, their own area of specialty. What would that mean for the health care consumer? It would mean openings in the net, through which too many needy people fall. I know. I’ve seen it happen that people in need go without treatment because their needs fit no single agency’s criteria.

Let me be personal about this kind of thing for a moment. I can remember a time in my childhood when my parents were looking at each other with troubled eyes. They were young, poorly educated and struggling to survive in an uncaring world. As children of the Great Depression and young adults during World War II, struggle was all they had ever known. After an unexpected telephone call from a high mucky-muck at the local school board, I noticed their exchange of troubled looks with sideways glances at me. I later learned that the odd, out-of-context call had given my parents the notice that system-wide testing had revealed that their son (me) had a “brilliant mind” and that it was their duty as parents to foster that mind with supplementary courses, mentors, special attention to my full development.

I tell this tale not to brag, but to point out how laughable the incident was and how it is typical of the way the system still works. The bureaucrat did his job, surely the parents would do theirs. The functionary couldn’t conceive of a family so poor that ‘supplementary courses’ were out of the question. He couldn’t conceive of parents so lacking in education themselves that they didn’t have a clue about what they should do next. But he had done his job. He gave notice to the parents.  Case closed.  Walk away happy.

I don’t actually feel short-changed in all of that. I did well enough in life. But when I see that people who attempt to assess why 183 agencies are not reaching their target clientele effectively, I don’t doubt for a moment that a similar thing is happening here.

Too often, functionaries tell their clients what to do and assume it will be done. How can such blasé, ineffective oversight be condoned? An agency representative advises a client, “Here, contact this counselling agency. They can help you. Goodbye.” But the client has no way of getting across town to where the counsellors have their office. The client has anxiety issues that forbid him from using the bus. The client doesn’t have quite enough money for proper food and shelter, let alone counselling or transportation. Still, the bureaucrat’s pay will come in on schedule. He or she has made a referral. He or she has done the job they were hired to do. The bean-counters are all happy with the data of so many referrals having been made. Such hard data proves the system is working. Everyone happy with the result? Ask the family of the next suicide victim.

Sorry to have posited such a disgruntled message. I’ll try to offer a more ‘gruntled’ one next time!