Re: The lost, beautiful mind of Ivan Car, Aug. 21.

A letter to the editor published in yesterday's edition of the Ottawa Citizen:

After reading this article, I wish first to offer thanks to Anouk MontpetitCar for sharing her story about her husband Ivan Car's [pictured] struggles with depression - a battle he fought bravely but sadly lost.

Car's story is more common than one might think - and so often, these kinds of stories go untold and unnoticed. By sharing her husband's story with Citizen readers, MontpetitCar has not only provided a glimpse into what is a severe, chronic and disabling illness, but also the frustrations that someone with mental illness faces in seeking appropriate treatment as quickly as possible.

As with any other severe, chronic and disabling illness, quick response, expertise and ongoing care are all necessary if one is to recover. Unfortunately, it appears that by the time Car decided to seek the services offered at the Royal Ottawa Mental Health Centre, it was too late; he was too tired to face what lay ahead.

Perhaps he would have received the proper care and treatment if the waiting lists for psychiatric treatment at mental health facilities weren't so very long and if the Ministry of Health hadn't decided over 10 years ago that psychiatric emergency services should only be provided at local hospitals that have certain emergency-room capabilities. (An exception was made for the Centre for Addiction and Mental Health in Toronto, which still operates emergency services at the Clarke Institute on College Street.)

Because of this government decision, the Royal - which has obvious expertise in mental health - was forced to close its emergency services department in 2000. Former patients of the Royal speak fondly of the empathetic, caring environment and expert care received at the emergency room prior to this forced closure.

I and many other families I know have experienced the extreme difficulties of sitting for hours in a hospital emergency waiting room with a severely ill loved one who is in immediate need of psychiatric services. Often, very sick people never receive psychiatric services because, due to their illness, they are unable to wait and are unlikely to return, no matter how severe the symptoms.

There are real practical benefits to receiving emergency service at a mental health centre as opposed to an emergency room geared to treating fevers and broken bones. When someone is suffering from mental illness, it is imperative that appropriate mental health care begin at the first encounter between the health provider and the client. It can make the difference between success and failure.

Given the recent discussions about "client-centred" care, it is incumbent that two things happen - that the wait list for psychiatric services be addressed and that emergency services be returned to the Royal where specialized, therapeutic care goes beyond dispensing of medication.

Cynthia Clark, Ottawa Chair, Family Advisory Council, ROMHC

Image credit

Editorial: A better way on mental illness

An editorial published in the July 22nd edition of The Times Colonist:

Make no mistake. The Archie Courtnall Centre has been a positive contribution to mental health care in this region. For all the problems, the centre marked a step forward in care. And the willingness of the Courtnall brothers - Bruce, Russ and Geoff [pictured] - to talk about their own father's suicide, while raising millions for mental health services, has brought an increase in awareness about the reach and grip of mental illness. Russ and Geoff Courtnall have used their status as former NHL hockey players to raise money and educate.

But there is much more to do, as the history of the Courtnall centre itself shows.

The centre - effectively an emergency room for people suffering from critical mental illness - was only built because the Courtnalls helped to raise the $2.2 million required.

Any other form of emergency room, like the one opened at Victoria General Hospital in 2009, would be funded by government as part of a functioning health-care system. Yet patients with mental illness rely on charity for emergency services.

The Courtnall centre opened in 2005. A Times Colonist editorial outlined the vision of offering patients "a quiet refuge in crisis situations." Four beds would offer shortterm care of up to 72 hours. Patients would be assessed and quickly provided with needed care in the community or admitted to hospital beds.

But demand quickly swamped the centre. Within two years, director Dr. Anthony Barale resigned. "The staff of the psychiatric emergency service struggle daily to provide even the most basic medical and psychiatric care for this suffering population," he said. "And they do so with little support and the pitiful resources provided by VIHA - resources which, even by so-called Third World standards, are entirely inadequate." In the same year, then premier Gordon Campbell acknowledged a province wide failure to provide adequate mental health treatment.

Today, mental health patients routinely spend days - some more than a week - waiting for admission to too few hospital beds, sleeping in reclining chairs in the Courtnall centre that were intended for a few hours' rest.

In any other emergency room, waits under such conditions would be considered intolerable. Again, people with mental illness are treated as second-class citizens - as if their illnesses are not real, or they do not matter.

The waits will likely worsen. VIHA has reduced the number of in-patient beds available for patients with mental illness, despite having acknowledged the shortage of beds before the cuts. Increased community resources, such as outreach teams dealing with people living with serious mental illness and addictions on the streets, have helped.

But patients and families continue to experience desperate waits for care and inadequate post-release support. Already serious conditions worsen. Some people abandon the effort to get help, or fall to the streets - or like Archie Courtnall, end their own lives.

The Courtnall centre has helped. And the fundraising events this weekend - see courtnallclassic.org for details - deserve your support.

But we wouldn't accept, as a society, that care for people with heart problems or cancer would depend on the success of golf tournaments or fundraising auctions.

Our neglect carries a huge human cost, as the Courtnalls and so many others can attest. It also carries a great economic cost, as untreated illnesses worsen and people's potential is lost.

We have talked, for decades, about removing the stigma from mental illnesses and providing equitable care, as we do for most others with a medical condition. Our actions have fallen far short of that reality.

Photo credit

Up Close and Personal with the Courtnall Brothers

Also see:

Former Canucks star Geoff Courtnall opens up about father's suicide, his own depression

Mental-health patients betrayed by VIHA

VIHA cutting community mental health support

Courtnall psychiatric emergency centre overwhelmed since inception, service reductions

Attitudes improving towards mental illness, survey shows

Quoting Marjorie Wallace (pictured), chief executive of the U.K. mental health charity Sane:

"If we aspire to end the stigma surrounding mental illness, we must not rely simply on educational campaigns, but must also provide the care and treatment people need at times of crisis, in order to prevent the tragedies that so often colour the public's view."

To read the entire article, please click here.