Report card: Mental health system needs New Year`s resolution

Since today is a day for evaluating all that has been accomplished in the past year and setting goals for the future, it just seems fitting for this week's column to discuss the state of Canada's mental health system.

Although Canada boasts one of the best health care systems in teh world with access for everyone and countless dedicated professionals, there is room for improvement.

A recent set of senate reports on Canada's mental health system point to some serious shortcomings in the way care is currently delivered in our country.

According to these reports, the mental health system is much more badly organized and under-funded than the acute care system. Some senate members referred to it as the orphan of medicare.

Canada does not have a national mental health policy and these reports indicate a need for such a policy to raise awareness of mental illness and improve the quality and availability of treatment.

Key issues addressed in the reports include the lack of integration between different mental health services and providers, the need for early diagnosis and intervention, continued stigma surrounding mental illness and the need for coordination between physical and mental health providers.

Currently, patients and their families have to navigate on their own the complex world of support groups, different health care providers, long term care facilities or supportive housing when necessary. In most cases, information doesn't pass smoothly between the various organizations so patients find themselves re-telling their story at each new place.

This lack of integration presents a real barrier to the provision of quality care.

Currently, most mental illnesses take several years to properly diagnose. This leads to people suffering longer with unexplained symptoms and having their lives disrupted as a result. As most mental illnesses are chronic in nature and progress over time, an early diagnosis is a key to successful treatment.

Sometimes patients don't seek help for symptoms, but often they do visit their doctors, but are still not diagnosed for several years. Again, better integration between health care providers, support groups and other organizations could make a big difference.

Many psychiatric conditions begin in childhood or adolescence with symptoms showing up in the schoolyard. In order for early detection and intervention to occur, it is vital for teachers, social workers and other school employees to be educated about the most common disorders and effective ways of dealing with them.

Unfortunately, the current reality in Canada is that school resources are very limited and appropriate intervention is difficult to provide. Large class sizes and less involvement from school nurses, psychologists and social workers make it difficult to identify and deal with mental illness in our schools.

Stigma continues to present a real problem for Canadians living with mental illness. Although it is often subtle, these individuals can face problems at work and in other areas as a result of prevailing attitudes about mental illness. Whether they are viewed as 'crazy' or 'weird' or 'neurotic', stigma is still a reality in our country.

An important first step to finally dealing with stigma is to modify the Canada Health Act (CHA) so that it places physical and mental health on equal footing. Currently, the CHA explicitly excludes psychiatric hospitals from its scope. This is outrageous given the amount of knowledge we now have of psychiatric illness.

Finally, in order to provide better access to and delivery of mental health services in Canada, we need to integrate physical and mental health care. These are two areas on a health continuum and need to be treated as such - they should no longer be seen as isolated entities.

Where needed, primary health care providers should be given access to more education about mental health and should also receive appropriate incentives to devote teh time necessary to address specific (usually time-consuming) needs of individuals affected by mental illness.

Above all, it is important for Canadians to understand that mental illness will affect virtually all of us in some way over the course of our lives - whether we suffer from illness ourselves or whether we have a loved one who does. This is not a subject we can afford to keep out of the public eye.


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