The Mental Health Commission of Canada (MHCC) announced in April that the Hon. Michael Wilson was taking over as chair from Dr. David Goldbloom. Despite replacing a practicing psychiatrist with someone who has been severely impacted by mental illness in his own family, the MHCC seems to be regressing. I had hoped to interview Mr. Wilson but have had no luck so far despite a number of contacts with their media relations staff.
Wilson was a former federal cabinet minister in the Mulroney government and Canadian ambassador to the U.S. who lost his son to suicide. He also co-chaired an Ontario government committee on improving mental health care in Ontario which, as I've said before, was ignored by the Ontario Government. He knows the pain of being a family member and of advocating for improvements which are ignored.
What troubles me is the press release announcing Wilson's appointment from Louise Bradley, the CEO. She says the MHCC will continue in its role of "advancing the promotion of mental health -- and the prevention of mental illness." There is no mention whatsoever of their role to improve the mental health system. I wonder if they feel that this has already been accomplished and I did want to ask Mr. Wilson about that but he answered that question in a special email edition of their newsletter, The Catalyst, which is not online. He said:
"This renewed mandate signifies a new chapter for the MHCC. Together we will continue to strive towards our common goal -- improving the mental health of Canadians."
Now, I have absolutely no idea what improving the mental health of Canadians means. It is a nice motherhood statement. As for preventing mental illness my question is, how? Dr. Thomas Insel, the director of the National Institute of Mental Health in the U.S., just wrote an interesting blog called "What Caused This To Happen?" He states:
"The proximal causes of depression or schizophrenia are almost certainly neural events that lead to altered regulation of mood or thinking. While we have not identified these specific neural events, science is closing in on the circuits and molecular pathways involved. This search is critical because, based on experience with cancer and AIDS, defining these pathways will lead to new, targeted treatments. Proximal causes can be the basis of precision medicine."
And he adds, "When the notion of cause arises, best to consider precisely what cause means and its value for either treatment or prevention."
Bottom line is that you cannot prevent unless you know the cause and science is not there yet. How is it then that the MHCC is going to prevent? Do they know more than the research scientists? And if they do, then they should fill them in.
However, I'm not sure that the MHCC would agree with Dr. Insel. In an earlier post of mine, I pointed out that the MHCC allows members of the public to post their ideas in their collaborative spaces. While the MHCC states that these are not necessarily their views, they are moderated to prevent outrageous comments. We have people like Mr. Fixmentalhealth writing there about the value of vitamins and Abram Hoffer's unproven theories on schizophrenia and that people with schizophrenia should avoid gluten.
A number of readers let me know that they sent emails to the CEO, Louise Bradley, complaining about these posts and in at least one case, they were not answered.
And what happened to improving services? Has the MHCC decided that those services have been sufficiently improved that no more needs to be done? In the past couple of weeks, two families have let me know how badly they were treated by Ontario hospitals. In one case, a suicidal young man was discharged even though the family told the hospital that he was still suicidal. The family was ignored even though the MHCC wrote a very good paper on how family caregivers should be involved and consulted. As soon as that young man was discharged, he disappeared and the police were left to look for him.
In another case, a young man was acting so psychotic that six police officers and a crisis worker arrived in response to the family's 911 call. After a careful interview of the family and then the young man, he was taken to hospital. He was neither treated nor admitted and is now in a shelter. In both cases, the police were exemplary while the mental health system was not.
The MHCC did develop a mental health strategy for Canada but as I've said many times in the past, they have no authority to implement anything as health care is under provincial jurisdiction. What I would like to know is if there has ever been any independent evaluation on the effectiveness of the MHCC programs. Those results would be very interesting.
If anyone knows how reluctant provincial governments can be to implement change, it is Michael Wilson who, as I said, co-chaired a commission that recommended massive changes for Ontario but it was ignored. At this point, I think that if they wish to advance the cause of prevention, then the funding for the MHCC (which has just been extended for a further 10 years in the recent budget), should be put towards research.
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