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Canada must overcome stigma of mental health
Dr. Remi Quirion
Star - Phoenix, Saskatoon, Sask.: Nov 2, 2006 pg. A.11

Following is the opinion of the writer, scientific director of the Canadian Institutes of Health Research institute of neurosciences, mental health and addiction.

As a society, we admire and idolize the wonderful accomplishments of the brain. We glorify efforts made through sheer brain power. We also have a special relationship with the brain because it defines who we are and how we relate to our environment. In short, we tend to put the brain on a pedestal.

But, let's start treating the brain with a more balanced perspective, as we would any other organ in the body. Let's focus our attention and resources on healing this organ when it is ill. Let's erase the discomfort, fear and stigma surrounding mental illness.

According to Statistics Canada, one-in-five Canadians will be affected by mental health problems during their lifetime. Equally distressing is the fact that only 32 per cent of people with a problem seek professional help.

This problem also hits Canada hard in the pocketbook. We lose close to $33 billion in industrial production each year due to mental illness. According to the World Health Organization, by 2020, if steps are not taken to control mental illness, depression will overtake heart disease as the leading cause of disability.

Numerous types of mental illness exist. These include depression, anxiety disorders, schizophrenia, behavioural disorders, such as eating disorders, and addiction to drugs, tobacco, alcohol and gambling. The variety and extent of these problems change throughout life as one's environment and circumstances change. There are also well established links between persons undergoing treatment for physical illness, such as cancer, obesity, etc., and the incidence of poor mental health.

Changing how we think about the brain and mental illness is critical for us to improve our treatment of the illness and confronting stigma around it. Stigma about mental illness is pervasive within society in general, within the workplace and even within the health-care system.

The Kirby Commission raised stigma as a major issue in its landmark report on mental health. Fear of being labeled as having a mental health problem prevents many people from accepting there is a problem, seeking help and being open about their treatment. Stigma in the workplace contributes to perceptions that people with mental health problems are unskilled, unproductive, unreliable and possibly violent. Stigma about mental illness also makes it harder for many people to find good quality, affordable housing. One of the Kirby Report's key recommendations involved creating a Mental Health Commission which would launch a national anti-stigma campaign.

To improve our response to mental illness we must fully acknowledge its impact. Mental illness can be hard to diagnose correctly. Neuroscientists are only now beginning to expand our basic understanding of how the brain is wired, the role of different neurotransmitters and receptors in exchanging information and how the breakdown in these connections lead to mental illness.

Mentally ill persons also face challenges in getting the proper care from the health-care system. The system is built on the foundations of making medically sound decisions based upon the best available evidence. While this is an excellent practice, it tends to overlook mental health issues which, for the most part, are not life threatening. We need mental health to take its seat at the table. This means we must make changes to medical school training to provide better instruction to students so that they acquire a deeper appreciation of mental health. This also involves changing the view of psychiatry not as some specialized function but as a mainstream health service.

Finally, we also need to continue to invest in research into mental health. The Kirby Report recommended an additional $25 million to be channeled to the Canadian Institutes of Health Research institute of neurosciences, mental health and addiction. The report highlighted the need for such an investment for applied research that would translate existing findings into improved quality of care and services to patients. This research would also play a major role in providing the sound advice and information needed for Canada to create a mental health strategy. Canada is the only G8 country without such a strategy.

The CIHR currently supports a large number of projects to begin to better understand and address these issues. For example, CIHR and the global business economic roundtable on addiction and mental health recently launched an ambitious research program to document the types and causes of mental health problems found in Canadian workplaces.

As we observe national mental illness awareness week in Canada, I hope that we can begin thinking about the brain and mental health with a new and healthy perspective.
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