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Let's Take Mental Illness Out of the Shadows

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In the May 2006 report Out of the Shadows at Last, Prime Minister Harper appointed Senator Michael Kirby to create the Mental Health Commission of Canada to develop our first mental health strategy. He's no stranger to mental illness. Senator Kirby spoke of his sister: "My sister suffered from serious depression all her life... She was hospitalized in a psychiatric ward and attempted suicide at one point...My sister went on to have a successful life, she got a master's degree and worked with others with mental illness." She passed away a few years ago from cancer. "If people get the right help, there is hope. But you can't even get started if people aren't willing to talk about it. Once we take away the stigma, we can begin the work."

Today, just 50 per cent of Canadians would tell friends or coworkers that they have a family member with a mental illness, compared to 72 per cent who would discuss diagnoses of cancer or 68 per cent with diabetes.

Sujitha Ratnasingham, lead author of the paper Opening Eyes, Opening Minds
wrote the burden of mental illness and addiction in the province of Ontario is more than 1.5 times that of cancer and seven times that of all infectious diseases when reduced functioning is considered. Mental health problems and illnesses are estimated to cost the Canadian economy about $51 billion a year.

If we are serious about treating mental illness, it needs to be viewed as no more shameful than heart disease, cancer, HIV-Aids or diabetes. In Canada there are more than 350,000 people with schizophrenia and as many with bipolar disorder. To put those numbers into perspective, there are 65,000 people living with HIV/AIDS.

In 2009 Senator Kirby said, "You shouldn't think any differently about somebody simply because their illness is above the neck rather than below the neck."

Thomas R. Insel, MD, director of the National Institute of Mental Health wrote that mental illnesses are no different from heart disease, diabetes or any other chronic illness. All chronic diseases have behavioral components as well as biological components.

"The only difference here is that the organ of interest is the brain instead of the heart or pancreas. But the same basic principles apply."

This is a relatively new understanding. Depression, bipolar disorder, schizophrenia, OCD, have biological and environmental pre-disposing risk factors. Why should these illnesses still carry the stigma -- it's all in your head, pull up your bootstraps, it's your fault, just get over it?

Senator Kirby:

"There's huge hope of recovery for people with a mental illness. What I mean by recovery is they're able to lead a pretty normal and productive life consistent with the limitations of their illness just as a diabetic is able to lead a pretty normal life subject to their illness, which may mean taking insulin. For the vast majority of people with a mental illness, they can recover within that definition of recovery."

Young people have a difficult time dealing with the stigma of mental illness.

Senator Kirby became involved with Partners for Mental Health (he's Chair of the organization), that targets young people and challenges views on mental illness by utilizing social media. Considering that only one in four young people with mental illness seeks help, this website can be life-changing.

I attended the inauguration of their social media website www.callbs.ca that encourages young people to share their stories about mental illness, and the difficulty they have accessing care and their treatment. Many spoke of the stigma. After the event I asked Ian Manion PhD, Executive Director Ontario Centre of Excellence for Child and Youth Mental Health, who was on the panel that day about rebranding mental illness to help reduce the stigma. He said, "Finding the right label is not as easy as it sounds... some people felt that brain illness focused on a bio-medical approach to these disorders and neglected the strong environmental influences. Others spoke of the stigmatized history of the term mental."

Stigma is behind the fear of "telling." And that's dangerous. Untreated mental illness can lead to thoughts of suicide and then the act itself. I was suicidal in my late 40s. I was left with a sensation of emptiness, hopelessness, of being a burden and not just physically. I wanted out. I think suicide is the ultimate act of control, the ultimate expression of the desire for order. Except the one considering suicide is suffering from an illness so overwhelming that her decision-making is not functioning. I was at that moment, mentally ill.

For whatever reason, I wasn't afraid to ask for help. I was able to access the care I needed to keep me alive; from psychotherapy to drugs and Spiritual Care. As one psychiatrist said to me, sometimes it is a matter of waiting a few moments, the sun will come out, the desire to end one's life will pass; you just need to wait. But you need care while you wait.

In Ontario, there's a shortage of psychiatrists, especially in the smaller towns where wait times for an appointment can be up to eight months. If you can't wait, then you must pay, out of pocket, for other therapists or therapies. It's bad enough that we have insufficient numbers of psychiatrists, but we make it worse by not covering the fees of other qualified specialists. Our health care plans must start paying for mental health care. Otherwise, mental illness will always be treated as second class and those with mental illness will continue to dwell in silence.

I don't want to leave you depressed. Mental illness is not a dead end in life -- it's merely a detour. I think the fear of mental illness also comes from the fact that we are inundated with horror stories of mental illness and rarely hear success stories. Here are some wonderful people with mental illness who have gone on to live full, happy, enriched lives.

The late Mike Wallace of CBS Sixty Minutes fame lived with depression; J.K.Rowling, author of the Harry Potter books, wrote about her obsessive compulsive disorder (OCD) and had been suicidal from depression; Kay Redfield Jamieson, Professor of Psychiatry at John's Hopkins School of Medicine described her life with bipolar disorder; and actress Catherine Zeta Jones continues her career while living with her bipolar disorder. Rebecca Marino, tennis player and Clara Hughes, Olympic gold medal winner; Ashley Judd and Brooke Shields. Albert Einstein had OCD.

And then there are people like me; your neighbour, lawyer, doctor or accountant, the butcher, the baker, the candlestick-maker. We live good lives despite our illness.

Do not despair. There is hope. There are treatments. You can live a wonderful life.