Barriers to psychiatric treatment

Last week I discussed some common misconceptions about accessing psychiatric services and highlighted that these services are covered under regular provincial healthcare at no cost to the patient.

In light of this, you’d think people in need of psychiatric care should have no difficulty getting it. Unfortunately, nothing could be farther from the truth. There are many barriers to receiving care – and many of them are completely unnecessary.

The single biggest barrier to a person receiving appropriate psychiatric or other mental healthcare is stigma. Many people feel ashamed to admit they need help – believing it somehow reflects badly on them to admit to a psychiatric problem.

Stigma is a well-recognized problem in mental health circles and it is difficult to overcome. As with any prejudice – changing mindsets can be very tough.

We know that the vast majority of those who could benefit from treatment do not receive it, even in Canada with universal health care. This is a societal problem and will not be overcome by mental health professionals alone but only when the public says they are not going to take it any more as has happened with gay rights activists, feminists and other groups who have been systematically taken advantage of.

Apart from stigma there are problems with the system itself. I hear from people who are relatively knowledgeable about mental health care and who still have trouble accessing appropriate care. They get referred from one practitioner, program or institution to another without anyone taking responsibility for providing the care. They may be put on a waiting list and forgotten about for months at a time. The worst offenders in this regard are government funded programs and large institutions. It is easy to pass the buck in these faceless bureaucracies.

In most communities, it is not easy even to find out what services are available or how to access them. There is poor communication between all the stakeholders.

A very powerful account of this is provided in the book by Pete Earley, Crazy: A Father’s Search Through America’s Mental Health Madness, in which he tried to get help for his bipolar son. This is an educated man and experienced journalist who could not navigate the system for his son and was appalled by what he found when he started to look at the system (or lack thereof) more closely.

Although I think the situation in Canada is better than what he found south of the border, we have no grounds for complacency. Far too many people are frustrated in their attempts to get timely treatment.

When you combine the fact that many people don’t want to be identified for treatment out of shame and many of those who do want to get treatment can’t find it, you have a sad comment on the current state of mental health treatment in our country.

 

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