P.E.I. mental health system must be client-centred: expert

The key to an effective P.E.I. mental health system is to make it client-centred and focus on early intervention, says a Nova Scotia mental health expert.

Registered psychologist and social worker Todd Leader laid out his vision for a better system in his book, It’s Not About Us: The Secret to Transforming the Mental Health and Addiction System in Canada.

Leader, who has consulted with Health P.E.I. for about three months, gave a public talk Wednesday at UPEI. At the core of his approach is a system designed around the client every step of the way.

“If the client was my mother or my son, how would I want this part of the system to work? It’s a personal question, not a professional question. Whatever the answer is, that’s the definition of a client-centred system,” said Leader.

“If at every step of the client’s journey through the program, they ask that question, they’ll end up designing policies that are efficient for the client.”

The title of Leader’s book means the system is about the users, not the workers, who must deal with inconvenience for the sake of the client.

Transforming the system “doesn’t happen without struggle and without pissing people off,” Leader said.

The P.E.I. government consultant said Health P.E.I. is “completely committed to this kind of approach and are trying to figure out the process to make that transition … I give them kudos for embracing the concept and starting the journey.”

The talk was attended by three MLAs. Health minister Rob Henderson was not among them.

Leader’s strategy was implemented in the South Shore Health Authority in Nova Scotia and resulted in wait times dropping from eight months to four to six weeks, without any new funding.

Leader stressed that the clients of the mental health system are the entire public, not just those who use it or those who are mentally ill.

“The mandate is not to provide services – it’s to improve health,” he said.

His plan addresses that by incorporating social and emotional learning into the school curriculum, reducing demand over time.

“There is tons of scientific evidence that if we teach our kids to understand and manage their emotions, those kids grow up with lower rates of mental illness and addiction. If we ignore this part of it, we are always going to have a capacity problem.”

Among Leader’s ideas to increase the supply to meet the demand is removing clinicians from non-clinical meetings, which would free up appointments and reduce wait times.

“It’s about picking apart every single part of the path and maximizing the use of resources for the sake of the client.”

Dr. Sarah Stewart-Clark, the organizer of the #HowManyWade mental health advocacy campaign, said reading Leader’s book gave her new hope for the future.

“In many ways it aligns with the asks in our campaign and I think it's an exciting direction for the province to go in.”

The Facebook campaign publicized stories from 100 families whose needs are not being met by the system and has helped make mental health a hot topic in the Island’s political discourse.

Stewart-Clark said Leader’s vision is finally an answer to the urgent need that has existed for many years. She agrees with Leader that proactive intervention to prevent personal crisis is “desperately needed.”

Part of Leader’s focus is on making the system easier to navigate and access. He said sitting in waiting rooms, not knowing what number to call for help and not having a “warm, compassionate person” answer that phone are all examples that can make the user’s condition worse.

“Waiting rooms are harder on mental health patients than others. It reinforces their low self-esteem and causes the issue they’re there to treat.”

His solution in Nova Scotia was to instruct all mental health professionals to drop everything and meet clients at their appointment time.

Stewart-Clark cautioned the province must deal with the current backlog of users in crisis before it can move forward with Leader’s approach.

“We're not exactly in a place to adopt that plan fully until we address the reality that on the spectrum of mental illness, we are far on the side of severe crises because individuals have not had care for so long.

“The system has been ineffective for so long and we need to address that first.”

Sports startup The Athletic captures veteran scribes' imagination

Michael Russo has covered the National Hockey League for 22 years. This season, he’ll finally be able to watch the third period.

Russo is among the growing number of sports journalists to leave newspapers recently for an online sports media startup called The Athletic.

Alex Mather and Adam Hansmann founded the ambitious project with funding from Y Combinator, an American start-up accelerator, in the summer of 2016.

The site launched in Chicago that year, hiring long-time sports writers to cover the Bears, Blackhawks, Bulls, Cubs and White Sox. It soon expanded to Toronto and beyond.

Subscribers pay a monthly fee to read coverage of pro sports teams across North America.

Russo was among the writers approached by The Athletic during a round of expansion this summer. He had covered the Minnesota Wild for the Star-Tribune since 2005. It would not be an easy sell – or so he thought.

“I had no interest in leaving the Star-Tribune. The newspaper treated me incredibly well,” Russo said.

That changed quickly when he spoke with Mather in early August.

“It kind of turned my life inside out. When you have a conversation with Alex, you immediately realize why they’re so successful. He had me sold on the first phone call. If I had to sign up that day, I would’ve taken the job.”

Russo was already doing his dream job. To jump to a startup with an unproven subscriber model and no advertising, some assurances were required. Could The Athletic afford to pay so many writers? Was their expansion to more than a dozen cities sustainable?

“They really had to sell me on stuff beyond money and security (as well). They had to sell me on creativity and space constraints and total autonomy. And that’s why I did it,” said Russo.

As much as the New York native loved his job, the inevitable constraints of writing for a newspaper wore on him. Space was at a premium and often dependent on whether the Vikings, Timberwolves or Twins were playing.

