Saturday, August 23, 2008

A passionate call for mental health services

From today's edition of The Chronicle Herald:
By John Gillis, Health Reporter

Deputy minister makes rare appeal for public support

Nova Scotia’s deputy health minister called on mental health organizations and the public Friday to help her light a fire under politicians to do more to help people with mental illnesses.

In a passionate off-the-cuff speech at the opening of the Canadian Mental Health Association’s national conference in Dartmouth, Cheryl Doiron said her department has put more money into mental health services over the years, but spending has declined as a proportion of the overall health budget.

"It’s very hard to get it to be the primary issue, particularly for politicians who are making budget decisions . . . because they are not getting the same pressure about mental health as they get about cancer and coronary disease and diabetes," she said.

"We, working from the opportunity we have within government, organizations such as (the national association) and the Nova Scotia (association) and other groups, and all of us collectively need to be doing something much more significant to make this a burning bridge issue for decision makers."

Mental health spending accounts for just over 3.5 per cent of the $3.2-billion provincial health budget.

Ms. Doiron said the relatively small amount of funding for those services means the province is failing to provide "absolutely essential help" to children and others.

She gave the example of an adolescent mental health program at the IWK Health Centre. The in-patient treatment lasts 12 to 18 months. But the 13- to 19-year-olds who might benefit from the intensive program have to wait that long just to be admitted.

Ms. Doiron said she pleaded the case to cabinet and was able to secure extra funding of $1.5 million this year and about $2 million in subsequent years to expand to 18 beds from 12.

An enduring bias against people with mental illness means people are often reluctant to speak about their conditions, and society doesn’t know they should be treated just like people with physical ailments, Toronto psychiatrist David Goldbloom told the conference in his keynote address.

"I think one of the challenges around mental illness is that its unique properties include affecting our thinking, our moods and our behaviour: the very dimensions that define us as individuals," he said. "That makes it a lot tougher to separate the illness from the person."

And while growing numbers of people report in surveys that they have had direct experience with mental illness, either personally or through a friend or relative, the perception that people with mental illnesses are dangerous or violent has increased, Dr. Goldbloom said.

That attitude is exemplified by reporting on events such as the recent beheading of a passenger on a Greyhound bus and crime dramas like CSI and Law and Order, he said.

"The reality of mental illness, its mundane reality, is virtually never depicted," he said. "The same applies to the newspapers, because somebody recovering from mental illness or somebody simply making a great adaptation to mental illness is about as newsworthy as a plane landing safely at the airport."

Dr. Goldbloom said research shows that negative perceptions are formed very early, so young children should be a focus of efforts to erase stigmatization.

Workplaces should be another major target, he said.

Finding and keeping meaningful work goes a long way toward helping a person with mental illness develop a sense of self and social connections; mental illness is the leading cause of short-term disability keeping people out of the workforce, Dr. Goldbloom said.

The Mental Health Commission of Canada, of which he is vice-chairman, says mental illness drains $51 billion from the Canadian economy each year.

But there is hope that negative attitudes can be broken down, Dr. Goldbloom said.

He recalled that when he was an intern in the early 1980s, hospital staff were "terrified" of the gay men who appeared with symptoms of what was later identified as HIV/AIDS, only touching them with triple-gloved hands.

"Think of how far it has come in the ensuing 25 years," Dr. Goldbloom said. "It’s really an extraordinary social transformation. Mental illness has not come anywhere near as far as HIV."
Photograph of Cheryl Doiron courtesy of The Canadian Institute for Health Information.

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