In my experience, equity in Canada's health systems is discussed a lot, but that seldom translates into effective action to ensure equal access and equal outcomes for all people regardless of their race or culture. Provinces rarely have a person who is in charge of health equity; lacking health equity plans or targets.
Earlier this summer, Canada's first transitional housing dedicated to LGBT youth opened in Toronto--the YMCA's Sprott House. Reading about this great initiative raised our awareness about an issue that needs to be on the radar of all Canadians -- the unacceptable rate of LGBT youth who have no place to call home. LGBT youth become homeless for much of the same reasons as other young people -- family conflict, abuse, mental health issues and addiction. LGBT youth also experience higher rates of mental health and addiction issues in large part because of discrimination.
One of the most popular topics on the 2015 elections agenda is legalization and cannabis is by far the most widely used illegal drug in the Canada. People often compare a potential legalization model to alcohol. The way alcohol is regulated in Canada provides some really important public health benefits.
Before any social progress can be made, mental illness has to be acknowledged as a real and powerful determinant of health which affects all social classes, but plays a greater role not only in the lives of those who are displaced, but in some cases also contributes to their displacement and state of living. It is those living on the streets who are the most affected by the stigma associated with mental illness. Yet the stigma is alive and well for those of us who are fortunate enough to continue working or have a strong support system advocating for us while we too struggle to climb the walls of our own personal hell.
How should psychiatrists' roles be defined in order to provide as much specialist care to as many high-needs individuals as possible in the most cost-effective way? Because psychiatrists appear to be organized in a far less than systematic fashion within Ontario's mental health system, there is a fairly steady level of unmet need no matter how many psychiatrists practice in a region.
In Ontario, the fee schedule does not have limits on duration or frequency of visits. Changing that may be one way of opening up room for psychiatrists to see more patients. Another idea, adopted in Australia, the U.K and the U.S., includes shifting the psychiatrist's role to that of a consultant on a multidisciplinary team. In such a model, psychiatrists provide the initial diagnosis, oversee any pharmaceutical treatment, and work with a team of social workers and psychologists to provide psychotherapy, support and to monitor progress.
More than once as a young person (and even in adulthood) I've encountered professionals who believe my sexual orientation is the cause of my depression. I've also encountered professionals old enough to be my grandparents who suggest my sexual orientation is a mental illness in itself. It is why I remain skeptical to this day of seeking treatment; especially with a professional I've never met before.