Russo’s last five stories for the Star-Tribune were cut in half in print. He understands the sacrifices that must be made in the modern print industry, but when The Athletic came calling, he realized it didn’t have to be that way.

“Slowly but surely, I started to see our newspaper shrinking. I kind of got frustrated by that, and I was thinking, ‘man, how cool would it be if I’m the one who decides what the length is and what I write and when I write it?’ I took the plunge.”

Veteran Columbus Dispatch sports writer Aaron Portzline chose to join The Athletic after almost 30 years in the print business, including the last 17 seasons covering the Columbus Blue Jackets.

Portzline’s love for newspapers runs deep, but the 47-year-old recognizes the industry is on very shaky ground at the moment. He chose to secure his future on his own terms rather than being potentially blindsided by future layoffs.

“They are the paper of record. They are a watchdog. That stuff means a ton to me, but I think newspapers everywhere are struggling,” Portzline said.

“Is there going to be a newspaper in 18 years for me to retire from? I don’t think that’s going to happen.”

The shackles are off

            John Tortorella likes to swear. A lot.

            Since the Blue Jackets hired him as their head coach two years ago, Portzline has been the man charged with censoring him.

            Portzline doesn’t have to do it anymore.

            “Whenever you talk to Torts, he’s dropping F-bombs. He cusses like a sailor. In the print model, you’re putting the word expletive in parentheses. The Athletic’s policy is to let it run. It’s a little weird typing that word and realizing this is going to be in print,” said Portzline.

            Four-letter words weren’t the primary reason Portzline jumped ship, though.

Beat writers for major dailies usually face a deadline of just minutes after the final buzzer to submit their game recap. This forces them to spend most of the third period writing instead of watching.

“You end up writing these stories and if there’s a late goal and you want to do it justice, you’re ripping up everything at the last possible minute,” Portzline said. “Sometimes you feel like you put in a long, long day at the rink, and you’re not necessarily proud of anything you did because it was so rushed and cramped.”

For Portzline, the decision to leave the Dispatch was not taken lightly, but the notion of having some “elbow room” and unlimited space appealed to him.

“There are times where people really open up and tell us very meaningful stories, and to not be able to do that justice in print is really frustrating after a while, when you just can’t present the nuances of a story.”

Working for a web-only outlet allows print lifers to expand their coverage and explore new ways of presenting the story. That was part of the attraction for Russo.

“I feel like the ability to write (at The Athletic) and write creatively and write really good, meaty stories is plentiful. I like to write longform, I like to write personality profiles, I like to write opinionated, I like to write analytically, and that stuff in the newspaper is very difficult to do.”

Both writers have already taken advantage of that freedom. Portzline recently penned a 3,000-word story about Ohio State’s failure to capitalize on a wave of hockey talent coming out of Columbus, where the university is located. Russo constructed a 2,000-word feature on Wild head coach Bruce Boudreau and his love for hockey.

            Portzline expects more from himself now that he can cover the Blue Jackets however he wants.

            “There are no excuses now. You can’t say the story sucked because the deadline was brutal, or you couldn’t do it justice. Put up or shut up.”

Reader-driven content changes the game

Russo is putting more pressure on himself to produce good writing since his move to The Athletic. He knows people are paying to read his work.

A monthly subscription is required to view content, so Russo’s readers are now invested in his coverage, something he said is “very humbling” to see.

His biggest fear in leaving the Star-Tribune was the paper's massive exposure. Whether people wanted to read his work or not, if they got the paper, they got him. But his concerns have been allayed by the unique reader-writer relationship at The Athletic.

“The reality is that these people are paying to specifically read me, which means their passion toward the sport is greater. They’re fans of mine. All of a sudden, you’re getting the best of the best of fans. You can see the person you’re writing for.”

             Portzline has also noticed the change in his reader base. Many of those readers followed him from the Dispatch to his new home behind a paywall.

“It’s a pretty specialized group of people who stand alone in their passion for their team, and also the media they consume. People feel like they’re part of something different. The only way to keep that edge is to continue to crank out the high quality stuff people feel they can’t get anywhere else.”

Along with their growing roster of beat writers who cover specific teams, The Athletic also recently hired veteran scribes Pierre LeBrun and Ken Rosenthal to anchor their national coverage of the NHL and Major League Baseball, respectively.

 “Their goal is to be the local sports section in every market, along with the ability to read (national writers like LeBrun and Rosenthal),” said Russo. “They want to hire the best sports writers they absolutely can. The way that this industry is shrinking right now, there’s obviously a ton of talent out there and they’re definitely scooping it up,” said Russo.

Russo and Portzline were both nominated for the Red Fisher award this year, which recognizes the best beat writer in the NHL. Both of them feel The Athletic has limitless potential.

“I believe in The Athletic wholeheartedly,” said Portzline.

Russo initially had to be convinced that the site’s business model was sustainable. Now, he’s on board.

“They’re doing their job back at headquarters. Now it’s up to the talent they’ve hired to really do its job. I think it’s going to grow and grow and grow, especially if they continue to get talent and people realize what type of product they can potentially get here.”